Falls are common among senior citizens, as the likelihood of falling increases with age. Senior citizens living in nursing homes may have serious health issues, which make them more vulnerable to falls and accidents. According to data published by the Centers for Disease Control and Prevention (CDC), nearly 800,000 elders are hospitalized for a broken hip or a head injury annually. Treating fall injuries among elders is a costly affair. In 2015, costs for treating senior citizen falls under Medicare alone totaled over $31 billion.
Apart from endangering the lives of residents and incurring significant medical expenses, nursing home falls and fractures can also result in tort lawsuits. To avoid serious legal consequences and bad publicity, nursing homes should implement a sustainable and efficient fall-prevention program. Besides, it is their responsibility to provide the best care to their residents. In fact, they are required to carry out a fall-risk assessment on every patient in their facility.
Here are four strategies that nursing homes can use to prevent falls and increase residents’ safety:
- Use Risk Assessment Tools
Risk assessment is the first step to preventing nursing home falls. A recent study shows that the incidence rate for falls in nursing home residents is two to three times greater than that in community-dwelling senior citizens. Almost 10 percent to 25 percent of falls among nursing home residents result in a fracture or hospitalization. The federal government has made it mandatory for hospitals, nursing homes, and assisted living facilities to carry out fall risk assessment on a regular basis.No single tool is capable of addressing all the risk factors in a long-term care facility. As a result, several different private and public healthcare providers, assisted living facilities, as well as federal and state institutions have developed risk assessment tools for determining the risk of falls among the elderly. You need to select a tool which can address the most common risk factors and is easy to use. Check out the Stopping Elderly Accidents, Deaths and Injuries (STEADI) tools created by the CDC for caregivers and healthcare workers.
The tool (even if it’s a one-page tool) should include a minimum of ten basic risk factors. These may include, but are not limited to, the history of falls, impulsivity, vision, continence, use of high-risk medicine, use of equipment, and the current mental status of the resident. However, the fall-prevention program shouldn’t affect the mobility of nursing home residents. The primary goal of such a plan should be to promote mobility and reduce the risk of falls.
- Monitor Medication
Medication is an integral part of a nursing home resident’s life. Most nursing home residents need to take antipsychotics, tranquilizers, and other drugs to address different health issues. The advancement in medication and drugs has resolved several health conditions. In certain cases, however, the same drugs may show adverse side-effects. Several studies have already established the link between increased fall risks among senior citizens taking heavier drug doses.A study of nearly 33,301 nursing home residents found that, on average, 6.7 drugs are given to each resident and almost 27 percent of the residents took more than nine medications daily. The same study also found that 28.5 percent of the antipsychotic doses given to 693,000 Medicare nursing home residents were excessive and 32.2 percent lacked appropriate instructions for use.
Proper medication can stabilize a resident’s medical condition and reduce the risk of falls, as well. It is also important to provide adequate instructions for use to avoid over-dosage. Nursing home staff and caregivers are responsible for maintaining a log of medication given to every resident. Speak with the attending physician and the pharmacists before administering medication to a resident with a history of falls.
- Install Safety Equipment
Environmental hazards are also responsible for the majority of the falls in an assisted living facility. Residents often tend to trip over an object in their path. The nursing home staff needs to keep floors clutter-free.Poor lighting can also contribute to falls. To ensure there is adequate lighting and the floor is clean and dry, the staff needs to make regular rounds. You can also place residents with higher fall risk near the nurse’s station for better observation and quicker response when the situation calls for it.
Installing safety equipment can not only reduce the risk of falls, but also increase the mobility of the residents. Using a gait belt or a hand rail wherever possible can reduce the risk of falls, especially in high-risk areas such as toilets, bathrooms, and stairs. Clean spills immediately to avoid slip-and-fall accidents. Bed rails can increase the mobility of residents in the bed, including sitting up and getting out of the bed. Make sure a resident’s personal belongings such as glasses, walkers or canes, and footwear are within his/her safe reach.
Residents with serious medical condition such as Alzheimer’s Disease often tend to wander off, increasing the risk of fall. In several cases, however, it is advisable to not use physical restraints to confine them to their beds or wheelchairs. Using bed alarms is perhaps the best way to prevent falls in such situations. Whenever a resident gets out of his/her bed, the alarm will go off and notify the staff on duty.
- Provide Adequate and Well-Trained Staff
Well-trained staff in sufficient numbers is critical for proper nursing home care and prevention of falls. An analysis led by the University of California San Francisco (UCSF) revealed that America’s largest for-profit long-term care facilities deliver low-quality service compared to their government-funded and non-profit counterparts because of inadequate staffing.Adequate staff is essential to ensure personal care and attention for every resident in the facility. The nursing home administration needs to make sure that there are enough registered nurses (RN) on duty, especially in the night shift. Only trained professionals should be allowed to handle the transfer of residents from the bed, shower, chair, toilet, and wheelchair.
Falls can result in life-threatening situations among the elderly. As the majority of senior citizens live in the assisted living facilities, it is the responsibility of caregivers and nursing home staff to ensure their safety. However, preventing falls can be a challenging task for a nursing home. The above four tips may prove helpful in the creation of a fall-prevention program.