6 Reasons An Elderly Resident Should Never Be Left On The Floor

If you don’t support a loved one living at home or work in a healthcare environment, such as a care home or hospital where you interact regularly with people over the age of 65, then it’s unlikely you’ve had to consider what happens when someone has a fall.

 

It’s common to find that after a certain age many people will struggle to get back on their feet after a fall and may require assistance. Often, the first action carers will take is to call an ambulance for help and this is true for residents living in care homes too.

 

Now you may be thinking that that seems like a sensible precaution, however consider this…a third of people aged over 65 (a statistic which rises to 50% in people aged over 80) will fall at least once a year; that equates to 2,000 people every day.

 

Over 45% will be uninjured and do not require an ambulance or any hospital treatment. This means that when the care home calls for an ambulance and lets them know the resident is uninjured but just needs help standing they’ll be automatically categorized as a ‘class C’ call, which is a low priority. In these situations, it can mean a wait time of anywhere between one and four hours, (we’ve even heard anecdotal stories of some residents waiting up to eight hours!)

 

This means the person who’s fallen will have to lie on the floor, probably in quite a bit of discomfort, whilst they wait for the ambulance to help them back up. In a care home environment, a staff member from the care home will be also be assigned to sit with them during the wait.

 

Can you imagine how’d you’d feel being forced to wait on the floor as people walk past you, or worse, how you’d feel if you were the care home worker, not allowed to help the person up?

 

20% of care home residents admitted to hospital after such a fall will have been on the floor for over an hour and perhaps most shocking is the statistic that of those, 50% will then die within six months from related complications, even if they were uninjured! Making the problem even worse is the fact that after you’ve fallen once, there’s a 60% chance of having another fall, which in a lot of people leads to loss of confidence and a reduction in activity which in turn leads to loss of muscle strength which then makes future falls even more likely, a self-fulfilling, vicious circle.

 

So why aren’t care homes lifting their residents?

Well there’s a variety of reasons.

 

  • Staff may not have access to the right equipment
  • They might not be fully trained in manual handling
  • They may have been told to call 999 to protect the home from being sued if the resident is injured whilst being lifted.
  • They may even genuinely believe calling 999 is the best thing to do for the fallen resident.

 

Whatever the reason, we’re sure everyone can agree that it’s not nice to be left on the floor for extended periods of time, no matter your age especially as there are a wide range of both physical and psychological implications to consider:

 

Pressure Sores/Pressure Ulcers

Pressure ulcers, also known as ‘pressure sores’ or ‘bedsores’ are an injury that breaks down the skin and underlying tissue when an area of skin is placed under increased pressure (sure as lying on the floor for long periods) and can form within half an hour of falling. The extra pressure causes a lack of blood to the affected region which causes it to become starved of oxygen and nutrients. Depending on the time spent on the floor, recumbent, in the same position, these sores can range from uncomfortable, to painful, right through to life threatening.

 

Incontinence

One of the more obvious and least dignified consequences of a resident being left on the floor for extended periods is incontinence which will come with a whole host of medical issues if the resident can’t easily be cleaned, not to mention the psychological embarrassment it causes people.

Again, ask yourself how you’d feel in that situation…

 

Dehydration

Whilst the risk of dehydration is greatly reduced in a care home situation it remains a fact that most people who do fall are at risk of suffering this if left for long periods. Being supine on the floor isn’t the most pleasant place to have a drink and many residents will prefer to wait till their back up on their feet; which can be a dangerously long time to go without any liquids at all.

 

Hypothermia

One of the more serious consequences of being left on the floor for long periods after a fall is hypothermia or the increased risk of contracting illnesses like pneumonia. In an ideal world a care home resident would fall over in a warm, heavily carpeted room, however life is rarely that fair. A lot of falls take place in corridors or walkways with cold tiles underfoot or even outside. This obviously makes things a lot harder when trying to keep the resident warm during the long wait for an ambulance.

 

Psychological

Research by the American Journal of Epidemiology shows the fear of falling in the elderly will subsequently have a massive impact in reducing their ongoing quality of life.  The fear of falling amongst older people occurs in approximately 30% of those who have never fallen and 60% for those who have fallen previously.

The person then becomes more dependent on others and less mobile and begins to cut their daily activities. As the fear of falling increases and activity diminishes, muscle strength weakens causing more and more falls.

In fact, frequent falls are often considered the main contributing reason for first admissions to a care home.

In addition, healthcare professionals who have been injured through manual handling tasks may also become reluctant to lift or move people going forward, becoming much more likely to call 999.

This can then directly impact the health of patients and increase the prevalence of pressure ulcers and other associated issues.

 

Death

Finally, 20% of people over 65 admitted to hospital as a result of a fall have been on the ground for over an hour. 50% of these will die within six months as found in the study by Vellas et al.

 

So, what can be done about this? Clearly the easiest answer is to empower care homes to lift fallen residents safely and only call ambulances in emergency cases. Unnecessarily admitting residents to hospital impacts services and it’s estimated that bed blocking costs the NHS and the UK taxpayer over £900 million every year (with some sources putting that figure a lot higher).

 

Now clearly we here at Mangar Health feel the right equipment to use would be our Camel or ELK lifting devices. They’re safe, dignified and are perfectly suited to single handed care however, we’d also be more than happy if care homes were using any other suitable lifting devices as well. We understand care homes are committed to providing quality, dignified care for their residents but we’d like to see less pressure on an already overstretched ambulance service.

