Falls & Fractures
Injury or wrongful death from a fall in a nursing home or assisted living residence, especially repeated falls, may be a sign of neglect.
Falls are the most frequent cause of bone fractures among the elderly. Fractures can lead to serious health conditions, such as a difficulty in clearing the chest by coughing (which can lead to pneumonia), a loss of appetite, bedsores, and infections. Twenty-five percent of elderly persons who sustain a hip fracture die within six months of the injury.
I represented a family whose husband / father died from a brain injury caused when his head struck a chair during a fall. The East Providence, Rhode Island, nursing home knew that the resident had fallen on several occasions and failed to update the care plan to include fall precautions, such as using a personal alarm, lowering the bed, or placing a mat beside the bed. As a result of the fall, the resident suffered a scalp laceration and bleeding inside his head. The nursing staff failed also to monitor him for signs of a head injury and he was found unconscious about 24 hours later and died.
Another family I represent lost their mother from a head injury caused when she was left unattended in an inappropriate wheelchair. The East Providence, Rhode Island nursing home was cited by the Department of Health for failing to supervise the resident and failing to use a properly equipped wheelchair.
Signs of Nursing Home Neglect
A recent study revealed that 19 percent of Rhode Island's nursing home residents suffered injuries from falls. Common factors which put an elderly person at risk for falls are:
- Previous Falls
- Heart Conditions
- Stroke
- Alzheimer's disease, Parkinson's disease and dementia
- Difficulty with walking
- Drop in blood pressure when standing up (orthostatic hypotension)
- Incontinence
- Medications
- Dehydration
- Vision Problem
- Failure to assist in personal hygiene, or in the provision of food, clothing, or shelter
Residents who fall should be evaluated to determine the reason for the fall. An immediate evaluation is required for falls that produce injuries or are associated with a new acute illness, loss of consciousness, fever, or abnormal blood pressure. If a resident is at risk, the nursing home is required to provide safety devices and services to prevent falls from occurring.
Ways to Prevent Falls in Nursing Homes
There are many interventions that can prevent falls:
- Monitor and supervise activities
- Use assistive device such as canes, walkers, wheelchairs and lap buddies
- Use personal alarms, lower beds closer to the floor and place mats on the ground in case a resident falls out of bed
- Remove tripping hazards
- Install grab bars in bathrooms or handrails on stairs
- Decrease the dosage of a medication that may contribute to hypotension, or substitute another medication
- Stop unnecessary medications
- Monitor for postural hypotension: a drop in systolic blood pressure of >=20 mm Hg or to <90 mm Hg on standing
Nursing Home Liability for Fall Injuries
A nursing home or assisted living residence may be found liable for failing to prevent resident falls.