Falls are not only the leading cause of traumatic brain injury among older adults, they are the leading cause of injury-related fatalities among those ages 65 years and older. Moreover, falls occur more often among those with Alzheimer’s Disease and related dementias. Research regarding the fall rate in assisted living facilities (ALFs) is still limited. However, the fact that more than one third of community-dwelling older adults and more than half of residents in long term care retirement communities and homes fall every year and that more assisted living residents than skilled nursing facility residents continuously suffer from a fall-related injury is clearly enough evidence that assisted living residents are vulnerable to falls.
Fall incident-reporting is an important mechanism for understanding fall incidences in older adults and clarifying how to prevent the occurrence of future falls. Assisted living facilities are the fastest-growing care settings for frail older adults. As more research is done about falls that occur in ALFs and the current methods of reporting falls by AL staff, fall risk monitoring, fall prevention strategies, and staff training must strive to meet the needs of the residents.
Research has proven that labeling falls as “accidents” is erroneous. A fall occurrence is a result of an older adult’s heightened vulnerability caused by the effects of age, disease factors, environmental hazards, and decision-making in regards to mobility. ALF residents commonly have many chronic health conditions that diminish quality of life and most residents are in need of assistance with activities of daily living (ADLs). Studies on older woman have shown that those who reported experiencing a fall were significantly more likely to be older, possess chronic disease, and use more medications.
The environment a resident is in may increase fall risk. Older adults who are fearful of falling have a higher likelihood of using assistive devices for mobility due to low confidence. However, an assistive device may interfere with an older adult’s ability to maintain balance when hindered by disruptions; further, appropriate use of the device is influenced by the strength and metabolic demands necessary.
Studies have shown that incident reports (IRs) often do not contain complete data regarded as important for monitoring health outcomes of falls and for implementing fall intervention programs. In a study that reviewed IRs of an assisted living facility, half of the IRs showed that staff failed to state the apparent cause or trigger for the fall. This finding confirms that staff do not always consistently use recommended reporting tools to describe fall events, a concern that permeates across care settings.
The reason for a fall is necessary information required to avoid future falls; yet, in many cases, crucial data about fall incidences are missing from IR forms. The same study that also used videos to capture in-depth analysis of falls events showed that the most common cause of falls by long-term care residents was incorrect transfer or shifting of body weight ensued by trips and stumbles while walking forward.
ALF staff should enforce evaluations to identify fall risk factors and preventions to enhance residents’ strength and balance. Wellness programs at ALFs that allow medical staff, fitness specialists, and caregivers to regularly communicate about fall risk to residents and the health outcomes of falls gives constant support for those living with fall risk. Exercise classes can be used to observe function and communicate falls efficacy on a regular basis.
Caregiver-supported interventions in ALFs can improve residents’ engagement in daily activities without augmenting the rate of falls. The presence of sufficient staffing within ALFs contributes to successful implementation of evidence-based fall prevention interventions.
ALF nurses are responsible for creating a culture of fall prevention in the facility. Unfortunately, many states do not require a registered nurse (RN) to be a part of the facility staff. Consequently, ALFs risk having untrained staff make decisions that should be founded on a quality nursing assessment. Performing regular assessments to assess whether there has been a change in health conditions and routinely reviewing medications for potential side-effects are crucial aspects of the nurse’s role. The ALF nurse must promptly communicate changes in a resident’s condition to the primary care provider in order to better equip the entire health care team to establish care plan changes that can decrease fall risk. ALF nurses must take a proactive, preventative approach to lower fall occurrences by giving necessary individualized information to staff whose role is to provide direct care and services and, therefore, most likely to be able to intervene to prevent a fall.
If you believe that you or your loved one suffered or is suffering from a fall due to neglect by an assisted living facility, please contact us today. The Law Offices of Ben Yeroushalmi are eager to determine if you or your loved one has been a victim of Neglect, which is a form of Elder Abuse. Not only will we aggressively fight to get you and your loved ones the compensation you deserve, we will advocate on your behalf, making sure that you do not have to handle this problem alone.
Contact us today for a free consultation. If you cannot come to us, we will come to your home or hospital bed to meet with you or your loved ones.