Simple steps that you need to take today to prevent your loved one from falling in a nursing home in your Kingston, New York nursing home
First, a few scary statistics about falls in nursing homes. According to the Center for Disease Control and Prevention, each year an average nursing home with 100 beds reports 100 to 200 falls (this does not account for unreported falls, which would raise the number of falls big-time). As many as three out of every four nursing home residents fall each year. That's twice the rate of falls for older persons living outside of nursing homes.
Need more scary statistics? Patients usually fall more than once and the average is 2.6 falls per person per year. About 10% to 20% of nursing home falls cause serious injuries, such as fractures that require hospitalization and about 35% of falls injuries occur among residents who cannot walk. Many falls go unreported.
Heard enough? If you have a family member about to enter a nursing home, this is scary stuff. Here's what you can do about it.
Falls are not only preventable, they are usually predictable. How, you may ask? The most common risk factor for falls is a history of falling. If, upon admission to a nursing home, your loved one has a previous history of falling, then he/she is likely to fall again. Interventions can be taken to minimize the risk of another fall.
What are the other risk factors for falling in a nursing home? Real simple: residents with altered mental status, such as Alzheimer's Disease, are at increased risk for falling. If a resident is taking mind-altering medications, such as sedatives and psychotropic medications, he is at increased risk of falling. If the resident expresses a desire to leave the nursing home, he is at increased risk. If the resident has difficulty with walking and balance, put another check box on the risk factor list.
The nursing home is required by federal regulation to do a comprehensive assessment of a new resident's functional capacity within 14 days of the resident's admission to the nursing home. The assessment is set forth in a document known as a Minimum Data Set (MDS). Among the categories in the Minimum Data Set will be an assessment of the resident's risk of falling. This is a document that you will want to see.
Most nursing homes assess a resident's risk of falling under a scale called the Morse Scale that assesses the resident in six categories. First on the Morse Scale is a history of falls and the other risk factors include difficulty with ambulation, mental status problems and psychotropic medications. Each resident will be classified as "no risk" of falling, low risk of falling or high risk of falling.
If your loved one is classified as high risk of falling, the next step is a plan to minimize the risk of falling with appropriate interventions. The interventions to reduce the risk of falling are set forth in a document known as the Resident Assessment Protocol (RAP). These interventions include close observation of the resident during daytime hours (i.e., not leaving a high risk resident alone in their room), bed and/or chair alarms to alert the nursing staff when the resident is trying to get up, providing assistance when the resident is trying to get up and placing mattresses around the side of the bed to minimize the risk of injuries from a fall out of bed.
Most falls at nursing homes occur for a very simple reason: no one is keeping an eye on the resident! Does this mean that a nurse or LPN has to sit with a high risk resident at all times? Of course not. What this means is that the resident who is known to be high risk of falling should not be left alone in their room in the middle of the day. When high risk residents are left alone in their room, something very predictable occurs: they get up and try to leave their room. This is the most common scenario leading to a fall in a nursing home.
If you have a loved one in a nursing home or about to enter a nursing home, make sure you ask two questions to the nurse assigned to your family member: #1: Has my parent been classified as high risk of falling, or even moderate risk of falling? If the answer to this question is yes, then ask: #2: What interventions are being taken to prevent a fall?
Do not accept bland answers to these questions! Insist upon reviewing the Minimum Data Set and the Resident Assessment Protocol with the Medical Director assigned to your loved one. Once you have these answers, you need to be an advocate for your loved one by making sure that the interventions in the Resident Assessment Protocol are carried out. Demand accountability from the nursing staff and medical director.
Now you are armed with the information that you need to prevent your loved one from falling in a nursing home!