Falls and Fractures

A very serious indication of possible nursing home neglect and abuse is a resident suffering a fall and subsequent fracture. Many injuries to nursing home residents (skin tears, bruises, and fractures) can be directly traced to lack of adequate staffing to assist with basic personal needs such as toileting or transferring to bed. Many residents are in the nursing home because they are unable to stand alone or ambulate to their meals or to the restroom without assistance. Residents who are able to call for assistance, but do not receive that assistance in a timely manner, are often injured while attempting to attend to their needs alone. Confused residents or those with dementia are unable to make decisions regarding their own personal safety and therefore their needs must be identified and addressed by staff. Additionally, some nursing homes inadequately train their employees in safe and appropriate transfer techniques, resulting in injury to the resident.

Recent statistics show that:

• A typical 100-bed nursing home will report 100 to 200 resident falls per year - and many falls do not get reported.
• As many as 3 out of every 4 nursing home residents fall each year.
• Many residents fall more than once.
• About 35% of these falls occur with residents who cannot walk.
• 10 to 20% of nursing home falls cause serious injury or death.
• Many nursing home residents fall while attempting to use the restroom alone or while moving between wheelchair or chair and bed without assistance.
• Diabetic nursing home residents are four times as likely to fall than non-diabetic residents due to a condition known as peripheral neuropathy, which affects the sensations felt in a diabetic individual's feet.

How can falls and fractures be prevented?

• First, it is the responsibility of the nursing home to properly assess the needs of each nursing home resident in order to provide the appropriate assistance to prevent injury.
• All residents in need of assistance with toileting should have a regular toileting schedule which will prevent residents, particularly those with diminished mental capacities, from attempting to perform those duties on their own.
• Body alarms or pressure alarms can be used to alert nursing home staff for a resident who has been identified as being at risk for falls. However, it is then incumbent upon staff to attend to that resident before an injury can occur.
• Adequate training in proper and safe transfer techniques must be provided to nursing home staff by the facility.

The reality in most nursing homes is that the direct caregivers are many times unfamiliar with the individual needs of the residents they are caring for. High turnover rates of nursing home employees, "agency" staff who are called upon to "fill in" in the event of absenteeism, and low worker morale contribute to these problems.

The information provided on this site relative to falls and fractures in a nursing home setting is meant as a brief overview. Specific Federal and State laws and regulations apply and each case is unique and fact-intensive.