When a parent moves into a nursing home, many families breathe a little easier: now there's staff, now they're being watched. It's logical to think so. But the data tells a different story than what is usually assumed.
Falls affect 60% of nursing home residents, compared to 30% of older adults living in their own homes.
Source: Bella Beorlegui, Esandi Larramendi and Carvajal Valcárcel (2017), Gerokomos.
A field study in Spanish nursing homes found an average of 1.3 falls per resident per month, with 12% of fractures resulting from them, and that half of the residents who fall, fall again in the same year.
Why this happens — it's not that no one cares
It's important to say it clearly: the staff in nursing homes, overwhelmingly, work extremely hard. The problem is not one of attitude, it's one of mathematics. In Spain, the minimum legal ratio of direct care staff is 0.25 to 0.35 professionals per resident depending on the autonomous community — that is, in the best-case scenario, one person attending to three or four elderly individuals at once. And a field study found even lower real ratios in practice: 0.12 nurses and 0.55 aides per resident.
Not even the best caregiver in the world can be in four people's rooms at once. At home, a son or daughter caring for their parent is almost exclusively focused on them. In a nursing home, that same attention is divided among several residents at the same time — and that's where the seconds that separate a controlled stumble from a fall with impact slip in.
Home vs. nursing home: why the risk changes
| Factor | At home | In a nursing home |
|---|---|---|
| Attention per person | Almost individual (family member) | Divided among 3-4 residents or more per caregiver |
| Environment | Familiar, adapted over time | New, same for everyone, not personalized to each individual |
| Resident's frailty | Variable | Usually higher — often the reason for admission |
| Highest risk period | Night, going to the bathroom | Shift changes, hours with less staff |
What you can do if your family member lives in a nursing home
✔ Ask for the actual staff-to-resident ratio per shift, not just what they advertise
✔ Request to be informed of any fall, no matter how small it seems
✔ Check if their room has grab bars, non-slip flooring, and good night lighting
✔ Provide the protection that doesn't depend on the caregiver being right there at that moment
The nursing home can improve its ratios. You can't change that. What you can do is ensure that, at the exact second no one is looking, your family member is already wearing protection. It's the only measure that doesn't depend on the staff on that shift.
🛡️ View the Anti-Impact Protective HelmetFrequently Asked Questions
Does this mean my family member's nursing home is bad? Not necessarily — most comply with regulations, and staff usually do their best with what they have. The problem is structural (low legal ratios), not a matter of a specific center being negligent.
Can I ask the nursing home to put on the protection? You can suggest it, but the safest thing is to bring it yourself and make sure it's part of their daily routine, just like their glasses or medication.
Will staff ratios improve? It depends on each autonomous community and ongoing regulatory reforms — but in the meantime, daily protection does not depend on any law changing.
You might also be interested in:
This article is for informational purposes only and does not replace the advice of a healthcare professional or social worker. For questions about care in a specific facility, consult directly with its management.