Cleveland Nursing Home Fall Lawyer – Holding Care Facilities Accountable

Many families make the difficult decision to place a loved one in a nursing home or assisted living facility because of safety concerns due to a recent fall. We all expect that loved ones will be safe from slip and fall accidents in the nursing home. After all, they’re experts in caring for the elderly.

Yet the fact is that falls are the fifth leading cause of death in senior citizens.1 Falls can cause broken arms, legs, and hips. In fact, 90 percent of fractured hips are caused by falls.2 Other injuries from falls include cuts or lacerations, sprains, and even subdural hematomas (brain bleeds). Research has shown that 50 to 75 percent of nursing home residents slip and fall each year. That’s double the rate of falls in the general community.3

So shouldn’t your mom or dad be safe from most falls in the nursing home? That depends on the actions of the facility and its staff.

Slip and Fall Risk Factors

Prevention of falls begins with a proper assessment of the resident to identify specific risk factors that increase the likelihood of a dangerous slip and fall. There are many medical and situational risk factors for falls:

  • New surroundings due to recent admission to nursing home
  • Recent transfer from hospital room or different room at facility
  • Moving from bed to chair
  • Previous falls
  • Urgency to get to bathroom to use toilet
  • Physical weakness, unsteady gait
  • Certain medications or multiple medications (poly pharmacy)
  • Diagnosis of dementia
  • Environmental hazards—poor lighting, wet or slippery floors, incorrect bed height, wheelchair obstacles
  • Underlying problems with health, memory, or cognition

Of these risk factors, the most common causes of falls are muscle weakness, walking problems, and environmental hazards.3

Duty of Nursing Homes – Why Might They be Negligent?

Nursing homes should use a Fall Assessment Tool to routinely evaluate each resident for the risk factors above. A team approach to the evaluation should include at least a nurse, doctor, physical therapist, and occupational therapist. This multidisciplinary team should take care to address these factors to determine whether they create a danger of falls for the resident.

Once risk factors are identified, the team needs to design an individualized care plan to minimize these risks. Interventions to minimize falls include a regular toileting schedule, low-height bed, mat alarm, chair alarm, and a review of medications. If a resident falls despite these precautions, the team must review the entire care plan, analyze each intervention in light of the circumstances of the fall, and formulate a new care plan.

While some falls in nursing homes result from conditions such as slick floors, the vast majority result from residents who should not be allowed to walk unattended, as well as falls from beds or chairs.

In determining whether the nursing home is liable for the fall, I will want to determine whether a a Fall Assessment Tool was used, when it was last used, whether an individualized care plan has been conducted, what was provided in the plan, how long ago the plan was last reviewed, and whether the resident’s condition has significantly changed since the last plan review. Once these and related matters are understood, it will be more clear as to whether a case of nursing home negligence exists for a fall.

Should Restraints Have Been Used?

Many families believe that physical restraints will prevent falls, but the research shows just the opposite: Restraints can increase the risk of injury and death.3 and limit a resident’s movement with a restraint can lead to muscle weakness and reduced function.4 Ohio statute has very specific requirements for physicians prescribing physical restraints.

Federal regulations govern almost every aspect of care in nursing homes. They also address the daily problem of residents falling and injuries (see 42 C.F.R. § 483.25 (H)(1) and (2)). These regulations along with state regulations are often incorporated into a facility’s own policies and procedures.

It’s easy to see how falls can cause injury. But there’s a less obvious concern: They also cause fear of falling again. That fear may cause people to limit their activity, resulting in decreased physical fitness, which may itself cause a fall.5

Cases and Experience – How I Help Clients Injured in Nursing Home Falls

While not all nursing home falls are the result of negligence, unfortunately many falls are completely predictable given a resident’s assessment for fall injury and the lack of proper safeguards that should have been taken.

To learn more about your loved one’s rights and whether the fall may have resulted from nursing home negligence, please call me for a free consultation to discuss your loved one’s case. We have handled many fall cases and are available to discuss your options with you. We are available to serve clients in Cleveland, Columbus, Toledo, and throughout Ohio.


Footnotes
1. Rubenstein, LZ, Robbins, A, Josephson KB, Schulman BL, Osterweil D. The value of assessing falls in an elderly population. Annals of Internal Medicine 1990; 113 (4):308–16.
2. Hayes SC, Myers ER, Morris JN, et al. Impact near hip dominates fracture risk in elderly nursing home residents who fall. Calcified Tissue International 1993; 1993 52:192–198.
3. Rubenstein LZ. Preventing falls in nursing homes. Journal of American Medical Association 1997; 278(7):595–596.
4. Sahyoun NR, Pratt LA, Lentzer H, Robinson KN. The changing profile of nursing home residents: 1985– 1997. Aging Trends; No. 4. Hyattsville (MD): National Center for Health Statistics, 2001.
5. Vellas BJ, Wayne SJ, Romero LJ, Baumgartner RN, Garry PJ. Fear of falling and restriction of mobility in elderly fallers. Age and Aging 1997; 26:189–193.