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KateH2 Asked November 2019

How do you define a fall?

I was asked to take my elderly uncle to the doctor after he hurt his fingers. I was explaining to the doctors what had been explained to me by my cousin and we got into a disagreement about what a fall is.


I was told that my uncle couldn't stay standing after she stood up. So rather than let him fall to the floor, my cousin held him and guided him down to the floor since my cousin couldn't support his weight with all the arm flailing he was doing (he was afraid). It was when my cousin stood him up to put him in a chair that he hit his fingers (because he was flailing again) and ended up breaking two of them.


For whatever reason, the doctors and nurses kept saying he fell. I kept telling them he didn't and kept explaining what actually happened, but they don't listen. My cousin is totally ticked off and ended up getting in an argument with them. He's worried about a "fall" going in his father's records because of some insurance reason.


Personally, I think there's a big difference between a person falling and being guided down to the floor. To me, a fall involves a hard impact, even if the ground is kind of soft. But if someone is holding you and gently sitting you on the floor, that's not a hard impact and it's not a fall.


Opinions? And how important is it to clarify these things with doctors and nurses? Especially if it's going into the medical records?

anonymous979634 Nov 2019
A guided fall is still a fall. We’re grateful someone was there to ease him down but the medical professional is not just looking at the immediate concern but at the whole picture. Such as, is there an underlying medical condition that precipitated this incident. If something is properly diagnosed, then actions can be put in place to improve your uncle’s safety.

I get that this is a frustrating answer but the doctor and nurse are doing the right thing. I don’t really understand the concern with the insurance being aware or that it’s being documented in the medical records unless there’s another dynamic. At the end of the day, what’s important is whatever is best for your uncle. I hope it goes well for him.

anonymous912123 Nov 2019
My step-father falls a lot, mostly getting from his wheelchair to the car. He fall down and go boom, nothing happens, he kind of bounces down to the curb. Yes, I would call these falls!

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FloridaDD Nov 2019
I think very important to document.  I assume they noted no broken bones, loss of consciousness, etc.  IMHO, falling will eventually be serious, health care providers need to be aware, meds may need to be modified, etc.

Tothill Nov 2019
Your Uncle fell, he could not support his weight.

Or would you prefer the term collapsed and was guided to the ground?

It amounts to the same thing. He could not support his weight, if your cousin was not there, he would have would up on the floor.

The 'fall' occurred when he could not support his weight, not when he hit the ground.

cwillie Nov 2019
Yes, I would count that as a fall, albeit a slow and controlled one - it certainly would not have been in doubt if no one had been standing right there.

So why the resistance to having it labelled a fall? Getting good medical treatment depends on having an accurate record of both his capabilities and weaknesses, I see nothing to be gained by glossing over this.

Beatty Nov 2019
Types of falls from the Falls Risk Assessment Tool:

Trip
Slip
Lost balance
Collapse
Legs gave way
Dizziness

I'd call it a fall - lost balance.

Slip or trip would be treated as a more minor incident as other factors are nvolved (slippery floor, uneven paving).

*Assisted to the floor* is a more minor fall in a facility (less paperwork) but still a fall.

The reason for fall is of course useful to look for problems.

My relative has had 9 falls this year (that I know about) so knows the lingo. She has described falls to medical staff as Slip (off bed) Trip (over own feet) or Assisted to the floor (but was home alone). Whatever SHE calls them - all noted as lost balance I expect.

The main thing now for your Uncle is prevention.

Countrymouse Nov 2019
A stumble is a potential fall that the individual is able to correct; that too should be recorded.

A fall is a situation where the individual is unable to prevent himself from going to ground (or the nearest surface where gravity might take him). Your uncle fell. The fact that your cousin was there to ensure that your uncle fell in a controlled way and was not more seriously injured doesn't alter the fact that your uncle could not sustain his own weight, for example by catching a grab bar or correcting his balance. It's a fall.

For the sake of accuracy, make sure the records show that the fingers were not broken in the fall. The flailing on rising was a separate incident. By the way, though - if somebody is panicking and agitated, keep him sitting safely where he is until he is calm and understands the plan, or there is someone else there to help.

It would be a very good idea for your cousin and uncle to get guidance from an occupational therapist. There are all kinds of ways to keep people on their feet and mobile safely, and all kinds of equipment to help.

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