Falls can have terrible consequences for aging individuals and occur all too frequently at nursing homes. Providers should have this assessment performed after nursing home falls.
Reasons for scrutiny
A medical evaluation is necessary. An older person may be weakened, dehydrated, or have a serious urinary tract infection or similar conditions that caused the fall. Older adults face a higher risk of falling again.
Studies also show that seniors usually do not receive recommended medical care after a fall. These post-fall visits generally concentrate on injury treatment instead of addressing conditions that cause falls.
Post-fall assessment
Doctors should conduct an assessment for underlying new illnesses. Falls occur when the person had generalized weakness, delirium, or other signs of being unwell. Other causes include urinary tract infections, dehydration, anemia which can be caused by bleeding in the bowel and other problems, pneumonia, atrial fibrillation and other heart problems, strokes and mini strokes that cause weakness on one side.
Blood pressure readings when sitting and standing are important, especially if there was light-headedness or fainting. Doctor should confirm whether there was a drop in blood pressure if the older person was taking blood pressure medication.
An older person’s blood count and conditions like too high or low sodium can worsen their fall. A complete blood cell count, check of electrolytes and metabolic panel are recommended. A blood sugar log or glucometer should be used if they have diabetes or take insulin.
Other tests include a gait and balance assessment. Vitamin D levels should be assessed because low level may cause falls and contribute to fragile bones.
A chronic problem with the heart or blood pressure systems, such as paroxysmal rapid atrial fibrillation, cause a minority of falls. Fall victims may have also developed a new chronic condition such as Parkinson’s disease. This should be evaluated if falls or near falls reoccur.
Medications
Some medications may increase the risk of falls. Doctors should review whether the person is taking sedatives, tranquilizers, or sleep medications. These include Ambien for sleep, Ativan for anxiety, and risperidone or quetiapine for restless dementia behaviors.
Blood pressure and diabetes medications should be evaluated because the older person may be taking medications at levels that cause lower blood pressure or blood sugar. Practitioners should also review any opiate pain medications.
Older adults also take anticholinergic medications that can reduce balance and thinking. These include medications for allergies, overactive bladder and vertigo and antidepressants which are used for pain treatment.
Nursing homes have the duty to prevent falls and provide prompt assistance afterwards. Attorneys can seek compensation if these facilities do not meet this standard of care.
