When our loved ones in nursing homes are injured, the first question that many of us ask is how the accident that caused the injury was allowed to happen. In an institution with around the clock nursing care and therapists and medical personnel on staff, it can be hard to imagine how some patients end up injured. The fact that we, as their family, are not there, often leaves us to try to piece together an event that happened in the past from notes or records.
The Causes of Falls can be Difficult to Ascertain
With some injuries, the cause can be revealed with relative ease. For example, bedsores are a result of a patient being left without attention on a bed for too long. When a loved one develops a bedsore, we can start with the presumption that the patient was not turned, or that devices that alter skin pressure on the bed were not used.
Falls create a much different problem because falls in a nursing home can be caused by any number of events. They can be created by someone falling over a substance or object (the same as what causes falls even outside of a nursing home). However, unlike outside of a home, nursing home patients may be unstable on their feet, or prone to falls even when there is no obstacle or substance on the floor.
In fact, sometimes families must place loved ones in a nursing home, specifically because they are unable to safely move around inside their own homes.
Nursing Homes Must be Aware of Fall Risks
Nursing homes absolutely have an obligation to make sure that patients who are fall risks are not left to navigate hallways without care or attendance. This is because nursing homes act as custodians of their residents. Homes are charged with knowing that one patient may have vertigo, another may have a bad hip, and another may suffer from Alzheimer’s, all of which may make it unsafe to allow them to walk about freely without assistance.
Nursing homes must stay on top of what medications a patient is taking. Someone who could walk normally and without problems today may be dizzy and unstable tomorrow if prescribed new medicines with these kinds of side effects.
Of course, this raises difficult questions for a family with a loved one in a home. In many cases, we do not like the idea of having a loved one restrained, or having their freedom to go where they want, when they want, restricted. Yet, a nursing home that does not restrain those who cannot navigate on their own, can be liable for negligence.
Use of a Post Fall Huddle
One way that homes ascertain how someone fell, or what led to a fall, is the use of a post fall huddle (PFH). The PFH is an immediate meeting of nursing home personnel where they piece together the circumstances of a fall. This can be particularly important in situations where nobody actually witnessed the fall, or where the patient is not in a condition to communicate how he or she fell.
The PFH will investigate the area surrounding the fall. Any conditions will be noted, such as objects that are on the floor that could have caused the fall. Even things that seem normal will be noted.
For example, if a nursing home resident falls near a bookshelf, the PFH will consider whether the patient was reaching for a book when she fell. For falls that occur in a patient’s room, the PFH will consider whether objects in the room were within easy reach for the patient, or whether they were somewhere that required the patient to get up from the bed and walk.
The PFH will also investigate staffing, which can be of special importance in considering whether a nursing home is negligent. For example, the PFH may answer questions such as whether the fall occurred during a shift change, or during a time when employees were out sick, and thus, the home was understaffed.
Every other consideration will be evaluated. For example, the PFH will ask whether the person fell doing something he or she had done without incident in the past, and if so, why this event was different. Medications—particularly ones the patient just began taking—will be evaluated, to see whether they may have side effects that made the patient prone to falling.
Families that are scoping out potential nursing homes for loved ones should ask about the home’s use of anti-fall technology. For example, many homes are equipped with bed or chair alarm systems, that will notify staff automatically if a patient gets up or leaves on his or her own.
Mats that are placed bedside also are available, which alert staff when they sense someone’s feet being placed on them. Of course, standard bed rails or safety bumpers should be used at all times to avoid even the accidental fall out of bed.
Families should also be sure to ask prospective nursing homes about staffing, which is probably the best way to avoid falls. Making sure that the staff to resident ratio is reasonable, and that patients are properly supervised is vital. In many instances, residents who cannot get staff’s attention to help them get up to use the bathroom or get a drink, resort to trying to do it themselves, leading to falls that could have been avoided with proper attention.
If you or a loved one have been injured in a nursing home, make sure your attorneys know how to conduct a proper investigation into how the accident occurred. Contact Brill & Rinaldi today for a free consultation to discuss your nursing home injury case.