Elder Abuse in Nursing Homes: Risk Factors for Falls
Falls are the leading cause of injury among over 65s, according to data from the CDC, with one in four older adults falling every year. Research suggests the figure may be twice that for nursing home residents, making fall incidence a major public health concern.
Falls are a key focus of many elder abuse lawsuits, raising urgent concerns about the adequacy of supervision and prevention measures, and the overall quality of care. Negative outcomes from falls include injury, loss of independence, and even death. Individuals suffering from cognitive impairment or mobility issues are particularly vulnerable to falls. Identifying the most at-risk is therefore critical to the development of effective fall prevention strategies.
Contributory fall risk factors can be divided into two broad subgroups: intrinsic and extrinsic.
Intrinsic Risk Factors
An individual’s cognitive abilities, physical condition, and overall health has a huge impact on a) the likelihood of suffering a fall, and b) their capacity for recovering from a fall. Intrinsic risk factors for nursing home falls include:
Age. Age related issues such as diminished muscle strength, slower reflexes, and impaired balance are all contributory factors to falls.
Cognitive Impairment. Dementia, Alzheimer’s, and other cognitive conditions impede the ability to follow safety precautions and increase the likelihood of wandering, elopement, disorientation, and other unsafe behaviors.
Frailty. Physical frailty, muscle weakness, and limited endurance reduce both the ability to maintain balance and to recover from a fall.
History. Residents with a history of falls are at a higher risk of falling again.
Medical Condition. Chronic health conditions such as heart disease and diabetes can affect balance, circulation, and cognitive function. Orthostatic hypotension (a sudden drop in blood pressure when standing), Parkinson’s, and arthritis are also common contributors to fall-related injuries.
Medication. Medications – particularly those affecting the central nervous system – can lead to dizziness, fatigue, confusion and low blood pressure, all of which increase the risk of falls. Drugs commonly associated with falls include hypnosedatives (eg Benzodiazepines), antidepressants, anti-epileptics, opioids, and antipsychotics.
Mobility. Residents with limited mobility – such as those suffering with arthritis, osteoporosis, and Parkinson’s – are at a higher risk of falling.
Sensory Impairment. Vision or hearing impaired residents have a harder time navigating their environment and identifying hazards.
Extrinsic Risk Factors
Environmental factors not directly related to residents’ physical or mental wellbeing are common points of contention in fall-related elder abuse litigation. Some common risk factors to look out for include:
Environmental Hazards. Poor lighting, cluttered walkways, and uneven or slippery surfaces are common hazards facing nursing home residents. Poorly designed or maintained handrails and furniture can also contribute to falls.
Incorrect Use of Mobility Aids. Misused, or poorly fitted or maintained mobility aids like walkers or canes, can pose fall risks.
Sudden Environmental Changes. Transitions such as moving to a new facility, adjusting to unfamiliar surroundings, and anything else that requires the resident to navigate new obstacles can increase fall risk.
Understaffing. Understaffing leads to residents attempting toileting and other mobility tasks unsupervised, increasing the risk of falls. High fall risk residents may require closer supervision, particularly for bathing, transferring between beds and chairs, and walking.
Fall Prevention: Nursing Home Obligations
Falls in nursing homes are both widespread and preventable. Facilities are required to develop prevention and intervention plans. This includes encouraging residents to remain physically active and maintain muscle strength, removing clutter, and other tripping hazards, and ensuring adequate lighting throughout the facility. Family members are advised to keep an eye on private rooms and common areas to identify and report potential fall hazards.
In fall-related elder abuse lawsuits, elder abuse attorneys evaluate the effectiveness and enforcement of fall prevention protocols. The existence (or lack thereof) of preventive measures plays a pivotal role in determining liability.
We’ll be doing a deeper dive into fall prevention and intervention strategies in next week’s blog.
If you believe your loved one’s fall was the result of elder neglect on the part of a facility, you may have grounds for an elder abuse lawsuit. To receive a free consultation from an elder abuse lawyer in Los Angeles, San Francisco or Sacramento, contact us here.