Preventing Our Seniors from Falling – Simple Steps, Big Rewards
Seniors who fall often suffer life altering injuries. In the United States, it is estimated that one-third of all seniors over the age of 65 will fall this year. Estimates rise to one-half for seniors over the age of 80. In 2010, falls were the leading cause of death from injury among New Jersey residents age 65 and older. More than 18,000 older Americans die every year as a result of injuries sustained in a fall. Many times these falls occur when the person is a resident at a nursing home. Often, these falls could have been prevented. This is why it is important for anyone who is caring for a senior in to understand why they fall and how these falls can be prevented.
The New Jersey the Department of Health and Senior Services recognized September 19-25, 2011 as, “Fall Prevention Awareness Week.” There are two reasons it is important to raise awareness about how to prevent our Seniors from suffering avoidable falls. First, it is easy and inexpensive to take the steps necessary to reduce the number of falls. Second, the severe injuries our Seniors suffer in these falls usually cannot be fixed. The most common injuries are fractures to the legs, hips, pelvis, and arms as well as closed head injuries. Surgery to repair the fractures is often impossible due to other medical conditions. Often these injuries prevent them from ever walking again. Their families often describe the fall as the “beginning of the end.”
“Falling down is too often a painful part of getting older,” said Health and Senior Services Commissioner Mary E. O’Dowd. “The good news – and the message we will be sharing throughout the week – is that most falls are preventable.”
Whether or not these falls occur at a nursing home, it is important to understand that many of these falls can be prevented. The admissions director at a nursing home will tell you that a nursing home’s job is to take care of people who cannot safely live at their own home. When considering if to accept a new resident, the nursing home needs to ask the family and doctor what led them to the decision to place the individual in a nursing home. Then the nursing home needs to develop an understanding of what needs to be done to provide that individual with a safe living environment. A good nursing home will create a culture where preventing falls is given a high priority and stressed repeatedly.
The good news is that the precautions that can reduce the amount of falls are simple to institute and to follow. The first step is for the nursing staff to analyze if a particular resident is at a higher risk for falls. Nursing homes are required to use a form known as a Fall Risk Assessment to figure this out. The form assigns a score to predetermined factors specific to each resident. Some of the factors to be considered include side effects from medications, cognitive impairments, and prior falls. The score determines whether a particular resident is at a high risk for falls. If the nursing home does not consider fall risk, there is little chance the appropriate measures necessary to prevent that resident from suffering an avoidable fall were followed.
It is the job of the resident’s physician to decide which measures are appropriate. These measures are known as the “doctor’s orders.” In the nursing home setting, the doctor’s orders are nothing more than a set of instructions specific to each resident that the nursing staff must follow. It is the nursing home’s obligation to communicate with the doctor and obtain these instructions. Some of the instructions ordered by the doctor will be intended to prevent falls; such as a toileting schedule. A toileting schedule is when the staff escorts the resident to the bathroom at regularly scheduled times. Toileting schedules are used to prevent instances when a Senior with cognitive impairment, who needs assistance to use the bathroom safely, will get out of bed and try to use the restroom by himself. Many times, when found on the ground after a fall, the injured resident will say that he was trying to use the bathroom. These residents either forget that they needed assistance, or attempt to go alone after long delays when the staff does not answer the call bell. Other types of instructions from the doctor will be intended to reduce the severity of any injury, such as lowering the resident’s bed closer to the ground and surrounding it with protective mats.
Unfortunately, many nursing homes fail to even consider if a new resident is at a high risk for falls. When they fail to consider fall risk, they fail to obtain the instructions from the resident’s doctor. When the nursing home fails to obtain the instructions, their staff will not know what needs to be done to prevent falls. This is why significant injuries from falls that could have been prevented frequently occur in nursing homes. There are times when we need to accept that a fall would have been difficult to prevent. However, this does not include times when a nursing home is paid for their promise to care safely for a senior, but the nursing home fails to do so.
Here are some steps you can take to lower the risk that your loved one will fall and suffer a potentially life altering injury:
- Ask your loved one’s doctor if they are at a high risk for falls.
- Schedule an appointment to have your loved one’s vision checked at least once a year.
- Ask the doctor or pharmacist to review the side effects of prescription and over-the-counter medications.
- Encourage use of appropriate footwear. The safest shoes tend to have lower heels, non-slip soles, and a secure fit with laces or straps. In the nursing home setting, non-slip slippers should be provided to the residents.
- Inspect your home for tripping hazards, such as wires and phone cords away from hallways and stairways.
- Install nightlights in bathrooms, bedrooms, and hallways.
- Install grab bars in your tub or shower.
- Install non-skid liners under rugs.
- Encourage exercise as much as possible. Exercise increases strength, flexibility and balance. This includes physical therapy for a nursing home resident often not provided. Ask your loved one’s doctor whether they should be receiving physical therapy.
- Lower your loved one’s bed to make it closer to the ground, and position it in the corner of the room. Place protective mats around the bed to reduce the severity of any injuries.
- Institute a toileting schedule where you encourage trips to the bathroom at regularly scheduled intervals. Seniors with cognitive difficulties, who are not capable of walking to the bathroom alone, often forget this when they experience the need to use the bathroom.
If you wish to discuss other ways to lower the chance your loved one is injured at a nursing home or you need to discuss your family’s legal rights relative to your experiences with a nursing home, feel free to call Ernest L. Alvino, Jr., 856-381-4837 at Hoffman DiMuzio. Ernie limits his practice to representing families who experience nursing home abuse and neglect, and he will explain to you what the nursing home was required to do.