Nursing homes, also known as long-term care facilities, are designed to provide care and assistance to elderly individuals and people with disabilities. While these establishments aim to maintain a safe and nurturing environment, injuries can and do occur due to various reasons, such as understaffing, inadequate training, and even neglect or abuse.
Falls are the leading cause of injuries in nursing homes, accounting for a significant number of emergency room visits and hospitalisations. The Centers for Disease Control and Prevention (CDC) estimates that an average nursing home with 100 residents experiences between 100 and 200 falls annually. Factors contributing to falls include environmental hazards, such as wet floors, poor lighting, and clutter; medication side effects, such as dizziness or drowsiness; and physical limitations of the residents, like muscle weakness, balance issues, and cognitive impairments. Common injuries resulting from falls are fractures (especially hip fractures), head injuries, and soft tissue injuries, such as bruises, sprains, and strains.
To minimize the risk of falls, nursing homes should implement comprehensive fall prevention programs, including staff training, regular assessment of residents’ fall risk, environmental modifications, and use of assistive devices, such as walkers and grab bars.
2. Pressure ulcers or bedsores
Pressure ulcers, also known as bedsores, are skin and tissue injuries caused by prolonged pressure on the skin. They typically occur in areas with bony prominences, such as the tailbone, hips, and heels. Bedridden or immobile residents are at the highest risk of developing these ulcers. Pressure ulcers can range from mild redness (stage 1) to severe infections involving muscle and bone (stage 4). Left untreated, pressure ulcers can lead to life-threatening complications, such as sepsis and osteomyelitis.
Pressure ulcers can be prevented through regular repositioning of residents, the use of pressure-relieving devices (e.g., special mattresses and cushions), proper skin care, and adequate nutrition and hydration to promote skin health. However, if your loved one has suffered from pressure ulcers due to the negligence of the nursing home staff, you should consider a nursing home bed sore lawyer so that they receive the compensation they are owed.
Infections are a common occurrence in nursing homes due to the proximity of residents, the presence of individuals with weakened immune systems, and the use of invasive devices such as catheters or feeding tubes. Urinary tract infections, respiratory infections (e.g., pneumonia and influenza), and skin infections (e.g., cellulitis and fungal infections) are some of the most prevalent infections encountered in nursing homes.
Proper hygiene practices, such as handwashing and use of personal protective equipment; infection control measures, like isolation of contagious residents and regular cleaning of shared spaces; and timely medical intervention, including appropriate use of antibiotics, are crucial in preventing and managing infections in nursing homes.
4. Medication errors
Medication errors are common in nursing homes and can lead to serious consequences. These errors can include incorrect dosages, administration of the wrong medication, or failure to administer medication at the appropriate time. The consequences of medication errors range from mild adverse effects, like drowsiness or gastrointestinal issues, to severe complications and even death. Elderly residents are particularly vulnerable to medication errors due to their complex medication regimens and increased sensitivity to drug side effects.
Proper staff training, implementation of medication management systems (e.g., electronic medication administration records), and vigilance in monitoring residents’ health and medication adherence can help minimise medication errors in nursing homes.
5. Dehydration and malnutrition
Dehydration and malnutrition are common yet often overlooked issues in nursing homes. Residents may not receive adequate nutrition and hydration due to staff neglect, inadequate dietary supervision, or medical conditions that affect their ability to eat and drink, such as dysphagia, dental problems, or dementia. Dehydration and malnutrition can lead to various complications, such as weakened immune systems, increased susceptibility to infections, muscle wasting, and declining cognitive function.
To prevent dehydration and malnutrition, nursing homes should provide individualized meal plans that address residents’ dietary needs and preferences, offer assistance with feeding if needed, and closely monitor residents’ intake of food and fluids.
6. Physical and chemical restraints
The use of physical and chemical restraints in nursing homes is meant to protect residents from harming themselves or others. However, misuse or overuse of restraints can lead to injuries and emotional trauma. Physical restraints, such as bed rails and belts, can cause bruising, pressure ulcers, and restricted circulation. Chemical restraints, in the form of sedatives or antipsychotic medications, can lead to over-sedation, falls, and adverse drug interactions.
To minimize the risks associated with restraints, nursing homes should adopt a restraint-free philosophy, prioritize non-pharmacological interventions for managing behavioral issues, and ensure that restraints are used only as a last resort when necessary for the safety of the resident or others.
7. Choking and aspiration
Choking and aspiration injuries are common in nursing homes, particularly among residents with swallowing difficulties or cognitive impairments. Aspiration occurs when food, liquid, or other objects enter the airway instead of the esophagus, potentially leading to pneumonia or other respiratory complications. Choking can result in oxygen deprivation and, in severe cases, death.
Proper feeding techniques, such as offering soft or pureed foods and thickened liquids; individualised dietary plans, taking into account residents’ swallowing abilities; and close supervision during meals can help prevent choking and aspiration incidents.