Nursing Home Falls

How big is the problem?

In 2003, 1.5 million people 65 and older lived in nursing homes (National Center for Health Statistics 2005). If current rates continue, by 2030 this number will rise to about 3 million. Each year, a typical nursing home with 100 beds reports 100 to 200 falls. Many falls go unreported. As many as 3 out of 4 people in nursing homes fall each year. That’s twice the rate of falls for older adults living in the community.

Patients often fall more than once. The average is 2.6 falls per person per year. About 35% of fall injuries occur among residents who cannot walk. About 5% of adults 65 and older live in nursing homes. But people in nursing homes account for about 20% of deaths from falls in this age group .
How serious are these falls?

About 1,800 people living in U.S. nursing homes die each year from falls. About 10% to 20% of nursing home falls cause serious injuries; 2% to 6% cause fractures . Falls can make it hard for a person to get around, cause disability, and reduce quality of life. Fear of falling can cause further loss of function, depression, feelings of helplessness, and social isolation.

Why do falls occur more often in nursing homes?

Falling can be a sign of other health problems. People in nursing homes are generally more frail than older adults living in the community. They tend to be older, have more chronic illnesses, and have difficulty walking. They also tend to have problems with thinking or memory, to have difficulty with activities of daily living, and to need help getting around or taking care of themselves. All of these factors are linked to falling.

What are the most common causes of nursing home falls?

Muscle weakness and walking or gait problems are the most common causes of falls among nursing home residents. These problems account for about 24% of the falls in nursing homes .Hazards in the nursing home cause 16% to 27% of falls among residents. Such hazards include wet floors, poor lighting, incorrect bed height, and improperly fitted or maintained wheelchairs. Medications can increase the risk of falls and fall-related injuries. Drugs that affect the central nervous system, such as sedatives and anti-anxiety drugs, are of particular concern

How can we prevent falls in nursing homes?

Fall prevention takes a combination of medical treatment, rehabilitation, and environmental changes. The most effective interventions address multiple factors.

Interventions include:

Assessing patients after a fall to identify and address risk factors and treat the underlying medical conditions.

Making changes in the nursing home environment to make it easier for residents to move around safely.Such changes include; putting in grab bars, adding raised toilet seats, lowering bed heights, and installing handrails in the hallways.

Reviewing prescribed medicines to assess their potential risks and benefits and to minimize use.

Providing patients with hip pads that can effectively prevent most hip fractures if a fall occurs.

Using devices such as alarms that go off when patients try to get out of bed or move without help.

Exercise programs can improve balance, strength, walking ability, and physical functioning among nursing home residents.

Source: www.cdc.gov

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