Nursing Home Falls & Fractures

Nursing Home Falls & FracturesInjuries from falls account for roughly 36 percent of potentially preventable visits to the hospital emergency room by nursing home patients. According to the U.S. Centers for Disease Control and Prevention (CDC), nursing home falls frequently go unreported. Despite the lack of accurate nursing home fall data, the CDC still receives between 100 and 200 reports of nursing home falls each year from average-sized nursing homes. A nursing home of average size, as defined by the CDC, has approximately 100 beds for elder residents.

Nursing home falls frequently cause a disability, functional decline, reduced independence, and reduced quality of life for an elderly person. Patients with a fear of nursing home falls may also experience feelings of helplessness, loss of function, depression, anxiety, and social isolation. It is important to take precautions, both in and out of a nursing home facility, to prevent elderly falls, fractures, and injury.

Nursing Home Fall Statistics

The problem with nursing home falls is severe, as cited by the CDC:

–      In 2003, the CDC estimated 1.5 million adults over the age of 65 were living in nursing homes. At this rate, there will be roughly 3 million nursing home patients by 2030.

–      Regular use of restraints is not proven to lower a patient’s nursing home fall risks.

–      Between 16 percent and 27 percent of nursing home falls occur due to environmental hazards, such as inadequate lighting or slippery floors within the nursing home.

–      Between 50 percent and 75 percent of elder patients suffer from a nursing home fall each year. This rate is twice as large as the rate of falls which occur for elders living in the community.

–      The CDC estimates that roughly 5 percent of elders, age 65 and older, are nursing home residents. However, nursing home patients make up about 20 percent of deaths as a result of an elderly fall.

–      Nursing home patients typically fall multiple times each year. The CDC averages this statistic at 2.6 falls per nursing home patient, per year.

–      Roughly 35 percent of elderly fall injuries happen to nursing home patients who cannot walk.

–      Between 10 percent and 20 percent of nursing home falls result in serious injury for the elder patient.

–      Between 2 percent and 6 percent of nursing home falls cause elderly fractures.

–      Approximately 1,800 elderly patients die each year as a result of nursing home falls.

Why do Falls Happen Most Often in Nursing Homes?

The CDC reports that falls occur more frequently among nursing home patients than elderly citizens living in the community. This may be partially due to the fact that nursing home patients typically have extenuating medical conditions, which forced them to move into the nursing facility prior to the fall. Nursing home patients may be older or less mobile than elderly persons living in the community. Residents of nursing homes may also experience severe problems with cognitive ability, chronic diseases, and an inability to perform daily tasks.

Causes of Nursing Home Falls

Nursing home falls may be caused by one, or a combination of, the following reasons:

–      Muscle weakness in the elderly patient

–      Walking or gait problems

–      Environmental hazards within the nursing home, such as poor lighting, wet floors, incorrect bed height, or inadequate wheelchair size and maintenance

–      Certain types of common nursing home medications, such as anti-anxiety or sedative medications

–      Changes in medication types or doses

–      Attempts to move from one place to another within the nursing home patient’s room, without assistance from nursing facility staff

–      Improper elder foot care

–      Using shoes that do not fit correctly

–      Improper use, or inadequate maintenance, of walking aids

Sleep Medication and Elderly Fractures

In May 2013, the U.S. National Library of Medicine reported a study that connected the use of nonbenzodiazepine sleep medications with nursing home falls and fractures. The study focused on nonbenzodiazepine hypnotic drugs, such as eszopiclone, zolpidem tartrate, and zaleplon that may be used to help nursing home patients sleep. The study concluded that elderly patients taking nonbenzodiazepine sleep medications were at an increased risk of nursing home falls. This nursing home patient risk was most significant for those who were taking the drug for the first time or suffered from cognitive difficulties.

Nursing Home Falls from Negligence

Research suggests that many nursing home falls are preventable with the proper fall prevention programs in place. Nursing homes must take the time to assess new patients for falling risks and potential modifications to enable safer mobility of that patient. The nursing home staff must maintain a high degree of education on nursing home fall prevention. The staff should also be aware of any nursing home patients that have a particularly high risk for falling. Any necessary mobility devices should be easily used and well-maintained.

Environmental hazards that cause nursing home falls present a pronounced risk for patients. Nursing home negligence may result in dim lighting, making it hard for patients to see well enough to walk. Wet or slippery floors in nursing homes are extremely unsafe, as elderly patients frequently have preexisting mobility and balance problems. Items such as beds, chairs, or mobility devices must be easily accessible for the patient. Bathrooms should provide seats, handles along the walls, and no-slip flooring when possible. Failure to supply a safe environment for patients is grounds for a nursing home negligence lawsuit.



Berry, S., Y. Lee, S. Cai, and D. Dore. United States. National Library of Medicine. Nonbenzodiazepine sleep medication use and hip fractures in nursing home residents. PubMed Health, 2013. Web.

Girman, C., J. Chandler, S. Zimmerman, A. Martin, W. Hawkes, J. Hebel, P. Sloane, and J. Magaziner. United States. National Library of Medicine. Prediction of fracture in nursing home residents. PubMed Health, 2002. Web.

United States. Centers for Disease Control and Prevention. Falls in Nursing Homes. Centers for Disease Control and Prevention, 2012. Web.

Vu, M., N. Weintraub, and L. Rubentstein. United States. National Library of Medicine. Falls in the nursing home: are they preventable?. PubMed Health, 2004. Web.