How Assisted Living Facilities Prevent Falls
Are falls in assisted living really unavoidable? Many falls are caused by poor assessments, unsafe environments, and missed warning signs. With the right steps, most falls can be prevented. In this week’s episode, nursing home abuse lawyer Rob Schenk welcomes guest Cassy Plaisir to talk about effective fall prevention strategies in assisted living facilities.
Plaisir:
So it’s more of an education, one-to-one talk when you bring them in a facility from all different disciplines, different scenarios and areas where you can treat your loved one. Assisted living. It’s more of the administrator, if they have director of nursing, if they have a case manager, if they have, maintenance person there, talking to ’em all together.
Intro
Schenk:
Hey out there. Welcome back to the Nursing Home Abuse podcast. My name is Rob. I’ll be your host for this episode. We are talking today about, fall prevention and assisted living facilities. I think it’s a little bit different than in skilled nursing and nursing homes. And so we’re gonna have a really great conversation about this topic with the fantastic Cassandra Plaisir.
We’re talking about falls and fall prevention and assisted living, and we have Cassandra Plaisir as our guest to walk us through it.
Cassandra is a healthcare professional with over 12 years of nursing experience specializing in geriatric care across various settings. A graduate of Florida a and m University. She has served as a wellness director and regional clinical specialist for assisted living communities. Cassandra is a certified LF core trainer and CPR First Aid instructor.
Committed to staff education and quality care. Her leadership and passion for elderly advocacy make her a respected voice in long-term care, and we’re so happy to have her on the show. Cassandra, welcome to the program.
For assisted living regulatory consulting and compliance guidance, visit ALF Consultant.
Plaisir:
Thank you for having me.
What are the most common causes of falls in assisted living?
Schenk:
So I guess the first thing would be how are the falls in the assisted living facility happening? What are the common causes for those?
Plaisir:
So a lot of people who move into assisted living, they already have falls at home. So the families bring them into assisted living to say, okay, maybe assisted living design, because it’s smaller rooms, smaller space to prevent fall prevention. It’s hard for residents.
Fall. So it’s a lot of reasons that go into falling even down to when they set up the room, how they set it up, a trip hazard of little things that can make them slip in fall as well in the community they’re in.
Assisted living compliance challenges are discussed on the impact of preventive health measures in elderly populations affecting resident safety.
Schenk:
I see. So I guess at least if it’s an individual’s first admission to an assisting facility, it’s like a new environment and that in itself could be a potential hazard ’cause they’re not used to it.
Plaisir:
Correct. It’s like they say, hospitals where you’re here, when you go to a hospital, you have this disorientation syndrome. It’s the same thing when you’re moving to a LF. It’s a new environment. You have to get acclimated. So that’s usually the first night for some residents to move into a facility.
Facility. They fall that night. Because you take them out of a room that’s very spacious and you put them in a little smaller one where they keep the same bed, the same rug, and they’re trying to get acclimated, as you were saying, and they trip the first day, the first night, they’re in the ALF.
Earlier findings remain relevant on the impact of preventive health measures in elderly populations when evaluating long-term care oversight.
Schenk:
Let’s say that we have a new admit to an assisted living facility and we have assessed that resident, the new resident as a high risk for fall.
How do assisted living facilities typically prevent falls?
Schenk:
What are some of the interventions that you’re going to be able to put into place for that particular resident at an assisted living facility?
Plaisir:
What the family brings in. So I could take an example. The rugs that I keep mentioning, I’ll tell families, bring non-slip rugs or just the rugs at all, or their bed.
The height of the bed, the size of the bed makes it. I give them as much ample. Space where they can move. If they have ablations, they can use their rolling walker or their wheelchair. So more space to make able to move around. Now with the physician’s order, you can also has position for them in the bed by the bed to help.
Recent analysis highlights regulatory gaps on the impact of preventive health measures in elderly populations in residential care settings.
Those are things that I see when they move in that I can say, okay, there are fall risks. Let’s implement. Especially at nighttime, night lights, anything that makes the room brighter, because sometimes they’re able to turn the light off because they have to walk to turn the light off. So you wanna make sure it’s nice, safe, spacious, clutter free.
