What You Should Know About Falls & The Elderly

The American Geriatrics Society predicts that within the next 15 years the number of Americans over the age of 65 will reach 71 million and account for 20% of the U.S. population, and about three million of them will live in nursing homes. You may be one of these – or perhaps your parents will be. Whether they live at home or in a nursing facility, falls are the leading cause of both fatal and nonfatal injuries for older adults, according to the Centers for Disease Control and Prevention (CDC). These are some of the things we all should be aware of as we and our parents age:

What causes older people to fall?

A number of factors contribute to common causes of nursing home injuries as well as to the increased risk of elderly falls in healthcare facilities. Their strength and balance may be affected simply by the passage of years. Seniors are more likely to have chronic medical issues, for which the medications come with side effects like dizziness. Eyesight is usually not as sharp as it once was, increasing the chance of a misstep or trip. And cognitive impairment or dementia may affect a person’s situational awareness or reasoning ability and contribute to the likelihood of a fall.

Are people in nursing homes at less risk of falling?

You may think – and hope – that your elderly loved one will be less likely to fall if they are in an assisted living facility or nursing home, but this isn’t necessarily the case. About 1,800 older adults living in nursing homes die each year from fall-related injuries, and those who survive falls frequently sustain head injuries that result in permanent disability and reduced quality of life. Between half and three-quarters of nursing home residents fall each year, the CDC reports. What’s more, in a study published in the January 2013 journal BMC Geriatrics, they found that people who fell usually had more than one such incident, with the average rate being 2.4 falls per person per year.

Why do nursing home residents fall?

Some medications which are frequently prescribed for nursing home residents — antipsychotics, antidepressants, non-steroidal anti-inflammatory drugs, vasodilators — can make them unsteady on their feet. Older folks who cannot stay at home are likely to have muscular weakness, balance and gait deficits, use a cane or walker and have poor vision. They may have delirium, cognitive and functional impairment and suffer from hypotension and urinary incontinence. The BMC Geriatrics study cited above found an association between falling and certain diseases: arrhythmias, anemia, peripheral arterial disease, cancer, obstructive pulmonary disease, anxiety, and arthritis.

Are there factors in the facility that could increase the risk of a patient’s falling?

Inadequate staffing can contribute to the risk of a nursing home resident’s taking a fall. One study found that about 75% of nursing home/assisted living falls occurred in the resident’s room or in the bathroom, places where the resident may be unsupervised for a long period of time if the facility is operating with a skimpy or incompetent staff. Additionally, where there are not enough nurses and aides to provide assistance, residents may be over-medicated so they will be more docile and less active, increasing their unsteadiness when they do attempt to get up.

What injuries may be sustained in a fall?

In the BMC Geriatrics study, one quarter of those who fell had serious injuries — open wounds, broken hips or other bones, cerebral hemorrhage or other injuries that required hospitalization. Most fractures among older adults are caused by falls, commonly involving the spine, hip, forearm, leg, ankle, pelvis, upper arm, and hand. Falls are the most common cause of traumatic brain injuries (TBI). According the National Institutes of Health (NIH), 155,000 elderly Americans per year sustain a TBI, leading to 12,000 deaths.

If a TBI does not result in death, are there still serious consequences?

Patients who have a severe traumatic brain injury often require surgery for intracranial hemorrhage or elevated intracranial pressure, and the risk of any type of surgery increases with age. Even if the fall does not cause immediate death, it can predispose an elderly person to a premature death. In addition to causing a fall, some studies have shown that dementia may result from a fall. According to the Alzheimer’s Association, moderate and severe TBIs have been linked to a greater risk of developing Alzheimer’s disease or another type of dementia. For those with a moderate traumatic brain injury, the risk is 2.3 times greater; if the TBI was severe, the risk is 4.5 times greater.

If my loved one is in a nursing home, how can I help them prevent a fall?

Talk to the nursing home administrative staff about their policies and procedures. Ask how they assess the fall risk of each patient and what measures they use to prevent falls. Know what medications your loved one is taking and inquire about whether they contribute to a fall risk; if so, ask whether their use can be minimized. Look for things like handrails, grab bars, raised toilets, and low beds. Inquire about occupational therapy to help an older person learn new skills for getting around and performing tasks of daily living more safely.

Will using physical restraints help prevent falls?

Research has shown that routine use of restraints does not lower the risk of falls or fall injuries. In fact, they can actually increase the risk of fall-related injuries and deaths by weakening muscles and reducing physical function.

What can I do to help an aging loved one who lives alone?

Most falls by older people occur at ground level as opposed to falling off of something like a stool or ladder. Look over their living quarters to make sure there are no throw rugs they can trip on. Install grab bars in the bath and at entrance doors. Make sure there is plenty of light and that bulbs are replaced when necessary. Organize cabinets so frequently used items are easy to reach. Encourage them to exercise, as appropriate, and make sure their vision is checked routinely. Make sure they have shoes that fit well, have non-slip soles, and provide support (no flip-flops or high heels).

Are there legal remedies for elders who fall?

When an elderly person is injured in a fall which occurs as a result of someone else’s negligence, a personal injury lawyer can seek monetary damages from the responsible party. This could be a landlord who failed to perform necessary repairs or properly maintain the premises; it could be a nursing home or assisted living facility which was negligent in the care they gave those entrusted to them; or it could be a clinic or hospital which failed to provide adequate assistance or exposed the patient to dangerous conditions.

The Indianapolis elder care lawyers at McNeely Stephenson have been trusted advisors and proven advocates since 1981. Call 1-317-825-5200 for a free consultation if your elderly loved one has been injured or killed in a fall. When others breach their duty, we keep ours.