Falls and Fractures in Nursing Homes

A big concern as we age is the ease of mobility. This is one of the primary reasons why nursing homes will often perform fall risk assessments on new residents.

A positive assessment helps staff to better understand that they can give that person more independence in navigating their facility and taking care of themselves. Less than positive results, however, can indicate that they need more attentive care from their employees to handle everyday activities like navigating to the dining room, going to the bathroom, getting dressed, etc.

Two concerns that often go together are falls and broken bones. The connection between falls and fractures in nursing homes is particularly concerning.

Below, we’ll discuss which residents are most prone to falls and why and also highlight the broken bones they most commonly break when they fall. We’ll wrap this piece up by also sharing how to prevent falls in nursing homes.

Residents Most Likely to Fall

As you might suspect, certain individuals living in assisted living facilities like these are more vulnerable to suffering falls than others. Those most at risk include:

• Active older residents who may suffer from arthritis or other medical conditions that affect their mobility
• Those with permanent physical disabilities such as spinal cord injuries, shortened limbs, or amputations
• Individuals with cognitive impairments, whether congenital, acquired, or stemming from conditions like traumatic brain injuries
• Persons with memory disorders like dementia
• Anyone diagnosed with conditions affecting their equilibrium or consciousness, like vertigo, postural hypotension (a sudden drop in blood pressure with sudden movements), or seizure disorders

As you can tell, residents afflicted with a wide range of conditions may be at particularly high risk for falls in these facilities.

Why Falls Occur in Nursing Homes

Above, we mentioned fall risk assessments. If the nursing home staff fails to perform these assessments or performs them but doesn’t keep a resident’s results in mind, this may lead them to assume that individual is far more independent than they actually are.

As a result, they may think residents can move about and do things, even when it’s not safe for them to do so.

Aside from that, the Centers for Disease Control and Prevention (CDC) cite some of the following factors as giving way to falls in general, which we’ve added to other issues that more often plague assisted living facilities:

• Ripped carpets, wet floors, uneven pavement, and other flooring or grounds concern
• An absence of handrails or properly installed ones
• Accumulated ice or snow that hasn’t been adequately melted or removed
• Little to no or dim lighting
• Uncleaned spills, boxes, or trash strewn about halls, stairwells, or walkways
• Decreased mobility, which may be caused by a pre-existing illness or injury, muscle weakness, balance issues, etc.
• Certain health diagnoses, vision problems, or medication issues
• Long hallways without benches where residents can take a “breather” before continuing on
• The existence of narrow doorways or hallways making navigating them without getting out of one’s wheelchair impossible
• Not having access to much-needed assistive devices like walkers or canes
• Trying relentlessly to summon nursing home caregivers for help and eventually having to take matters into their own hands
• Beds that are too high to easily get onto without adequate assistance
• The absence of wheelchair cutouts on sidewalks to make getting down off curbs possible without standing up
• Not including a shower seat or grips in the bath for residents to use when bathing themselves

We can certainly go on and on with listing the causes of nursing home falls. However, we think that the examples above give you an idea about factors contributing to these accidents and how some may be preventable with a little more effort on behalf of a resident or their caregivers.

Types of Broken Bones That Result from Falls

Fractures are one of the most common injuries that occur that stem from falls.

Some of the following body parts are more prone to break than others when these types of injury incidents occur:

• Arms and wrists: Fractured upper limbs, and broken wrists included, generally result from a person stretching their arms out in front of them to break their fall. Broken arms may also result from a nursing home resident’s arms colliding with inanimate objects on the way down or landing on them when they make it to the ground.
• Knees, hips, legs, and ankles: Broken lower extremities may happen when someone residing in an assisted living facility trips and falls, which causes these body parts to make forceful contact with a hard surface, such as the ground, resulting in fractures.
• Head and neck: It’s not uncommon for a person to strike their head on something on the way down and even ultimately on the ground. This can result in blunt force trauma to the head and neck, which can lead to a broken cervical spine or skull fracture.

How To Prevent Falls in Long-Term Care Facilities

As referenced above, falls that occur in nursing care facilities are largely preventable. Ways to minimize the chances of them occurring include:

• Maintaining an active lifestyle
• Ensuring one’s environment is kept clean
• Getting potential medical concerns diagnosed, especially ones affecting the equilibrium or musculoskeletal system (like osteoporosis), right away
• Monitoring a loved one’s response to certain medications or supplements (and notifying doctors of any concerns noted)
• Having assistive devices within reach
• Having eye health regularly checked
• Performing regularly scheduled fall assessments and implementing new plans of action depending on the results
• Being attentive to residents’ needs for help

Falls and fractures in nursing homes are largely preventable, but it takes knowing why they occur and someone taking the initiative to implement the prevention approaches described above (and others) to stave them off.