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Traumatic Brain Injury

TBI – Traumatic Brain Injury in Seniors

A TBI or traumatic brain injury can occur in several different ways. It can come from a blow to the head or from a fall that results in a blow to the head, an explosion, and any type of head trauma. The brain damage can be extensive or barely noticeable.

A severe jolt or blow to the skull can cause many points of damage to the brain. In some cases, the damage is localized to the affected area but in others, it is widespread. A spinning jolt can tear the cell structures of the brain.

Seniors are most likely to experience a traumatic brain injury from a fall or some sort of blow to the head. Unfortunately, a very high percentage of seniors never recover from a traumatic brain injury.

According to statistics, a person over the age of 65 that suffers from a TBI only has a 40% chance of full recovery. Each additional year of age over the age of 65, the prognosis of a full recovery drops by 3%.

There are some pretty unsettling facts about nursing home residents that may contribute to the high rate of brain injuries to seniors. According to the CDC (Center for Disease Control):

  • Approximately 2000 seniors die from fall injuries in nursing homes each year.
  • While only about 5% of the population of seniors 65 and above live in nursing homes, they account for 20% of the deaths in this age group from falls.
  • A typical nursing home with 100 beds reports between 100-200 resident falls each year, although this is thought to be a grossly underreported figure.
  • The average resident falls 2.6 times per year, which is twice the rate of falls among their peers living in the community.
  • A full 50% of all falls reported result in head trauma.

What do these numbers mean? In a nutshell, a nursing home resident is far more likely to suffer a TBI, which is directly related to a fall than their peers that live in the community. Improper supervision (35% of all falls resulting in head injuries occur among the residents that cannot walk), inadequate precautions and an unsafe environment can play a huge role in contributing to these unnecessary injuries.

Why Are Nursing Home Falls So Prevalent?

Residents that are living in nursing institutions are likely to suffer from ill health when compared to their peers that live in the community, this can be a contributing factor for the higher than average risk of serious falls. Other risk factors include:

  • Ill-fitting shoes/improper foot care
  • Poorly lit walkways
  • Uneducated staff members
  • Poor supervision
  • Environmental hazards

Failure to ensure that residents have the proper shoes and foot care can contribute to the higher than average rate of serious falls resulting in TBI. Poor lighting in common areas, environmental hazards like wet floors and poor supervision of residents that struggle to walk are also common factors that contribute to serious falls.

Staff members that are not educated in fall risk management are another factor that likely affects the fall risk that result in serious brain injuries.

Many nursing homes choose to restrain residents that are potential fall risks to prevent serious injuries but studies indicate that restraints are not an effective management tool for falls. Restraints may service the staff of the nursing home but they do not service the resident.

Residents that are restrained have reduced physical function and often are injured by bed rails. Overall, studies indicate that restraining residents (which has dropped in practice by about 30% since the 1980s) does not prevent falls.

Not Just the Falling

Of course, there are other situations that can cause a TBI in a senior resident. Frail residents that are handled roughly by staff members can be at risk for this type of injury. Shaking, shoving, and rough handling can easily cause a brain injury to elderly patients.

The problem is that most family members are dependent upon reports from the nursing home when there is an injury to determine how the injury was caused. In many cases, the reports are honest and frank but in some cases the reports are suspect.


If your loved one has been injured while a resident in a nursing home, it is your responsibility to act as their advocate:

  • Inspect the incident report.
  • Speak to your loved one if you can.
  • Contact the local governing agencies.
  • Get a good lawyer.

Read the incident report, get a copy of it and highlight any concerns. Speak to your loved one if you can to see if they remember what occurred. Contact the local agencies that oversee adult services in your area and finally get a good lawyer to represent your loved one.






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