Because that’s another thing when they move in, they bring everything from their home. So you wanna say, remain clutter free. Keep it where it’s bright for them even to have a pathway if they have to go to the restroom, lay down, sit in the area, if there is a living room, accommodations and so forth.
Injury prevention strategies are evaluated on the impact of preventive health measures in elderly populations across assisted living and nursing homes.
Are certain residents more at risk of falling than others?
Schenk:
What role, if any, does the continence level of the resident play with respect to the likelihood of falls?
Plaisir:
For the continence level, what happens is if they’re incontinent, they have to make sure that the staff there is coming to them, depending how much voiding they’re going to the restroom. So let’s say someone is.
Taking a diuretic. A diuretic is a medication that makes them use a bathroom more because it releases the fluid retention. So that person will need more assistance going in the room, transferring, changing them, making sure they have enough supplies, incontinent supplies to make sure they don’t have that urge to get up and that’s where they fall.
Or you can have a commode because some people wear pull-ups or briefs, they have a bedside commode that you can put that is in with reach that they can walk to and sit. Safely and this, prevents fall precautions as well.
This article examines care transitions and risk exposure on the impact of preventive health measures in elderly populations for vulnerable residents.
What role does staff training play in fall prevention?
Schenk:
Speaking of staff assistance, what are some of the roles, I guess is a better word, what role does staff play in the prevention of falls in assisted living?
Plaisir:
It’s the same thing when staff come in. When staff meet the resident, they know everything about the resident. So for example, we’ll say this person’s a fall precaution. They’ll go in their room, they’ll do extra checks, because the standard supervision where you have to know the whereabouts and check the residents at all times.
So they’ll get in the room and they’ll look at these areas and they’ll come to the administration and say, Hey, we recognize there’s some things that are hazardous that can cause this resident to potentially have more falls. This person’s incontinent. I’m taking them to the bathroom, I’m taking them to the restroom every hour.
Operators and families can review expectations in our facility guide to meeting Georgia assisted living regulations.
I’m changing them on a frequent basis. So their role is more than just hands-on. They’re observers, they’re reporters, so we can keep that person safe and make sure the falls are decreased when they move into an assisted living facility.
If abuse is suspected, this article explains what happens after you report nursing home abuse.
What about the “right to fall” or the right to be independent?
Schenk:
I feel like just by the very definition of assisted living that there is a tendency to be less aggressive with fall risk interventions as opposed to a nursing home where they get into the nitty gritty of, rounding, toileting programs sensors, like mats, these types of things.
Do you see what I’m saying? Is that an accurate statement?
Plaisir:
Absolutely, because skilled nursing, as we know, is more of an institutionalized environment where assisted living facility, the basis of is to make it homelike, to make it like it’s their home. So families take that and they put everything there, because they wanna, they’re emptying out their loved ones apart and they’re starting fresh doing a facility so they can continue.
So I believe it is lax because of that, because of the perception of how a LF should be.
Families facing fatal neglect may have options under Georgia law, as outlined on our page about wrongful death in nursing home cases.
How can families help reduce fall risks for their loved ones?
Schenk:
So how can a family, what advice would you have for a family that has moved a loved one into an assisted living facility for the first time? Maybe they’re, they are worried about their loved one falling.
Plaisir:
So there’s a couple things. It’s not just only the things they bring into, it’s the body mechanics. So for example, someone has Parkinson’s disease. You have to say, are you getting therapy for them? Are you reviewing their medications? Because they’re a fall risk at home doesn’t mean they will not be a fall risk in the ALF.
Learn how and where to file complaints by reading where to report nursing home abuse in Georgia.
So I tell ’em to make sure that they always have therapy, they can continue therapy in a ls. When they come in, stuff even down to wearing the appropriate shoes because you have residents where families bring them. Sandals that are not non-slip or high heels. Residents still wear it as well. And you have to say, in this environment they do a lot of walking and sometimes it could be a trip hazardous coming out of the room.
So accommodate their clothing as well to look at that, know their medication, keep up with doctor’s appointments, keep up with home health, third party services, and et cetera.
Residents in Cobb County can seek help from a Smyrna nursing home abuse lawyer
Schenk:
I think that’s a through line in the episode to this of this show is that typically the more family involvement there is and the more the family is educated on the baseline of their loved one.
