Slip and Fall Injuries

Fall-related injuries are a major health threat for nursing home residents. Older people who live in nursing homes tend to fall more frequently than older adults who live within the community. Approximately 50 percent of nursing home residents aged 65 and over fall each year, and nearly 1,800 die annually as a result of their falls. About 10 to 20 percent suffer injuries, and 6 percent sustain fractures. In a typical 100-bed nursing home, 100 to 200 falls are reported each year, and many go unreported. When older people fall, they can experience decreased physical functioning, a reduction in the quality of life, decreased confidence, and an increased fear of falling, which can lead to further functional decline, depression, social isolation, and feelings of helplessness.

The law requires nursing home residents to receive adequate supervision and assistive devices to prevent accidents. When a resident enters a nursing home, a plan of care must be developed. Within this plan of care, the resident's risk of falling must be assessed to determine what assistance the person may need to get around.

There are a variety of reasons why a nursing home resident might fall, including weakness and gait problems associated with old age. Unfortunately, however, many nursing home residents fall because of the nursing home's negligence. Examples include falls caused by:

• Wet floors
• Poor lighting
• Lack of necessary bedrails and improper bed height
• Improperly maintained or fitted wheelchairs
• Clutter
• Medications, especially psychoactive drugs
• Difficulty in moving patients, or assisting them to the restroom, due to understaffing
• Failure to have sufficient staff to answer call buttons
• Failure to have call buttons that are in proper working condition
• Failure to properly train staff in lifting and handling techniques
• Failure of the staff to adequately supervise residents
• Poor foot care
• Restraints
• Weakness and gait problems linked to malnutrition and/or dehydration

Tips to prevent fall-related injuries to nursing home residents

The best way to protect your loved one from falling in a nursing home is to develop a fall prevention plan. You should:

• Consult your loved one's physician and request placement in a physical conditioning or rehabilitation program that might include exercises to improve strength and endurance, physical therapy, a walking program, or gait training. Remember, there are many benefits to keeping people mobile as long as possible, including greater muscle strength, independence, ability to interact with the environment, greater sense of well-being, preservation of dignity, and greater self-esteem.
• Assess the nursing home environment and request modifications to improve mobility and safety, such as grab bars, handrails, raised toilet seats, and proper bed height.
• Find out if the nursing home has an alarm system that activates when a resident tries to get out of bed or move without assistance.
• Get regular eye check-ups. Poor vision can put the elderly at a greater risk for falling.
• Know how to safely use the call bell so you, or your loved, one can get fast assistance to get out of bed.
• Make sure assistive devices like wheelchairs, walkers, and canes are properly maintained and fitted.
• Feet should be well maintained. Make sure shoes fit properly, are in good condition, and have sufficient tread.
• Review all prescribed medications and discuss their potential risks and benefits with the doctor. Side effects of medication may place an older person at a higher risk for falling.
• Assess the resident's room. Remove throw rugs, electrical cords, and any other items that might cause a person to trip and fall.
• Ensure that the entire facility is well lit.

Legal evaluation of fall injury claims

One fall in a nursing home does not necessarily imply lack of care or attention. Accidents happen. However, if the nursing home was on notice that the person was at risk for falls, preventative measures should have been taken. Some preventative measures, such as restraints, may be a violation of the resident's rights. Therefore, there must be clear documentation in the chart that the restraints were necessary to prevent the resident from harm and a physician order is necessary before a restraint may be used.

In evaluating a potential case involving a fall and injury, we will review the medical chart for the following information:

• How many falls occurred and how soon after admission to the home?
• Was the fall witnessed by a staff member, other resident or family member?
• What documentation of the fall exists in the medical chart?
• Was there a fall risk assessment and care plan completed by the nursing staff when the resident was admitted to the home?
• If so, was the plan of care being followed, updated when necessary and were safety precautions being taken to prevent falls?
• What were the physician orders regarding how much assistance a resident required to get out bed and walk?
• Was the resident on medication that caused drowsiness, confusion or weakness?
• Were safety measures taken such as lowering the bed and placing the mattress on the floor?
• What injuries did the resident sustain as a result of the fall?

If the injuries sustained as a result of the fall are not serious, such as bruising and injuries that did not require medical intervention, they may not justify the cost of bringing a lawsuit. On the other hand, if the injuries are serious, especially if the resident has a history of prior falls at the home, you should contact our law firm for a consultation.