If you can afford it, hire a private granny nanny. My mom's been in a nursing home for 2 month, has fallen at least 6 times. She has a 24/7 sitter now, expensive but d@mn well worth it.
My boyfriend's parents are both in a nursing home in Oregon. They keep falling due to one having alzheimer's and the other one just being very elderly and mostly bed ridden. They usually try to get out of bed to go to the bathroom and fall. It's always an emergency and the usually end up in the hospital and he has to drive 1.5 hours to go see them every time it happens. This "no restraints" law is in Oregon and it's really stupid to sat the least. I'm sure it applies to some people, but I think it should be enforced only if the legal guardian ok's it. They should have a choice. Bed rails would help so much as I don't think they can get a lower bed, but that is a good idea. Some laws need to be revisited as I don't see how falling and breaking bones is better than bed rails. Really???
The problem with bed rails is they have been proven to do harm. People try to climb over, resulting in even worse falls or get limbs trapped between the rails resulting in broken bones.
More than 1.4 million people 65 and older live in nursing homes.2 If current rates continue, by 2030 this number will rise to about 3 million.3 About 5% of adults 65 and older live in nursing homes, but nursing home residents account for about 20% of deaths from falls in this age group.4 Each year, a typical nursing home with 100 beds reports 100 to 200 falls. Many falls go unreported.4 Between half and three-quarters of nursing home residents fall each year.5 That’s twice the rate of falls among older adults living in the community. Patients often fall more than once. The average is 2.6 falls per person per year.6 About 35% of fall injuries occur among residents who cannot walk.7
How serious are these falls?
About 1,800 people living in nursing homes die from falls each year.1 About 10% to 20% of nursing home falls cause serious injuries; 2% to 6% cause fractures.1 Falls result in disability, functional decline and reduced quality of life. Fear of falling can cause further loss of function, depression, feelings of helplessness, and social isolation.5
Why do falls occur more often in nursing homes?
Falling can be a sign of other health problems. People in nursing homes are generally frailer than older adults living in the community. They are usually older, have more chronic conditions, and have more difficulty walking. They also tend to have thought or memory problems, to have difficulty with activities of daily living, and to need help getting around or taking care of themselves.8 All of these factors are linked to falling.9 What are the most common causes of nursing home falls?
Muscle weakness and walking or gait problems are the most common causes of falls among nursing home residents. These problems account for about 24% of the falls in nursing homes.5 Environmental hazards in nursing homes cause 16% to 27% of falls among residents.1,5 Such hazards include wet floors, poor lighting, incorrect bed height, and improperly fitted or maintained wheelchairs.5, 10 Medications can increase the risk of falls and fall-related injuries. Drugs that affect the central nervous system, such as sedatives and anti-anxiety drugs, are of particular concern.11, 12 Fall risk is significantly elevated during the three days following any change in these types of medications. 13 Other causes of falls include difficulty in moving from one place to another (for example, from the bed to a chair), poor foot care, poorly fitting shoes, and improper or incorrect use of walking aids.10, 14
How can we prevent falls in nursing homes?
Fall prevention in nursing homes presents multiple challenges. It requires a combination of medical treatment, rehabilitation, and environmental changes. Fall prevention interventions can be implemented at the organizational, staff or patient levels.15 The most effective interventions address multiple factors or use a multidisciplinary team.16
Fall interventions include:
Assessing patients after a fall to identify and address risk factors and treat the underlying medical conditions.6 Educating staff about fall risk factors and prevention strategies.10 Reviewing prescribed medicines to assess their potential risks and benefits and to minimize use.17, 18 Making changes in the nursing home environment to make it easier for residents to move around safely. Such changes include putting in grab bars, adding raised toilet seats, lowering bed heights, and installing handrails in the hallways.10 Providing patients with hip pads that may prevent a hip fracture if a fall occurs.19 Exercise programs can improve balance, strength, walking ability, and physical functioning among nursing home residents. However, such programs do not appear to reduce falls.20,21 Teaching residents who are not cognitively impaired behavioral strategies to avoid potentially hazardous situations is a promising approach.23
Do physical restraints help prevent falls?
Routinely using restraints does not lower the risk of falls or fall injuries. They should not be used as a fall prevention strategy.24, 25 Restraints can actually increase the risk of fall-related injuries and deaths.5, 25 Limiting a patient’s freedom to move around leads to muscle weakness and reduces physical function.3 The average rate of physical restraint use in nursing homes has fallen from more than 40% in the 1980s to approximately 10%.26 Some nursing homes have reported an increase in falls since the regulations took effect, but most have seen a drop in fall-related injuries.9 Direct injury from bedrails appears to be due to outmoded design or incorrect assembly; bedrails do not appear to inc
There are several situations where a nursing home could be sued for a resident or patient injury. If a nursing home accepts Medicare, the nursing home must follow Federal Regulations which set forth the standard of care. One of these regulations is 42 CFR sec. 483.25 (h) which provides:
The facility must ensure that:
The resident environment remains as free of accident hazards as possible; and Each resident receives adequate supervision and assistance devices to prevent accidents.
