Nursing homes seem to be chronically understaffed. Often, the goal seems to be to hire as few employees as possible to keep costs down. However, the end result is that residents at these nursing homes do not receive the care and attention that they need and for which they pay. I have had many clients tell me over the years that the nursing home in which their loved one was injured was clearly understaffed. In fact, I can't remember a case in which the client acknowledged that the facility was sufficiently staffed. One result of this is that many times the resident will put on his or her call light for assistance, and no one on the staff responds, even after the passage of much time. The resident then tries to do on their own what they were hoping to do with the assistance of staff, and often fall and are injured.

The failure to respond to call lights may not only be the result of lack of sufficient staff. Clients have told me of occasions in which nursing home employees have been watching television, talking, or outside the building smoking and simply ignore the call light. These are issues that are likely the result of negligence in hiring, or inadequate training. People sometimes go to nursing homes because it is just not possible, for many reasons, for their family members to care for them. This may be because of work schedules that do not permit the kind of care needed, other obligations, or a family member just simply needs skilled nursing care. Whatever the reason, the person enters the nursing home with the expectation that he or she will receive the care and support that they need. Unfortunately, this is often not the case.

Falls are a common negative event in nursing homes and hospitals. According to the National Quality Measures Clearinghouse, falls are a leading cause of hospital-acquired injury, and frequently prolong or complicate hospital stays. Despite increased awareness of the impact that falls can have, falls resulting in injuries in healthcare settings are on the rise. Depending on the setting, as many as 50% of inpatients experience at least one fall, and The Joint Commission estimates that 30% of falls in healthcare settings result in serious injury.

Falls can result in sprains or strains of different body parts, deep bruising and broken bones. In particular, falls in which the person strikes his or her head can be particularly serious, resulting in bleeding in the brain. Falls can result in injuries that require or cause a resident to be confined to his or her bed. This lack of mobility often leads to other problems, such as pneumonia or blood clots. Especially in the elderly, falls can cause a decline in the person's overall condition and result in death.

In my opinion, most falls in healthcare settings should not occur. We should expect that in nursing homes, hospitals, or other healthcare settings there is sufficient staff that are properly hired and trained so as to protect our loved ones and keep them safe. We are so used to poor staffing, hiring and training, especially in nursing homes, that our expectations are too low. We should expect that our loved ones are well cared for in these places, physically, mentally, socially and spiritually. A client was recently telling me about how her husband, who was in significant pain, was constantly not receiving his pain medications on time. She said,