Environmental Factors

Environmental factors include home hazards, e.g., clutter; no stair railings; loose rugs or other tripping hazards; no grab bars in the bathroom; and poor lighting, especially on stairs.⁶

Environmental hazards that may be specifically encountered in a nursing home setting are, e.g., wet floors from incontinent episodes, poor lighting, bedrails (which the resident may try to climb over), elevated bed heights (for the convenience of the staff), and throw rugs and other objects on the floor. ² Ill-fitting shoes may also increase the inherent susceptibility of an elderly person to falling to cause an accident.² In addition, mechanical restraints may paradoxically increase the risk of falls as well as serious injury, seriously challenging the belief that restraints protect patients. This may be due to deconditioning of the muscles of patients who are restrained. Thankfully, the use of restraints is highly regulated by the federal government and has largely fallen out of favor.

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