IDPH has cited and fined Generations at Neighbors nursing home in Byron after a resident there suffered a broken leg in a fall.
One of the basic truisms regarding nursing home falls is that falls beget falls – meaning that once a nursing home resident experiences a fall, they tend to experience additional falls. One of the important tasks of the nursing home staff has after a resident fall (beyond dealing with any injury that may have resulted from the fall) is figuring out why the resident fell and adjusting the resident fall prevention care plan to account for the factors that contributed to cause the fall. For example, if the resident fell while getting to go up to the bathroom on their own, placing the resident on a toileting schedule so that they are brought to the bathroom at regular intervals may help reduce the risk of falling.
The resident at issue here had three prior falls before the one at issue. The resident had severe cognitive impairments and suffered from anxiety. Sh required the assist of one with transfers and ambulation. One of the “knowns” about her behavior was that she had a strong preference for a tidy room and t hat she would often get up to close drawers and adjust things in her room.
On the day of her injury, the staff was alerted by a visitor that the resident was on the ground. When the staff arrived in her room, they found her on the floor with a plastic hangar on top of her. She told the staff that there was a plastic hangar out of place and that she fell while going to hang it back up in the closet.
She was taken to the hospital where she was diagnosed as having suffered a fractured femur in between her artificial knee and artificial hip. Obviously with orthopaedic hardware already in place, the surgery to correct the broken leg will be complex. Further any type of extensive surgery will place her at risk for losing her ability to walk, placing her at increased risk for developing bed sores and other complications.
One of the basic fall prevention measures that should be a part of either the facility’s fall prevention policies and procedures or a resident’s fall prevention care plan is to anticipate the needs of the resident. In a case like this, where there is a resident who suffers from anxiety and cognitive impairments the staff should understand that they have limited ability to control their own behavior both in terms of making good decisions about their own safety and resisting their own impulsive behaviors. In this context, one the things that would go under the heading of anticipating the resident’s needs would be to make sure that the room is tidy before leaving her unattended because she will not be able to control her own desire to tidy things up. Unfortunately, that proved to be the case here and led to serious injury for this resident.
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