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My 88 year-old mother has fallen several times while rehabilitating at a SNF. I'm told she is 'fine' after each fall.
Should x-rays be done?



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No, not really. Falls are a part of life for many seniors, and some do it weekly. They would be radiated to death if xrays were done for every fall. Especially in rehab they are very good at assessing pain and injury by subjective and objective symptoms.

It is the case with ALF and MC that they also do not send to ER after every fall if everything seems fine. They DO if there is a bump, lump, injury to the HEAD and they should.

I am not saying that this method doesn't miss some things, for it DOES. And those things, cracked ankles, ribs, pelvis can cause complications. I am only saying it isn't feasible to send senior who are having balance issues and frequent falls for an xray after every fall. This is a matter of there not being a perfect answer which is so often the truth in aging issues.

Hope this all turns out well.
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My question would be, why is Mom falling this much. Even though my Mom used a walker at the AL, Rehab required her to stay in a wheelchair. There was an alarm that went off if she tried to stand,

How can Mom be doing rehab when she keeps falling?
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NeedHelpWithMom Jun 2023
Same for my mom when she was in rehab.
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Yes
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If your mom complains of any pain the SNF should send her to the ER. I'm assuming this is short term rehab? During my mom's rehab she fell 2 days in a row in covid isolation. She was 'attempting to self toilet' the nurse found her on the bathroom floor. 1st time just a scraped knee, 2nd time complained of tailbone pain and was sent via Ambulance to the hospital.
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Yes!
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If pain yes. Xray.

But, why the falls? Dizzy? Not walking with appropriate aide? Walker, with staff?
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I am going to ignore the questions about x-rays for a moment...
2 broken hips in 4 months!
Is mom actually participating in her rehab?
Is mom forgetting that she should not get up without assistance?
Is she forgetting her walker?
It might be time that mom is in a wheelchair, with a tilt back so it is more difficult for her to try to get out of.
And if mom has been living alone that should change.
Given the fact that in 4 months she has had 2 fractured hips I would say that she should have x-rays.
That said X-rays for someone with dementia is difficult as is the hospital trip. It is frightening for anyone. I do hope the facility has someone go with her and stay with her. (I am presuming that since they call you and say that she is fine that you are not able to be there as well)
Another difficult decision for you...what if the next fall would typically require surgical correction. What are your plans? She is less likely to participate in rehab. Anesthesia as well as a hospital stay is not good for someone with dementia and can further decline.
If you decide that no more surgical intervention be done if she breaks another bone then the x-ray is not necessary.
If she hits her head she can be monitored for concussion I would not put her through any scans.
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There are mobile Imaging companies that can come to her rehab to do the X-rays.
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My 100-yr old Aunt was doing the same thing: forgetting that she couldn't walk without assistance, then got out of her bed one night, fell and broke her hip. She had mod/adv dementia. At rehab she several times tried to get out of bed (ignoring her broken hip). We were in the process of transitioning her into LTC when she passed in her sleep (maybe due to a clot from the break -- we don't know).

If I were you I'd start looking at LTC facilities for her to go to straight from rehab. At the very least the rehab facility should put her mattress on the floor or get her a concave mattress so she can't get out. BUT this won't solve the problem of her getting up and out of a wheelchair... or any chair.
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Short answer: Yes, of course! Even if there is no 'pain' there can be fractures that complicate her recovery. There are mobile units, x-rays can be done in bed. It concerns me that the facility is not doing them, just saying 'she's fine'...maybe not wanting further work or taking responsibility. Demand x-rays to rule out further injuries/complications.
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Um. X-rays possibly, however there is a bigger issue. Why is she allowed to fall? She’s obviously a fall risk so you need to prevent the fall, maybe by hiring some extra care to watch over her and do the pt exercises so her muscles can get stronger. Or move her to a different facility.

I agree and disagree with the X-rays. My opinion is based from experience not medical. How does she fall? What is she doing prior to the fall? If she falls backward or forward and her head hits the ground, definitely. If someone is holding her and her legs give out, that is completely different, yet considered a fall.

Falling in a rehab SNF? That should not happen , especially if she is in a rehab facility due to a fall.
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Her Physician should be notified and directing her care.
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Tabbycat1: Imho, her physician would be the individual to make that determination. Bear in mind that elders fall a lot and it could be more detrimental to subject the frail elder to radiation for each fall event. Of course, the facility will assess the body to determine if there exists an emergent situation and react accordingly.
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Yes. She needs and X-ray & CT scan of her head. Especially if she's on blood thinner medication. SF get sited by the state when a patient falls in their facility.
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