Broken Bones

Broken Bones In The Nursing Home

In one instance, a resident living at the Regency Heights Nursing Home in Clearwater, Florida sustained a broken foot when a staff member closed a shower door on it. The nurse’s aide responsible for the incident was given a write-up as a warning and orders to become retrained.

Broken toes and feet, along with fractures of the hips and legs, put elderly patients at a greater risk of sustaining another fall in the future. A broken bone can also decrease the resident’s mobility and affect their overall quality of life, even after the fracture has healed.

Statistics Related To Falls and Fractures in the Nursing Home

  • Almost 90 percent of fractures among individuals aged 65 years or older are the result of a fall (1).
  • Recent research studies have indicated that one out of every 3 Americans older than 65 years will fall each year, and the odds of breaking a bone during the fall is extremely high.
  • Fractures are a common phenomenon among the elderly population, particularly in those who suffer from osteoporosis or decreased muscle and fat that would normally absorb the impact of the fall.

Common Sites of Broken Bones in the Nursing Home Population

The most common types of fractures seen in the elderly population include the following:

  • Hip fractures
  • Thigh fractures
  • Pelvic fractures
  • Fractures of the back or vertebrae
  • Arm fractures
  • Hand fractures
  • Ankle or leg fractures

The foot is not as common as an injury such as a hip fracture. So, when these types of fractures happen to nursing home patients, it is important to inquire about the cause of the fracture.

In some instances, it is the result of a simple accident in which the resident attempts to stand on his own without waiting for the aide, or the bone has already become weakened due to osteoporosis or another type of illness. In other situations, the fracture is due to negligence on the part of the nursing home staff member.

Risk Factors Involved With A Broken Foot

Loved ones living at a nursing home facility are at a greater risk of falling when compared to people of the same age who suffer a fall in the community (2). The risk of sustaining a fracture is greater if the resident has any of the following:

  • A history of falls and fractures in the past
  • A history of osteoporosis
  • A history of vertigo or dizziness
  • A history of fainting episodes
  • Have Parkinson’s disease, dementia or other diseases that may impact the individual’s decision-making skills and mental capacity
  • Having missing toes
  • Wearing a prosthetic device
  • Having problems getting up from a sitting position
  • Being fully or partially blind that prevents them from seeing hazards that can cause them to trip
  • Being 75 years of age or older

Various Causes of a Broken Foot in a Nursing Home Resident

Elderly citizens of a nursing home facility are at a greater risk for falls when compared to senior citizens who consider themselves to be able-bodied. This is largely because of the care they receive in the nursing home that otherwise keeps them alive. Some of the most common causes of a broken foot and other fractures in a nursing home setting include:

  • Lifting the patient into or out of the bed in an improper way
  • Failing to give the resident devices to help them to stand or move into a wheelchair
  • Failing to put the patient’s feet in their chair holds securely so that they are off the ground and nowhere near the wheels of the wheelchair
  • Missing or ignoring the diagnosis of certain bone diseases, including osteoporosis or osteosarcoma
  • Wearing the wrong kind of footwear for the activities planned for the day
  • Keeping too much clutter in the resident’s room or having heavy and large objects to be stored in a high or in a precarious position

Should You be Worried About a Broken Bone?

If your family member suffers from a broken bone, you need to find out how it happened and if any nurse’s aides or nurses were present at the time of the fracture. If the resident was alone, inquire further about why a member of the nursing staff was’t present (3).

You should also obtain a detailed medical report from the nursing facility and the nursing home or hospital in which the nursing home resident was treated.

If there seems to be suspicious details around the injury, you may need to seek the advice of an attorney.  If the stories of the staff members and the resident do not match, or the stories are different between the nursing home and the emergency department, this may be reason for concern.

You should ask your elderly family member what happened when the bone was broken if they are able to coherently communicate the incident to you. If there were witnesses present that are considered to be reliable, make sure that they are interviewed privately, sometimes by a lawyer.

In an ideal situation, falls and fractures should not exist in the nursing home. Nursing home staff members should be present the entire time around high-risk residents while they are standing or performing activities that require bodily movement. Nursing home staff should always be available for residents who wish to get up from the bed or from a chair.

References:

  1. American Family Physician, “Falls in the Elderly.” http://www.aafp.org/afp/2000/0401/p2159.html. Accessed 3/18/16.
  2. Connecticut Health I-Team, “Medication Errors, Falls Result in Nursing Home Fines.” http://c-hit.org/2015/03/23/medication-errors-falls-result-in-nursing-home-fines/. Accessed 3/18/16.
  3. MedicineNet, “Falls and Fractures in Seniors.” http://www.medicinenet.com/script/main/art.asp?articlekey=7774. Accessed 3/18/16.
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Dr. Christine Traxler

Christine Traxler, MD is a retired family practice physician, graduate of the University of Minnesota School of Medicine in 1986, and freelance writer, having worked with patients in rural Minnesota for two decades. She has written several books on medical topics and currently resides in Minneapolis, MN, where she works as a freelance writer on medical topics.

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