It is very common for nursing home residents to take several medications. While these medications are ordered by a physician and reviewed by a pharmacist, they may have the side effect of increasing the risk of falling for the nursing home resident.
There are several classes of medications which are well-known to increase the risk of falling:
- Antihistamines– Many of these medications are sedating and therefore increase nursing home fall risk
- Antiseizure/antiepileptics- Residents who take these medications are already at an increased risk for falling due to their epileptic condition, however, these medications can be sedating and can cause residents to feel dizzy, particularly when they are first started.
- Diuretics– Commonly known as “water pills,” these medications increase the frequency of urination. This means that residents may try to go the bathroom without needed assistance to avoid wetting themselves or may slip in urine after an episode of incontinence. Because they work to decrease the fluid a patient has within their system, they are also known to cause lightheadedness, dizziness, or loss of balance and can significantly increase a resident’s risk of a nursing home fall.
- Antihypertensives– Commonly known as blood pressure medication, these medications can be sedating and can also cause sharp drops in blood pressure after rising, which can produce dizziness and falls.
- Narcotics– Pain medications are often sedating which contributes to confusion and loss of balance, leading to nursing home falls.
- Benzodiazapines- Like the psychotropics, these medications, which are often given for anxiety, can have a sedating effect, and can cause impaired judgment and safety awareness.
- Hypoglemic agents- These are medications which are given to diabetics and can produce a drop in blood sugar which may cause the resident to be unsteady and fall.
- Psychotropics- These medications can cause dizziness and impaired balance, as well as affect a resident’s judgment and safety awareness.
- Anti-Parkinson’s- Residents with Parkinson’s should be watched closely due to their often unsteady gait. Medications to treat this disease also increase the risk for fall due to the side effects which can often cause impaired balance, tremors, and at times, dizziness.
- Sedatives/Hypnotics- These medications are sedating, and can cause sleepiness, unsteadiness, and impaired balance and safety awareness
The giving of multiple medications is also considered to be a factor that increases nursing home fall risk because of the manner in which medications interact together.
Medication usage must be taken into account in conducting a fall risk assessment of a nursing home resident. Failing to account for the resident’s medication usage in doing the fall risk assessment can result in an inadequate fall prevention care plan. This is due to the failure to account for the specific risks of the kinds of medications listed above.
As skilled Chicago nursing home lawyers, we know to check the resident’s medication orders and match that against the fall risk assessment. We also know that as medication orders are changed (and they frequently are in nursing homes), this can change the fall risk profile and know to check whether the fall prevention care plan was changed accordingly.