January 08, 2014
Falls are one of the most common and dangerous incidents in nursing homes. According to the Agency for Healthcare Research and Quality, about half of all nursing home residents fall each year, with many experiencing multiple falls. For older adults, even a single fall can lead to serious injuries and even fatalities.
While some risk factors are related to aging and medical conditions, many nursing home falls are preventable. Proper supervision, individualized care planning, and a safe environment all play a critical role in reducing risk.
If the facility your loved one is in failed to prevent a devastating fall, Chicago nursing home abuse lawyers can go over your family’s legal rights and help you plan next steps.
Why Nursing Home Residents Are at High Risk for Falls
Nursing home residents face a higher risk of falling due to a combination of health conditions, medications, and environmental factors. Understanding these risks helps explain why fall prevention requires more than just general supervision—it requires consistent, individualized care.
Many residents experience muscle weakness, balance issues, and reduced mobility as part of the aging process. Chronic conditions such as Parkinson’s disease, stroke, arthritis, and diabetes can further affect coordination and stability. In addition, cognitive impairments like dementia may cause confusion, wandering, or poor judgment, increasing the likelihood of a fall.
Medications also play a significant role. Certain medications—especially sedatives, sleep aids, and blood pressure drugs—can increase fall risk by causing dizziness or confusion. When multiple medications are used together, these effects can be amplified, making ongoing monitoring essential.
Beyond medical factors, the nursing home environment itself matters. Poor lighting, cluttered walkways, improper bed height, and lack of assistive devices can all contribute to unsafe conditions. Just as importantly, staffing levels and attentiveness directly impact whether residents receive the help they need with walking, transfers, or getting to the bathroom safely.
Because these risks are often known in advance, nursing homes are expected to take proactive steps to reduce them. When those steps aren’t taken, the chances of a preventable fall increase significantly.
What Nursing Homes Should Do to Prevent Falls
Effective fall prevention starts with recognizing that every resident has different needs. Nursing homes are expected to take proactive, individualized steps to reduce risk, not simply respond after a fall occurs.
One of the most important steps is conducting a fall risk assessment when a resident is admitted and updating it regularly. Many facilities use standardized tools to evaluate factors like mobility, prior falls, and medication use. These assessments should directly guide the resident’s care plan and daily supervision.
From there, prevention depends on consistent follow-through. Many falls happen during routine activities—such as getting out of bed, using the bathroom, or transferring to a wheelchair—when residents need assistance but don’t receive it in time. Ensuring that staff are available and attentive during these moments is critical.
Medication management also plays an important role. Certain drugs, especially sedatives or blood pressure medications, can increase the risk of falls by causing dizziness or confusion. Ongoing monitoring and coordination with physicians can help reduce these effects.
The physical environment should also support resident safety. This includes:
- Adequate lighting, especially at night
- Clear walkways free of clutter
- Proper bed height and easy access to call buttons
Some nursing homes also use tools like bed or chair alarms to alert staff when a resident tries to stand without assistance. While these can be helpful, they are most effective when used alongside attentive care, not as a replacement for it.
When all of these elements work together, the risk of falls can be significantly reduced. When they break down, preventable injuries become much more likely.
Common Failures That Lead to Preventable Falls
Falls still happen when nursing homes fail to follow basic safety practices. A 2025 report from the Office of Inspector General (OIG) found that nursing home residents enrolled in Medicare suffered 42,864 falls over a one-year period. That said, this number may not be entirely accurate because nursing homes do not report every fall: another OIG report found that, nationwide, nursing homes failed to report 43 percent of major falls that resulted in injury and hospitalization.
In many cases, these incidents are not unavoidable, they result from breakdowns in care.
Inadequate Staffing and Supervision
Residents who need assistance are sometimes left waiting too long for help, especially during busy shifts or overnight hours. Falls often occur when a resident tries to move on their own because no one is available to assist them in time.
Ignoring Known Fall Risks
When a resident is identified as high-risk, that information should guide their care. Falls can happen when staff fail to follow care plans, overlook prior incidents, or don’t take necessary precautions despite clear warning signs.
Unsafe Transfers and Mobility Assistance
Helping residents move safely requires proper technique and attention. Falls frequently occur during transfers when staff are rushed, untrained, or not using the appropriate equipment.
Delayed Response to Call Lights
Many residents use call buttons to request help with basic needs. When those calls go unanswered or are delayed, residents may attempt to get up on their own, significantly increasing the risk of a fall.
Failure to Update Care Plans
A resident’s condition can change quickly. After a fall, illness, or medication change, the care plan should be reassessed. This includes identifying the cause of the fall and making adjustments to prevent it from happening again. When facilities fail to take these steps, the same risks remain—and additional falls can follow.
What Families Can Do to Protect Loved Ones in Nursing Homes
While facilities are responsible for providing safe care, family members often play an important role in identifying concerns and asking the right questions.
One of the most effective things you can do is stay informed about your loved one’s fall risk and care plan. Don’t hesitate to ask staff how risk is being assessed and what specific precautions are in place.
Some helpful questions to ask include:
- Has my loved one been identified as a fall risk?
- What assistance do they receive with walking or transfers?
- How often is their care plan reviewed or updated?
- Are any medications increasing their risk of falling?
It’s also important to pay attention during visits. Changes in mobility, confusion, or the condition of the room—such as clutter, poor lighting, or hard-to-reach call buttons—can all signal increased risk.
What to Do After a Fall
If your loved one falls, you have the right to clear answers about what happened and what will change moving forward. You may want to ask:
- How did the fall occur?
- Were staff present or notified right away?
- What injuries were identified and treated?
- What changes are being made to prevent another fall?
A fall should always trigger a reassessment of the resident’s condition and care plan. If it doesn’t, or if answers are unclear, that may be a sign that proper procedures are not being followed.
Staying engaged and asking questions can help ensure your loved one receives the attention and protection they deserve.
When Falls May Be a Sign of Neglect
Families in Evanston and the greater Chicago area have the right to expect that their loved ones are protected and cared for with attention and dignity. When that doesn’t happen, it may be a sign of a larger problem within the facility.
If your loved one was injured in a fall and you have concerns about the care they received, it may be worth speaking with an Evanston nursing home fall attorney. Robert J. Rooth has decades of experience holding negligent nursing homes accountable and helping families pursue answers and justice. Call the Rooth Law Firm now to get started with a free consultation.
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