Falls are the leading cause of injury and injury-related death among nursing home residents. Elderly residents face elevated fall risks due to mobility limitations, medication effects, cognitive impairment, and environmental hazards. Nursing homes have legal duties to assess fall risks and implement appropriate prevention measures. When facilities fail to protect residents from foreseeable falls, they can be held liable for resulting injuries.
Why Falls Are So Dangerous for Elderly Residents
Hip fractures are among the most serious fall consequences for elderly individuals. These injuries often require surgery and extended rehabilitation. Many elderly hip fracture patients never regain their previous mobility level, and some never walk again. Studies show that hip fractures in the elderly significantly increase mortality risk, with many patients dying within a year of injury.
Head injuries from falls can cause traumatic brain injuries, subdural hematomas, and death. Elderly individuals taking blood thinners face particular danger from head trauma as bleeding may continue unchecked. Even seemingly minor head injuries can prove fatal in this population, making fall prevention critical.
Falls create fear that limits mobility and independence. Residents who fall often become afraid to walk, leading to muscle weakness and increased fall risk. This cycle of falls, fear, and decline is predictable and preventable with proper fall prevention programs that address both physical and psychological factors.
Fall Risk Assessment Requirements
Nursing homes must assess each resident's fall risk upon admission and regularly thereafter. Assessments should identify factors including gait instability, vision problems, cognitive impairment, medications that affect balance, and history of previous falls. The assessment informs care planning to address identified risks.
Standardized fall risk assessment tools provide consistent evaluation frameworks. Tools like the Morse Fall Scale or Hendrich II Fall Risk Model score multiple factors to quantify fall risk. Residents scoring above thresholds should receive enhanced precautions. Facilities that fail to use systematic assessments cannot claim falls were unforeseeable.
Care plans must include specific interventions for identified fall risks. Generic care plans that do not address individual risk factors fail to meet standards. Interventions should be specific and actionable, such as bed alarms for residents who attempt to stand unassisted or non-slip footwear for those with gait instability.
Fall Prevention Measures
Supervision appropriate to risk level is the most important fall prevention measure. Residents who cannot safely ambulate independently need staff assistance. Those with dementia who lack safety awareness require closer monitoring. Staffing levels must allow adequate supervision of high-risk residents.
Environmental modifications reduce fall hazards. Non-slip flooring, adequate lighting, clear pathways, and accessible grab bars help prevent falls. Bed heights should allow residents to safely stand, and call lights must be within reach. Facilities that maintain hazardous conditions create foreseeable fall risks.
Assistive devices including walkers, wheelchairs, and transfer equipment help residents move safely. Staff must ensure residents use prescribed devices and that equipment is properly maintained and adjusted. Residents attempting to ambulate without ordered assistive devices need redirection and supervision.
Proving Fall Negligence
Medical records document fall risk assessments, care plans, and fall incident reports. Records should show that facilities identified risk factors and implemented appropriate interventions. Repeated falls suggest that initial interventions failed and should have been modified. Gaps in documentation may indicate that required assessments were not performed.
Incident reports detail fall circumstances including location, time, activity, and injuries. Multiple incident reports showing falls in similar circumstances demonstrate pattern failures. Reports should trigger care plan reviews and enhanced interventions; facilities that fail to respond to fall patterns breach their duties.
Staffing records reveal whether adequate personnel were available to provide required supervision. Understaffing is a root cause of many nursing home falls because insufficient staff cannot monitor and assist all high-risk residents. Staffing levels below state requirements create strong evidence of negligence.
Damages in Fall Cases
Medical expenses for fall injuries include emergency treatment, surgeries, hospitalization, and rehabilitation. Hip fracture surgery and recovery can cost over $50,000. Head injury treatment may require intensive care and extended hospitalization. Ongoing physical therapy and mobility equipment add to total costs.
Pain and suffering from fall injuries significantly affects elderly residents. Fractures and surgical recovery involve substantial pain. The psychological impact of losing independence and mobility adds emotional distress. Fear of additional falls and resulting activity restrictions diminish quality of life.
Wrongful death claims arise when falls cause fatal injuries. Head trauma, hip fracture complications, and injuries that accelerate overall decline can all prove fatal. Families can pursue wrongful death claims against facilities whose negligence caused falls resulting in death.
Common Defense Arguments
Facilities often argue that falls are unavoidable in elderly populations. While some fall risk always exists, this argument ignores facilities' duties to minimize foreseeable risks. Proper assessment and intervention significantly reduce fall rates. Falls are not acceptable consequences of aging that excuse negligent care.
Blaming residents for their own falls is another common defense. Claims that residents were non-compliant with safety instructions or attempted activities against medical advice may shift some responsibility. However, facilities remain responsible for providing adequate supervision, especially for residents with cognitive impairment who cannot follow instructions.
Conclusion
Nursing home falls cause devastating injuries that proper prevention programs can significantly reduce. Facilities that fail to assess fall risks, implement appropriate precautions, and provide adequate supervision breach their legal duties to residents. Fall injury claims hold negligent facilities accountable and provide compensation for injuries that should have been prevented.