September 19, 2019
Why Falls are a Major Issue in Nursing Homes: Personal Injury Attorney Illinois

Why Falls are a Major Issue in Nursing Homes: Personal Injury Attorney Illinois


Welcome back to fighting for what’s right with personal injury attorney buried oil, bury I was surprised to learn that Falls were one of the most common kinds of cases that you handle I thought that Falls were kind of just one of those things that happen as you get older Why are fall such a major issue in nursing homes? well One of the real common reasons that people get admitted to a nursing home to begin with is because they’re experiencing falls at home they’re just not safe to be on their own and if a nursing home is taking a resident on who’s experiencing falls at home this is something that needs to be care plan because this is one of these things it really is a Risk to the health and well-being of the nursing home resident with a senior citizen population Falls are something that have a serious effect on mortality morbidity Meaning that Falls are more likely to result in death Falls are more likely to result in significant declines in the overall quality of life So Falls are a big big deal in the nursing home industry and most often they get treated as such Okay And so what are the most common scenarios in these kinds of cases most of the false that I see are? False it involved people who have been identified as being fall risks who managed to get up Unattended most typically to go to the bathroom and on the way there or on the way back Experience a fall typically with some fairly significant fractures or other injuries So this is not like your basic slip and fall at a grocery store No, not at all when you’re talking about a slip and fall involving your grocery store you typically talking about Someone who slips and falls on a foreign substance whether its water or grain for something like that And those kind of Falls do happen in a nursing home setting and keeping floors Clean is part of a basic care plan in any Nursing home setting but more often the kinds of false that we see are what are called physiological Falls in other words their Falls are associated with Somebody’s overall state of well-being typically involves musculoskeletal issues. Sometimes it involves medication uses Sometimes it involves what’s called orthostatic hypotension, which means a sudden drop in blood pressure So these are false out that really are completely unrelated to anything that might be on the floor of the condition of the property itself It has more to do with the condition of the resident and if you’re working with a lawyer on a nursing home case Involving a fall who wants to treat this like a slip and fall case It’s not it’s one of those science that you’re working with. Somebody who really doesn’t know what they’re doing So then what kind of nursing home resident is most at risk for Falls for me? They’re two really crucial criteria One of those is musculoskeletal issues in other words, there’s weakness There’s a limp the basic things that tell you they have some difficulty walking on their own the second part of this is either Intermittent or constant confusion and the resident can’t be relied upon to do the kinds of things. That would keep them safe So when I look at these kinds of cases intermittent confusion is just as much a risk factor as constant confusion The reason for it is this when you have nursing home residents who are in their 70s 80s or 90s? Their level of confusion is going to vary throughout the day and it’s going to make things kind of Unpredictable for the staff as to whether or not somebody’s going to be able to Follow instructions and take those steps that they need on their own to really assure their own safety so those two factors together musculoskeletal issues plus intermittent or constant confusion to me are the two Biggest risk factors that are involved for trying to determine whether or not somebody’s a fall risk now there are some other factors as well medication usage is one of them having vision problems is another Incontinence is another incontinence becomes a big issue because somebody is going to have the urge to go to the bathroom It’s play come out fairly quickly. And even though they may have trouble controlling their bowel or their bladder There’s still people who are grown adults People who have dignity and don’t want to have an episode of incontinence where they have to be cleaned again so they may get up unpredictably suddenly to go to the bathroom and Go go without getting the help. They need to get there safely and If all may occur on the way, that’s really sad So what are the most common steps that need to be taken to prevent Falls? Well, one of these is to supervise the residents activities. It’s not always possible to give a one to one sitter day In fact most nursing homes. It’s really not possible to do that at all But it certainly is possible to make sure the people are in a common area Throughout the day where there’s going to be staff keeping an eye on several residents all at once when somebody needs help their staff on hand who can help them get up and go to the bathroom putting somebody on a Toileting schedule so they’re brought to the bath on a regular basis and the episodes of incontinence become a little bit less Unpredictable that tends to be something. That’s really pretty effective one of the real common interventions We see is the use of a bed alarm There are really two different kinds of alarms that are used One alarm eight is a a clip that’s affixed to the back of somebody’s clothes and when they stand up it Basically, it pulls a sensor away from a box. It sounds an alarm which is loud. It’s piercing It makes a horrible noise, but just as it importantly is notifying the staff that somebody is up It also serves as a reminder of the resident They’re not supposed to be up and unattended on their own the other kind of pet alarm that you see is one That’s a pressure sensitive strip that goes under the sheets and when a resident starts to get up out of bed the alarm goes off Same thing it’s a loud piercing noise that brings the staff and also remind Cerreta They’re not supposed to be up and unattended. So all those steps are things that can be taken together There are things that need to be done day to day shift to shift to help reduce the risk of somebody falling So why not just use a restraint to keep somebody from getting up? Okay. So restraint is a device which Inhibits a residents ability to move their body freely and a lot of times people will come into my office and suggest to me that the nursing home should have used a restraint to keep their mother or father from getting out of that or Getting up out of their chair the problem with the restraints are that many times people will actually injure themselves struggling against the restraint you’ll have a loss of muscle tone because they spent so much time in better in a chair and that actually increases the fall risk once they’re up and about and many times you’ll see bed sores result because people spend so much time just Kind of paste it into their seat and not able to move at all So there are a lot of problems are associated with the use of restraints. They’re very strongly discouraged by the federal regulations It’s just not a good solution to a real problem and if you’re dealing with a lawyer who suggests that They’re really answer to the – the problem was that they should have used a restraint It’s a sign that you’re dealing with somebody who really doesn’t know what they’re talking about And you should probably run as fast as you can in the other direction. So Barry you mentioned that Falls our care plan Do you see breakdowns in the care planning process? they’re really three maybe four areas where I see breakdowns in the care planning process most often the first year it would be In the area of assessment that there’s an inadequate assessment done of somebody’s fall risk most often The fall risk is understated because the staff doesn’t get a good history as to some of these incidents of prior Falls Which is one of these things that tends to feed into fall risk the second area that you tend to see breakdowns in the care planning process is with a care plan itself that steps that really should be taken to Mitigate fall risk aren’t included as part of the care plan the third area where you see Breakdowns in the care planning process is in the implementation stage and that’s simply just not doing the things that need to be done day and day out to Address fall risk that tends to be allowing people to get up unattended when the care plan calls for an assistive one While the ambulating I’ve had a surprising number of cases where people have been given bed alarms but the bed alarm has been shut off in the last place you tend to see breakdowns in the care planning process is in the evaluation revision stage where you have people who are at increased risk for falling because they’re demonstrating increased levels of confusion more musculoskeletal weakness taking new medications that all contribute to fall risk and no consideration is given to Changing the care plan because the residents condition or situation has changed Thanks, Barry. 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