Nursing home falls can be fatal. Existing medical conditions can make injuries even more severe or even lead to death. In 2014, there were 29 million reports of falls in elderly nursing home residents. Those falls resulted in more than 7 million serious injuries and 1,800 deaths.
Falls can still happen even when staff takes the utmost care to prevent them, but reducing the risk and ensuring that proper safety protocols are in place is crucial.
What can nursing homes do to help prevent falls?
Follow the Falls Management Program for Nursing Homes
The Falls Management Program for nursing homes, which was created by the Agency for Healthcare Research and Quality (AHRQ), says falls are due primarily to person-centered factors and external factors. These include:
- Medication side effects
- Effects of aging or inactivity
- Unsafe behavior
- Disease and other medical conditions
- Unsafe footwear
- Malfunctioning wheelchairs, walkers and furniture
- Wet, uneven flooring
- Cluttered living spaces
- Poor lighting
- Difficult-to-manage clothing
- Unstable furniture
While aging and illness cannot be prevented, they can be managed. External factors that increase the risk of falls can also be addressed.
The Falls Management Program outlines protocols to follow in the prevention and management of falls in nursing homes.
Eliminate Environmental Risks
Environmental risks are the simplest to address, and they are a tremendous contributor to patient falls. Conduct an environmental audit of the nursing home facility to reveal problematic areas that may increase the risk of falls.
These may include:
- Slick floors
- Loose carpeting
- Poorly arranged furniture
- Dim lighting
Non-slip rugs can be installed. Slick, hard flooring can be replaced with vinyl to reduce the risk of slipping. Installing brighter light bulbs in dim areas can help improve visibility, which is a major contributor to falls. Additionally, furniture should be rearranged to prevent the risk of tipping over.
Shelves in rooms should be just the right height to prevent stretching or straining for items.
The bathroom area can be the most dangerous for nursing home patients. All bathrooms should be equipped with handrails and raised toilets. Toilets that are too high or low can increase the risk of a patient falling.
Staff should be constantly assessing the environment to eliminate fall risks, such as spills and obstacles in walkways that may cause falls.
Assess Health Risks
It’s important to understand each patient’s needs as well as current and past health issues.
Mobility issues should be considered, and the facility should understand whether the resident will need to use a cane, walker, wheelchair or other assistive device. Certain medications can also make patients dizzy, tired or unsteady on their feet. It’s important that the nursing home be made aware of all medications, so these side effects can be taken into consideration.
Additionally, the staff should be made aware of physical or mental conditions that may increase the risk of falling. This may include dementia, vision problems, heart conditions or a history of seizures.
Encourage Safe and Healthy Exercise
Daily exercise is important not only for overall health, but also in the prevention of falls. Nursing home patients who engage in regular exercise can improve their:
- Balance
- Strength
- Range of motion
- Ability to prevent falls
It’s unfortunate, but many seniors are assigned to wheelchairs when they really have little need for them. Reliance on a wheelchair only allows balance and strength to erode, which increases the risk of a fall or injury.
Encourage residents to participate in exercise classes that are safe and healthy for them. Those who are wheelchair bound can still be active by performing chair exercises. Water aerobics can provide a cardiovascular workout that’s easy on the joints.
Ensure Proper Footwear and Clothing
Nursing home residents should be comfortable, but not to their detriment. Rather than allowing residents to wear socks, slippers or go barefoot, encourage them to wear rubber-soled athletic shoes or strap-on shoes that fit snugly.
With that said, residents should still be evaluated for gait issues that can make treaded shoes more dangerous.
Educating Staff
Fall prevention is an ongoing challenge. Providing continued education to staff can help prevent or minimize the number of falls in a nursing home. Staff should be taught how to provide the level of care and attention residents need.
Staff should know and understand the signs when a patient is about to fall. Proper protocols should be in place so that staff knows what to do if a fall does occur. Of course, staff should be trained in the most effective strategies to prevent falls from happening in the first place.
Activities and mobility programs, such as yoga and tai chi, can also go a long way in preventing falls.
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