If the nursing home fails to comply with these regulations and a resident is injured, the nursing home is liable to be sued
For future readers of this old post: They have beds that are lower than the traditional hospital bed and still have side rails to protect the patient. I'm not sure where you're located but check to see if they have low hospital beds and the rails should be padded for protection against bruising and or/getting a leg/arm caught in the rails if the person is trying to climb over the rails or trying to get up and is confused they won't know the dangers. I had a patient that was in a room right across from the nursing station at the nursing home, fell out of bed and broke her hip. she died 3 weeks later due to complications of the hip fracture. They tried to cover up the fact that the nurse had left the rails down until I pushed for an answer not letting go then it was confessed. I'm a senior advocate, by trade and a care manager so I will not leave any stone unturned and will get to the bottom of any incident or injustice. Nursing homes must be closely monitored by family members, an advocate/care manager, etc. and the chart should be reviewed, not everything will be disclosed to family members and by the time red flags go up, it could be too late. I've been in healthcare 40 years so please trust that I know what I'm talking about. Dr. Sheila
More than 1.4 million people 65 and older live in nursing homes.2 If current rates continue, by 2030 this number will rise to about 3 million.3
About 5% of adults 65 and older live in nursing homes, but nursing home residents account for about 20% of deaths from falls in this age group.4
Each year, a typical nursing home with 100 beds reports 100 to 200 falls. Many falls go unreported.4
Between half and three-quarters of nursing home residents fall each year.5 That’s twice the rate of falls among older adults living in the community.
Patients often fall more than once. The average is 2.6 falls per person per year.6
About 35% of fall injuries occur among residents who cannot walk.7
How serious are these falls?
About 1,800 people living in nursing homes die from falls each year.1
About 10% to 20% of nursing home falls cause serious injuries; 2% to 6% cause fractures.1
Falls result in disability, functional decline and reduced quality of life. Fear of falling can cause further loss of function, depression, feelings of helplessness, and social isolation.5
Why do falls occur more often in nursing homes?
Falling can be a sign of other health problems. People in nursing homes are generally frailer than older adults living in the community. They are usually older, have more chronic conditions, and have more difficulty walking. They also tend to have thought or memory problems, to have difficulty with activities of daily living, and to need help getting around or taking care of themselves.8 All of these factors are linked to falling.9
What are the most common causes of nursing home falls?
Muscle weakness and walking or gait problems are the most common causes of falls among nursing home residents. These problems account for about 24% of the falls in nursing homes.5
Environmental hazards in nursing homes cause 16% to 27% of falls among residents.1,5
Such hazards include wet floors, poor lighting, incorrect bed height, and improperly fitted or maintained wheelchairs.5, 10
Medications can increase the risk of falls and fall-related injuries. Drugs that affect the central nervous system, such as sedatives and anti-anxiety drugs, are of particular concern.11, 12 Fall risk is significantly elevated during the three days following any change in these types of medications. 13
Other causes of falls include difficulty in moving from one place to another (for example, from the bed to a chair), poor foot care, poorly fitting shoes, and improper or incorrect use of walking aids.10, 14
How can we prevent falls in nursing homes?
Fall prevention in nursing homes presents multiple challenges. It requires a combination of medical treatment, rehabilitation, and environmental changes. Fall prevention interventions can be implemented at the organizational, staff or patient levels.15 The most effective interventions address multiple factors or use a multidisciplinary team.16
Fall interventions include:
Assessing patients after a fall to identify and address risk factors and treat the underlying medical conditions.6
Educating staff about fall risk factors and prevention strategies.10
Reviewing prescribed medicines to assess their potential risks and benefits and to minimize use.17, 18
Making changes in the nursing home environment to make it easier for residents to move around safely. Such changes include putting in grab bars, adding raised toilet seats, lowering bed heights, and installing handrails in the hallways.10
Providing patients with hip pads that may prevent a hip fracture if a fall occurs.19
Exercise programs can improve balance, strength, walking ability, and physical functioning among nursing home residents. However, such programs do not appear to reduce falls.20,21
Teaching residents who are not cognitively impaired behavioral strategies to avoid potentially hazardous situations is a promising approach.23
Do physical restraints help prevent falls?
Routinely using restraints does not lower the risk of falls or fall injuries. They should not be used as a fall prevention strategy.24, 25 Restraints can actually increase the risk of fall-related injuries and deaths.5, 25
Limiting a patient’s freedom to move around leads to muscle weakness and reduces physical function.3
The average rate of physical restraint use in nursing homes has fallen from more than 40% in the 1980s to approximately 10%.26
Some nursing homes have reported an increase in falls since the regulations took effect, but most have seen a drop in fall-related injuries.9
Direct injury from bedrails appears to be due to outmoded design or incorrect assembly; bedrails do not appear to inc
If a nursing home accepts Medicare, the nursing home must follow Federal Regulations which set forth the standard of care. One of these regulations is 42 CFR sec. 483.25 (h) which provides:
The facility must ensure that:
The resident environment remains as free of accident hazards as possible; and
Each resident receives adequate supervision and assistance devices to prevent accidents.
If the nursing home fails to comply with these regulations and a resident is injured, the nursing home is liable to be sued
They have beds that are lower than the traditional hospital bed and still have side rails to protect the patient. I'm not sure where you're located but check to see if they have low hospital beds and the rails should be padded for protection against bruising and or/getting a leg/arm caught in the rails if the person is trying to climb over the rails or trying to get up and is confused they won't know the dangers. I had a patient that was in a room right across from the nursing station at the nursing home, fell out of bed and broke her hip. she died 3 weeks later due to complications of the hip fracture. They tried to cover up the fact that the nurse had left the rails down until I pushed for an answer not letting go then it was confessed. I'm a senior advocate, by trade and a care manager so I will not leave any stone unturned and will get to the bottom of any incident or injustice. Nursing homes must be closely monitored by family members, an advocate/care manager, etc. and the chart should be reviewed, not everything will be disclosed to family members and by the time red flags go up, it could be too late. I've been in healthcare 40 years so please trust that I know what I'm talking about.
Dr. Sheila