 

Every ambulance trust in the UK uses our ELK lifting cushions and when the paramedic arrives at a care home they are likely to use the ELK to perform the lift; all we’re suggesting is that care homes reconsider their falls policies and create care pathways that best protect the health of their residents. It’s worth checking out the Scottish Care Inspectorate falls pathways and the recommended action for residents that fall.

 

Also, take a look at IStumble, created by West Midlands Ambulance Service and a great guide for carers wanting to check if their resident if injured.

 

If you want to learn more about how health and adult social care is regulated in the UK then there’s a lot of resources available on the CQC website here; the CQC (Care Quality Commission) being the regulatory body for the industry, or if you want to speak to them about this or any other issue you might have then you can reach them here.

 

#UpLiftingCare



  1. Georgina bush says:

    How can a carer be 100% sure a person is not injured.
    During my career as a community nurse I have seen it time again resident picked up only to later to be found to have head injury or a fractured hip often they don’t survive.

  2. Margaret says:

    I agreed with everything said upto the claim that every ambulance carries a lifting device IE an ELK. As a paramedic, I know this is definitely not true (my service doesn’t!!!) so when we are called to a care home who leaves their patient on the floor because they have a ‘no lifting’ policy, that policy covers the property which obviously includes the ambulance crews as much as the home staff.

  3. CharlesCutting says:

    Sadly this is the problem with so many people who live on thereown in their own homes and never see any one for days or weeks and no one to help.

  4. Lisa Perry says:

    This is all well and good but what about lone workers and places with a non lifting policy?

  5. Margaret Davison says:

    My sister has been in this situation more times than I care to remember over the past 5 years. 4 hour waits for an ambulance the norm rather than the exception. The last occasion an ambulance was called, just over a week ago, was the first occasion I have seen the crew bring in one of these lifting devices, only problem being, it didn’t work a) because they appeared unfamiliar with it and b) because it wasn’t charged up – I had to point this out to them as I spotted the battery indicator showing blank

  6. Jeanette Hitchen says:

    My mother died in January through dimentia. To much went on between March and January to write on here only to say I am disgusted at some of the treatment she has to endure. Even in the hospital she was 4 days NILL by mouth because the salt team would orecommend could not come out to her.Although she was in a dementia ward in the hospital she was left sitting on her own although they new she was quite upset and worried not knowing where she was was she fell and needed butterfly stitches above her eye

  7. Carol says:

    I have been in this situation when we have made someone as comfortable as possible on the floor and later found out that the person had a broken hip. Have also known someone who has been moved and caused more harm because they was moved and had a broken hip .and later died .im fully trained to do my job with basic first aid ,if in any doubt would never risk moving a fallen person .every fall should be treated as different to another you never know what injuries could happened especially if you didn’t see the fall ..there’s too many horror stories of people being left for hours these days waiting for help.

  8. Amanda says:

    Most company’s have a no lifting policy & rightly so – if someone has fallen the carer is not a GP or a paramedic & are not qualified to say if that person is medically fit to be moved – if the person is injured they could cause further complications & make the injury worse!! It’s not about carer’s not caring they make them as comfortable as possible & reassure them whilst waiting for someone whom is medically trained to assess the person & for them to say that in their professional opinion they are able to be moved

  9. Andrea says:

    Care homes should be equipped with some sort of lifting device and carers should have the training. But it is easier to call an ambulance. (and cheaper for the employer)

  10. Valerie says:

    I believe every care home needs a manga because the ambulances don’t carry them and I would guess that 99% of care homes don’t have one and rely on the ambulance staff to come and pick the person up off the floor. For those not sure whether a person has a broken hip after a fall please go online and check this out and it will show you in picture forms what to look for it could potentially save a persons life.

  11. Paula says:

    Lifting a person from the floor can also result in injury to oneself. As a community care worker who does have extensive training and practical experience of moving and handling protocol, I would not recommend lifting from floor due to the risk to service user or health care assisstant. Care assistants do not have medical training and as such cannot make a medical judgment. Equally each house does not contain the safe equipment in which to raise a person from the floor.

  12. Ann says:

    My mother fell in a care home and was lifted up and taken the length of a corridor to be laid on her bed. When the doc. Arrived it was obvious to him that she had broken her hip. Because she had dementia and couldn’t learn to walk again we had to move her into a nursing home. I don’t think she should have been moved in the circumstances.

  13. Kay says:

    Can I buy my own ELK to keep at home …or take into a home if I’m admitted to one in the future…

  14. Ruth says:

    I work in a Care home and have this issue time and time again. It’s difficult to explain to the patients that they have to wait for an ambulance which may take hours. But then again I’ve seen a patient with a very obvious broken hip and then another one who got himself up and complained that his hip was a little sore after his fall and it was then discovered he had broken it. I’ve also had it when a gentleman fell and he was demanding that someone picked him up the carers refused and said they will call an ambulance. So the on-site hairdresser and shop keeper can and picked him up. The next day we found his hip round his back and unfortunately he died from the fall. Carers do not have the necessary training to determine if someone is injured or not. And often it can be difficult to tell. I’ve been frustrated sat on the floor with a service user many a time wishing I could just pick them up because I can see they are uncomfortable but I’ve also seen it so many times where there unseen injuries that could have been made worse

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