Why Frequent Falls May Signal a Larger Problem with Resident Care

ELDER CARE - Are you concerned that a loved one in a residential care facility seems to be experiencing more falls than seem reasonable? According to the Centers for Disease Control and Prevention (CDC), each year, over 3 million adults aged 65 and older visit emergency rooms for treatment of falls. If you focus on residents of nursing homes, the figure is even higher. A 2023 study published in the Journal of the American Medical Directors Association (JAMDA) looked at the data from 18 individual studies and found that 43 out of every 100 residents experience a fall.

Accidents among older citizens have become so common that many people mistakenly believe that regularly falling is an expected and predictable part of the aging process. As a result, their falls may not be examined with the same care and taken as seriously as those of a younger person until an experienced nursing home abuse lawyer becomes involved. However, health professionals maintain that each situation should be properly assessed. The CDC advocates:

• Screening patients for their risk of falling
• Assessing reasonable ways to lower that risk
• Intervening to implement the necessary plans to increase patient safety

Screen Patients

The Institute on Aging lists several conditions likely to contribute to falls among older adults. These potential factors are not exotic in nature and therefore should be conditions for which experienced healthcare providers screen routinely. For example, reduced eyesight and hearing are common among older adults and increase the likelihood of tripping.

Medical challenges like heart disease and diabetes negatively impact the circulatory and nervous systems, reducing the body's ability to maintain good balance. Older adults also tend to lose muscle mass, reducing their strength. As they weaken, they may find it challenging to walk with a steady gait, maintain balance, or regain balance after encountering a hazard.

Medications can also contribute to falls. Many common prescription and over-the-counter remedies have the unwelcome side effect of making the user feel dizzy or drowsy. It's easy to underestimate the effect such medications can have on a person's ability to navigate even familiar territory, such as their home, safely. Frequent falls may signal that an older patient has not been carefully or appropriately screened for conditions that contribute to falling.

Assess the Situation

If healthcare providers are aware of a patient's risk of falling, yet the falls continue to occur, it may be that, despite a successful screening of the patient, the healthcare provider has not created a plan to lower that risk. For example, someone in need of better eyeglasses or an improved hearing aid could continue to suffer unnecessary falls if they do not receive the proper medical items.

Similarly, a patient with heart disease or diabetes needs a workable plan to improve those conditions or at least mitigate their negative effects. It's not unusual for concerned healthcare providers to help design a simple but effective exercise program for such patients. Exercise is also a primary way to fight the loss of muscle mass. And medications that prove too powerful for the patient and induce dizziness or drowsiness may need to be replaced by medications more compatible with the patient’s physiology.

Implement a Plan

​The Centers for Medicare and Medicaid Services (CMS) mandates that residential care facilities go a step further than screening patients for factors that contribute to falling and designing strategies to reduce accidents. Instead, the federal organization requires a facility to actually implement steps that would make it less likely that a resident would suffer a fall. For example, the CMS manual for state operations requires that residential care facilities clear their property of as many trip hazards as is practical.

The manual also states that the operators of care homes must provide reasonable supervision to residents to help prevent falls. The CMS reminds residential care operators that their residents may be frail and look to their healthcare providers for support and protection, viewing the facility as their home where they expect to be safe and secure.

One methodology to prevent falls is frowned upon by the federal government. CMS states that physical restraints should not be used simply for the convenience of the healthcare provider. CMS goes even further and says there is no evidence in support of using restraints to prevent falls. The organization cautions that when a person falls while restrained, the resultant injuries are typically more severe than they would have been without the restraint in place.

The CMS gives the example of the resident who had a history of falling when he was alone and attempted to transfer himself from his wheelchair to his bed. The staff used a restraint to secure him to his wheelchair until they were finished seeing to the needs of other residents. However, during the interim, the restrained resident attempted to leave his wheelchair despite the restraint, lost his balance, and fell, breaking his wrist. He also received several lacerations to his face and a subdural hematoma, or bleeding around the brain from a head injury.

​As shown in the example above, frequent falls could merit your scrutiny of your loved one’s healthcare provider. It could be a sign that the patient has not been properly screened to identify inherent issues that increase that person's chances of falling. If a proper screening has been conducted, the frequent falls may be an indication that no workable plan was created or put into action to improve the patient's chances of avoiding falls. In either case, the situation may demand further investigation by a knowledgeable professional, such as a nursing home abuse lawyer. While occasional falls are to be expected in aging adults, frequent falls are not. Instead, they may be a sign that some aspect of the resident’s health care is being neglected.

For more information about nursing home safety and your potential legal rights after a loved one is injured, My Nursing Home Abuse Guide can be an excellent resource.

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