Nursing Homes Must Take Greater Action to Prevent Residents from Falling—Especially for Those with Dementia

Falling is a serious issue in nursing homes and leads to deleterious consequences. Every year, 4% of falls result in fractures and 11% result in soft tissue damage. Patients who fall experience functional loss, self-imposed functional limitations due to fear of falling, and restraint from activity imposed by care givers.

Fall occurrences increase healthcare spending, as well. Those that result in fractures cost billions of dollars annually, while those that do not result in injury increase nursing home care costs due to time required for staff evaluation, examination, and reporting.

Fall-risk is heightened for patients with dementia. This cognitive disease impairs judgment, gait, visual-spatial perception, and the ability to identify and evade dangers. Studies have shown that nursing home residents with dementia fall twice as often as those without the disease. Moreover, dementia has been proven to be an independent risk factor, leaving residents with dementia more vulnerable to sustained fall injuries over time. Elderly nursing home residents who are female, functionally independent, have mechanical restraints, or have had a history of fall occurrences are especially at risk of maintaining fall injuries. Therefore, it is vital that nursing home caregivers provide closer supervision to residents with dementia. These patients are critical candidates for fall- and fall-injury-prevention and intervention strategies. Nursing homes must identify patients at high risk of falling prior to admitting them as residents. They must also perform routine assessments of their risk factors to implement appropriate fall-prevention standards to residents who need them. Nursing home staff must educate their residents on how to identify weakness or dizziness and what proper footwear to use. If a fall does occur, residents should be more closely evaluated to prevent overlooking post-fall injuries not self-reported.

Nursing homes must implement effective fall-prevention interventions by changing the environment of the older adult resident to make mobility safer and easier. The installation of grab bars and handrails, raised toilet seats, and lowered bed heights are a few examples of nursing home environmental changes that can enhance patient quality of life. Residents can be provided with hip pads to avoid hip fractures, as well as floor mats to protect them from the risk of falls. Alarms that notify a staff member when a resident tries to get out of bed or move unassisted are also effective fall-prevention tools.