Can Falls Be Prevented in a Nursing Home?
One of the most common types of cases that we handle here at The Dickson Firm involve a nursing home resident who has fallen. Tragically, when a nursing home resident falls, they can suffer a fracture, they can suffer a head injury, they can suffer a dislocation. They can suffer any number of a series of very serious, and sometimes even fatal, injuries. Nursing homes like to argue that not all falls can be prevented. And while it is probably true that not all falls can be prevented, many can be prevented, and even if a fall cannot be prevented, if a nursing home resident is receiving appropriate care, then the staff can prevent that resident from suffering serious injury even if they do fall.
How are falls prevented in a nursing home?
First and foremost, nursing homes are required in the State of Ohio pursuant to the Ohio Nursing Home Residents Bill of Rights, which is a state law in Ohio, to provide their residents with a safe environment. Under the federal law, known as the Code of Federal Regulations, nursing homes are legally required to provide their residents with adequate supervision to prevent accidents.
How do nursing homes adequately supervise their residents?
One of the ways to do this is with alarms. There are alarms that involve a pad under the bed or the chairs so that when the resident tries to get up and takes their weight off the pad, an alarm sounds, alerting the staff to the fact that that resident is trying to get up. There are alarms that have a clip that clips onto the resident's clothing and then there is a string that goes to a magnet on the alarm. If the resident pulls the magnet off of the base, it sounds an alarm and alerts the staff that the resident is trying to get up.
Oftentimes, nursing homes argue that alarms are restraints because they can startle the resident and make them afraid to move. Usually, this is just an excuse for not using alarms. There are many alarms available today to keep your loved one safe. Some alarms, rather than sounding an alarm, use your voice. It can actually record your voice, encouraging your mother or father to sit down. This is often not startling at all, and in fact, quite soothing. You can have an alarm that makes no sound whatsoever. You can have a bed or chair alarm that lights up a light over the resident's door or sends a signal to the nurses station or buzzes a pager worn by the nurses. None of these make a sound that would startle a resident.
If the nursing home is telling you that they cannot use an alarm on your resident, ask them if they tried. Before they give up on using an alarm, which is an excellent way to provide your resident with adequate supervision, they ought to try the alarm with your loved one. Does the alarm startle your loved one? Does it make them afraid to move? The answer is usually no. If the nursing home is not using an alarm, then the next thing you have to ask is what are they doing to provide your resident with adequate supervision. Imagine the staff working on the night shift. You have a nurse and two aides who are taking care of thirty five (35) residents who are all in their rooms with the lights out and the doors may be open or the doors may be closed. How are three people possibly keeping track of thirty five (35) residents? Now imagine that the two aides are in one resident's room transferring that resident using a Hoyer lift to take them to the bathroom, and the nurse is in another resident's room providing that resident with care. So you have two residents being attended to and thirty three (33) residents left unattended. How are those residents receiving adequate supervision? The answer, tragically, is often they are not. These residents are not being protected. They are not being kept safe. They are not being provided with adequate supervision.
Why is preventing falls so important?
Fall prevention is literally a matter of life and death in the nursing home. Falls can be fatal. As a result, nursing homes must take fall prevention seriously. If you are admitting your loved one to a nursing home, and they are at risk for falls, you need to ask the nursing home what they are going to do to prevent your resident from falling. Any resident who cannot walk safely on their own is at risk for falls. Nursing homes are not permitted to restrain residents, which is a good thing. Putting the bed rails up on the bed is not the answer because typically residents climb over the bed rails, and then they simply wind up falling from a higher height. Restraints are ineffective, and oftentimes, nursing home residents get tangled in the restraints and suffer the risk of strangulation. The answer is adequate supervision.
During the day, your loved one can be kept in a common area with multiple other residents where the staff can keep an eye on them. They can be brought out into the hallway, where the staff can keep an eye on them. They can be placed in a chair that tilts back and is more difficult to get out of. They can be placed in a bed that's either in the lowest position or even directly on the floor so that if they do tumble out of bed, they don't have far to fall. The nursing home can put mats next to the bed so the resident does not suffer injury. There are numerous ways that nursing homes can prevent falls. The nursing home can put a motion sensor in the resident's room so the staff is aware if the person is up and moving around. These are particularly effective at night. That way, the nursing home can know who is sleeping peacefully in their beds and who is starting to get up because they have to go to the bathroom.
Toileting programs are incredibly effective at preventing falls. If the reason that your loved one is getting up every night at 3:00 in the morning is because they have to use the bathroom, the nursing home simply needs to put them on a toileting schedule and preemptively go and take them to the toilet every night at 2:30 A.M. This eliminates the nursing home resident's desire to get up. Sometimes residents get up because they are in pain, sometimes residents get up because they are hungry, sometimes residents get up because they are bored, sometimes residents get up because they have dementia, and they are confused. All of these issues can be addressed.
What can I do to keep my loved one safe?
If your loved one has signs that they are falling, like minor injuries, or, if you are aware that they have fallen, you need to seriously consider moving your resident to a safer nursing home. If you go to visit your resident and find them unattended, particularly if you find them walking around their room, or having made their way to the bathroom unattended, these are all indications that your loved one is not receiving adequate supervision and is not being kept safe.
While it may be very challenging to move your loved one to a different nursing home, if they are not receiving the appropriate care, you must think long and hard about moving them to a safer nursing home where falls will be prevented.
If someone you love has been neglected or abused in a nursing home, please call us at The Dickson Firm at 1-800-OHIO LAW as it would be our pleasure to talk with you and help you in any way that we can.