The elder abuse, nursing home case, involving a resident who falls is a common occurrence. When the fall results in an injury, and the injury is serious it may result in litigation by the resident against the nursing home. A common injury is a hip fracture. Oftentimes, hip fractures caused by falls to elderly residents in nursing homes result in complications, including death. The purpose of this short blog is to address the fall from the wheelchair scenario.
The typical( )fall occurs either from bed or from the wheelchair. The prevention of falls should be treated as a serious concern. But there is a large distance between the academic knowledge of the problem of falls by the elderly resident in the Nursing Home, and the actual practice on the floor by the aides, the Certified Nurse Assistants, and the nurses. This is compounded by the proof problems in the litigation: Although an elderly resident may be sitting in her wheelchair calling out for minutes to go to the bathroom, before trying to get out of her wheelchair and falling, how do you prove that?
In the majority of falls from the wheelchair the resident needs to go to the bathroom, or to get back to bed. So the first line of defense against falls from the wheelchair is to ensure that the resident is timely brought to the bathroom.
The following are the facts of a recent case: the nursing home is a restraint free environment. The aide comes on shift and is told by the nurse that the resident is not to be left unattended. The room of the resident is down the hall from the nurse’s station. The aide is going into another resident’s room to clean and bathe her. Privacy concerns lead her to close the door. She leaves the other resident, a high fall risk, in the hallway in her wheelchair. The aide later testify s that she left the elderly resident in her wheelchair in the hallway so that she could be visualized by others. While the aide is tending to the other resident with the door shut, the resident in the wheelchair may have asked for help. We will never know for sure. The aide testify s to being in the room with the other resident for 5 minutes. We will never know for sure, but of course, it was probably longer than that. The resident in the hallway stands up, falls, suffers a broken hip, and ultimately dies.
The nurse on duty that night is deposed. She testifys that there is a wall between the nursing station and the wing of the hallway the resident was left alone in her wheelchair. She could not visualize her. She heard some commotion, came around the nurses station and made it 45 feet towards the resident before the resident fell.
Could this fall have been prevented? Than answer is simple. A reasonably prudent person, the aide, would have simply wheeled the resident to the nursing station where the nurse is, and then gone to the other residents room to do her routine cleaning and bathing in bed. Her failure to do that reasonable step of bringing the elderly resident in the wheelchair to the nursing station was the cause of the hip fracture. Had the resident been at the nursing station the fall would not have happened, because 1) when the resident asked to go to the bathroom, the nurse at the nursing station would have simply assisted her to the bathroom: 2) The nurse would have simply told the resident to wait a second and sit down, coming around the nurses station to assist. 3) The likelihood that the resident would have fallen at the nursing station is remote, and had she fallen the fall would have been the nurses assisting her gently to the floor, and the fracture would not have occurred.
I am happy to hear what you think, either from the point of view of an aide, a nurse, a elderly resident, or a family member.
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