Broken Necks in Nursing Homes Explained
Falls are the leading cause of a spinal column injury in the elderly. As with many injuries, the older a resident is, the more likely they are to suffer from a broken neck. Chronic conditions like Parkinson’s disease can also factor into falls. The severity of the injury can lead to high death rates.
There are many factors that could lead to a broken neck suffered in a nursing home. Elderly residents who are predisposed (more likely) to suffer a broken neck include those with osteoporosis, osteopenia and risk factors that include sensory issues from the medication. Chronic conditions in the elderly like diabetes, osteoarthritis and decreased stability can also be risk factors that lead to an increased likelihood of falling.
Death rates within the first 3 months to 1 year following a neck injury can range from 10-57% depending on the age of the person.
Type of Broken Neck Injuries
Broken necks, or upper cervical injuries, are the most common location of fractures in the elderly population.
There are 3 types of injury that are most common in relation to a broken neck:
- Central Cord Syndrome (CCS) — A disorder of the spinal cord due to hyperextension of the neck.
- Cervical Extension/Distraction Injuries — An injury that occurs in the elderly as a result of a decreased range of motion, which increases the chance of falls.
- Odontoid Fractures — When an elderly resident falls and hits their head.
Several studies have found a risk of acute (in-hospital) mortality of greater than 20% for elderly patients with isolated cervical spine fractures.
Effects of Broken Necks
When a resident suffers a broken neck, there are several potential health complications that result from the injury. Residents experience some of these effects immediately (short-term) and many effects are chronic (long-term). A broken neck doesn’t just affect a resident’s physical health—the injury can compromise their emotional and mental health as well.
Short-Term Effects of Broken Neck Injuries
Short-term problems related to a broken neck include respiratory complications and cardiovascular complications (lungs and heart). After doctors diagnose a broken neck, they make sure to establish and ensure adequate airway, oxygenation and ventilation. This can prevent secondary injuries that often increase the mortality rate.
The primary cardiovascular complication is hypotension (abnormally low blood pressure) due to neurological shock from the broken neck or cervical injury. Other short-term problems that may result from a broken neck include bowel function issues, muscle atrophy, pressure ulcers and a variety of issues regarding gastrointestinal (stomach and intestines) function.
Long-Term Effects of Broken Neck Injuries
Even after a patient has recovered from a broken neck, they may still experience health complications stemming from the injury.
Some of the long-term problems related to a broken neck include:
- Bladder dysfunction
- Gastrointestinal dysfunction
- Autonomic dysreflexia (dangerously high blood pressure occurring in people with spinal cord injuries)
It’s critical for patients who suffer from a broken neck to be monitored for regularity in bladder and bowel function. Many elderly residents already suffer from constipation and other functional issues so proper medication and observation are a must. High blood pressure (autonomic dysreflexia or AD) can mean the body is in distress so it is important to fully evaluate a patient with this symptom.
Depression can also result from a broken neck. The treatment for a cervical spine injury could be surgery or immobilization for a period of time to allow healing. This can lead to a lack of participation in normal events and exercise. Death is also an unfortunate side effect of broken necks in the nursing home. The death rate of residents suffering from a broken neck increases with age.
Nursing Home Abuse and Broken Necks
Nursing homes and staff often argue that falls are ‘unpreventable’ in the elderly. Despite this attempt to excuse neglect, there are many ways to prevent falls in elderly residents living in nursing homes. Minimizing the use of medications that alter blood pressure, decluttering the floor, encouraging residents to use assistive devices like walkers and providing adequate staff are all ways to decrease the risk of falling in the nursing home.
When nursing home staff do not take these precautions it can result in a fall and broken neck. Such was the case with a 91-year-old nursing home resident in Minnesota. The patient was at high risk of falling due to memory loss and advanced osteoporosis. The investigation showed that even though nobody was present during the fall, the nursing home was still responsible for not being proactive in preventing the fall that caused the resident’s eventual death.
If a loved one has suffered from a broken neck in a nursing home there is legal help available. Please complete our free case evaluation to determine if you have a case.