Feeling guilty about resident falls

[rebellefleur]

I'm a CNA in an assisted living facility. This is my first time working as a CNA. I have been off orientation for two days and a resident I was responsible for has fallen during both shifts. I work in an memory care facility and our residents often like to walk around the facility and the ones who require walkers often forget to use them. This is how the falls occur. I'm feeling extremely guilty because these residents were assigned to me. Is there a way to prevent these falls from happening? Is it normal for me to feel at fault?

[hookyarnandblanket]

It's perfectly OK to feel guilty. It would be more worrisome if you didn't feel guilty. As far as the residents falling, as long as you have done everything you can possibly do to keep them from falling, there isn't much more you can do. They have the right to fall, even if they are not alert and oriented. You can remind them as much as humanly possible to use their walker, but the nature of memory loss will always prevail.

Maybe you can suggest interventions to the person in charge of care plans, or collaborate with the nurses on your shift about what you can do to help them. Assess what was happening around the residents when the falls occurred. Were they going to the bathroom or just wandering about? Were they upset, angry, anxious? Was it quiet or loud? What time of day was it? Where and when did they think they were? What did they say they were going to do when they fell? Were there obstacles in their way? Was it in a common area or their rooms? Were they hungry or thirsty? These are just a few things to consider when going over the incident.

[BBboy]

My first 6 months as a CNA were spent in a100% memory care facility with very difficult residents that were all essentially fall risks. The most conducive thing that would asssist you is to make sure that your residents that are at risk of falling the most you should keep in a communal area together with other residents so that there can not only be eyes on your resident but the various others as well. I'm not sure what kind of activities you have going on during your shift but for me this was made very easy as we had activities for the residents going on at almost every waking hour of the day. The only difficulty was residents getting up in the middle of the night as you could almost fortell a fall on your pager but hey thats when you sprint to the room and hope for the best. Sometimes falls are inevitable

[valliloves]

Are they not hooked up to alarms when they get out of bed?

[Leonardsmom,LPN]

It's perfectly OK to feel guilty. It would be more worrisome if you didn't feel guilty. As far as the residents falling, as long as you have done everything you can possibly do to keep them from falling, there isn't much more you can do. They have the right to fall, even if they are not alert and oriented. You can remind them as much as humanly possible to use their walker, but the nature of memory loss will always prevail.

Maybe you can suggest interventions to the person in charge of care plans, or collaborate with the nurses on your shift about what you can do to help them. Assess what was happening around the residents when the falls occurred. Were they going to the bathroom or just wandering about? Were they upset, angry, anxious? Was it quiet or loud? What time of day was it? Where and when did they think they were? What did they say they were going to do when they fell? Were there obstacles in their way? Was it in a common area or their rooms? Were they hungry or thirsty? These are just a few things to consider when going over the incident.

This was exactly what I was going to say. As long as you have done everything that you are suppose to do the next thing to do would try anticipating their needs. Is there a particular time they need to use the bathroom or like to lay down. If you are able to anticipate a particular need then you may be able to reduce the chance of a fall.

[hookyarnandblanket]

Are they not hooked up to alarms when they get out of bed?

In some facilities, alarms which attach to residents are considered to be restraints. Ridiculous, I know, but CMS is really cracking down on things. When I worked in a nursing home, we couldn't have bed rails on any beds because they say rails are a form of restraint and a doctor has to write a specific order for rails to b present.

[valliloves]

In some facilities, alarms which attach to residents are considered to be restraints. Ridiculous, I know, but CMS is really cracking down on things. When I worked in a nursing home, we couldn't have bed rails on any beds because they say rails are a form of restraint and a doctor has to write a specific order for rails to b present.

That's crazy. In our hospital, we are allowed to have three rails up. Four requires a doctor's order because it's considered a restraint.

[Tex.]

I feel you, OP. Three days ago and what feels like this morning....my functional quad patient decided to conjure up superhuman strength (literally 2 minutes after I left him sleeping in his bed) and fly head first onto the tile floor. Two liters of wine later, I am still beating myself up about it. And I will be filling out restraint forms for side rails up x4 for the length of his stay now.

[hookyarnandblanket]

That's crazy. In our hospital, we are allowed to have three rails up. Four requires a doctor's order because it's considered a restraint.

I know, right? We, thankfully, can use RN Alarms, wheelchair alarms, and two bedrails at the hospital where I work now. The whole no alarm thing is connected with the right of dignity and the right to fall, but it's such a catch-22: With no alarms, you have twice as many reports on falls and you get tagged during state survey for having too many falls. It's a no-win situation. We know we can't be everywhere at once, but I wish the ones in charge of writing direct healthcare laws and regulations would recognize that.

At the rate things are going, the next thing that will be labeled a restraint will be wander guards and we'll have non alert and non oriented elderly people all up and down the streets and missing on a regular basis.

[RainMom]

Are they not hooked up to alarms when they get out of bed?

In some facilities, alarms which attach to residents are considered to be restraints. Ridiculous, I know, but CMS is really cracking down on things. When I worked in a nursing home, we couldn't have bed rails on any beds because they say rails are a form of restraint and a doctor has to write a specific order for rails to b present.

OP stated this is an assisted living facility, not a nursing home or hospital. Residents are quite a bit more independent & free to move around the facility as they wish.

[hookyarnandblanket]

If you read above, I gave the OP a comprehensive list of suggestions directly related to her original post. This was just a related side conversation.

Good day.

[valliloves]

OP stated this is an assisted living facility, not a nursing home or hospital. Residents are quite a bit more independent & free to move around the facility as they wish.

I know that. I still think it's nuts if someone is a high fall risk to not at least have some kind of an alert device for caregivers to get there before a fall happens. I would think someone would rather that than a broken hip. From what I've witnessed and have been told by many geriatric patients, a broken hip is not fun! lol