What’s in the care plan, these types of things. There’s a tendency that the resident is safer.
Plaisir:
Absolutely. And the thing sometimes with the care plans, that’s why in skilled nursing, you’re sitting, you’re having that social worker, you have the care planning with all disciplines where when they’re moving in to an assisted living, you have the marker that gives ’em the tour that lets them know the lay of the land.
And then the care plan comes into a point where you are moving them in and someone’s the advocate for them, like a director of nursing or the administrator to say, we will institute these things. Make sure the room is. Safe for your loved one. Make sure you’re bringing the appropriate things that are needed for your loved one.
Key staffing and assessment indicators are discussed in Key MDS Data to Identify Fall Risk in Nursing Homes.
Because this is a new environment and the first thing that can happen is the possible fall within the first 24, 48 hours. So it’s something that you have to really sit and educate the families. When you do the. Policies, the contracts or anything, house rules. You discuss the assistive devices, if they have any.
Make sure they’re in good condition. Make sure of all that’s known, because a lot of families are not educated, especially people who have loved ones locally and they live far away. They’re just. Coming to really move them in. So it’s more of an education, one-to-one talk. When you bring them to a facility as a skilled nurse where they’re sitting and you have a care plan with all the disciplines saying, Hey, from any, from all different disciplines, different scenarios and areas where you can treat your loved one.
Assisted living is more of the administrator. If they have a director of nursing, if they have a case manager, if they have, maintenance person that’s talking to them all together.
Liability issues are explored in Episode 42: How Nursing Homes Can Be Liable for Injuries from Falls.
Schenk:
It’s interesting that I hear you say that a lot of falls happen within the first 48 hours. I feel if the onus is on the facility to try to get ahead of that, if we know that is a higher likelihood, what are we doing to prevent it then? Is it, typically, more monitoring in the first couple of days or?
Plaisir:
I’ve had instances where that happened. If I know some residents coming to my facility when I was a former director of nursing and I saw they had fall precautions, I would tell the family, maybe you can have a private duty aid the first night to be around them so we can get used to their patterns.
’cause everybody, every individual is different. When you move in the first 48, you can have someone who doesn’t sleep at night. That takes naps and is more active and if the staff is not used to the facility. They wander and fall because they’re not used to, so it’s basically you welcoming them.
Families comparing care options can listen to Episode 210: Assisted Living Facilities – Understanding Long-Term Care Options.
You make suggestions, you have a system. So those are a way because it’s hard to take each and every individual that comes in and take a snapshot because there’s someone that can never fall, has never fallen, emulates with no assistive device, walks into the facility, falls within 24 hours and has a hip fracture, and the family says.
Where did I go wrong? I brought them here to make sure they’re safe again. Anyone who changes orientation changes. Sometimes body mechanics change. Sometimes it’s just something that’s unavoidable, unfortunately.
Day-to-day care failures are examined in Activities of Daily Living Assistance in Nursing Homes.
Schenk:
Yeah, I guess as long as the appropriate assessment is there, it’s timely. The interventions are in place based on the assessment, and you revise the assessment as you go along. Like you can’t prevent every single fall. It’s impossible.
Plaisir:
No, you can’t prevent it. And that’s something families miss where again, they say my loved one fell at home five times. I’m bringing them to your assisted living facility and now you’re calling to tell me that they’re falling again.
Schenk:
Yeah.
Plaisir:
There’s nothing you can do. There really isn’t. You just keep them safe. Like you said, keep revision with the care plan. Notify the PCP of the Cree Falls, have home health therapy come in. You do the best you can to keep that resident safe.
Legal distinctions are explained in What Makes Assisted Living Facility Cases Different.
Schenk:
Very well said. Cassandra, thank you so much for coming on the show and sharing your knowledge with us today.
Plaisir:
Thank you for having me.
Schenk:
Folks, I hope that you found this episode educational, perhaps entertaining. If you have an idea for something that you would like for me to talk about that’s long-term care related, let me know. If you have an idea for a guest that you’d like for me to talk to, please let me know that as well.
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Cassy Plaisir’s Contact Information: