Broken Bones: What’s Common in Nursing Home Facilities

It’s natural to be concerned about an aging loved one’s health and well-being, especially when they’re in the care of a nursing home. Unfortunately, with the increasing number of nursing home abuse cases, there’s justified concern that elder injuries like broken bones may result from mistreatment or falls.

When a loved one breaks a bone in a nursing home, it helps to know the type of injury and recovery process. Let’s examine the most common causes of broken bones in nursing homes.

The Most Common Fractures in Aging People

In older populations, fractures are particularly common near sockets and joints. The most frequent fracture locations include the:

  • Hip and pelvis
  • Femur (thigh bone)
  • Shoulder
  • Spine
  • Upper arm
  • Wrist

Other types of fractures are possible but less common. For example, a fractured foot is significantly less common in older adults.

Risk Factors for Broken Bones

All adults lose bone density as they age, leaving the bones more vulnerable to breakage. Some healthy adults eventually develop osteoporosis, which further increases the risk.

Some medical conditions can further reduce bone density or put older people at greater risk of falling. Adults with dementia, for instance, may become confused about their surroundings or frequently wander, increasing the risk of fall injuries in nursing homes. Similarly, if your loved one has arthritis or a history of alcohol or tobacco use, their bone structure may be weaker.

Common Causes of Broken Bones in Nursing Homes

While good nursing homes take precautions to reduce the likelihood of broken bones, not every broken bone is preventable. Bone breaks in the elderly can also be due to negligent care in a nursing home, such as not providing appropriate supervision or aid for patients as they move around the facility.

In nursing homes, some of the most frequent causes of fractures include:

Slips and Falls

Older adults have a significantly harder time catching themselves when they lose their balance, as age slows the reflexes and weakens muscles. Some health conditions and medications, like antidepressants or immunosuppressants, can also cause impaired balance, low blood pressure, or nerve problems that increase the risk of falling or fainting.

Many nursing homes have safety precautions to reduce the risk of falling. These include stairway railings, bathroom grab bars, and non-slip shower floors. Most will also remove rugs from the floor, which can bunch or roll up and pose a fall hazard.

Sudden Impact or Typical Use

A weakened bone may be unable to handle sudden or sharp impacts. For example, an older person who stumbles while walking may be at higher risk of fracturing their foot or ankle.

When the bone is too weak to support the weight of regular activities, it can lead to a spontaneous insufficiency fracture. Nursing home residents who fear a loss of independence may attempt to care for themselves and avoid mobility aids, subsequently fracturing a bone while performing daily activities like walking.


Residents of nursing homes are vulnerable to abusive or short-tempered caregiving staff. Physically abusive caregivers may strike, push, grab, kick, or otherwise physically harm residents. As older people have significantly weaker bones, these physical traumas can cause fractures.

Broken bones are not always caused by physical abuse; residents may suffer broken bones due to psychological or emotional abuse. For example, a caregiver may ridicule a resident for needing help getting dressed. Residents may try to dress themselves to avoid emotional distress, lose their balance, and break a bone in the fall.


A neglectful caregiver does not directly cause a broken bone. However, they may fail to provide necessary care to a resident. If an elderly patient does not receive appropriate care, they may try to care for themselves. This can place nursing home residents at risk of falling or spontaneous insufficiency fractures as they try to maintain their needs, such as going to the bathroom or getting dressed.

Neglect poses a particular hazard for nursing home residents with health conditions or cognitive disabilities like dementia. Some health conditions require frequent monitoring to prevent loss of balance or fainting. If these residents are not given appropriate care, they are at a much higher risk of falls and subsequent fractures.

Common Signs of a Broken Bone

Many nursing home patients are reluctant to ask for help when they injure themselves, as they may feel like they are losing independence. If your loved one has a broken bone, you may notice:

  • Redness or bruising
  • Swelling or visible displacement
  • Tender or painful skin, muscles, or joints; your loved one may wince or move away from your touch
  • Trying not to use or put weight on the affected bone
  • Unusual difficulty moving the affected area
  • Protecting the broken limb by covering it or not letting others see it

Federal law requires that nursing homes notify a resident’s legal representative of any injury serious enough to potentially require medical treatment. However, abusive or neglectful facilities may not notify you about your loved one’s injury.

Broken Bones at a Nursing Home: Should I Worry?

Nursing home injuries can be genuine accidents but can also result from mistreatment. Unfortunately, your loved one may be unwilling or unable to disclose this to you. If you suspect your loved one’s fracture was caused by mistreatment, investigate more closely for signs of abuse or neglect, including:

Signs of Neglect

If a loved one suffers broken bones from nursing home neglect, they will often show other additional signs. You may notice that your loved one:

  • Has poor hygiene (body odor, greasy hair, wearing dirty or stained clothes)
  • Frequently appears sick
  • Seem visibly malnourished or dehydrated
  • Has access to things they need but is not assisted in using them
  • Missing medication or other medical aids, like glasses
  • Has a dirty, unkempt, or sparse room
  • Collecting or hoarding essentials like food, water, and medication

In addition, take a look around the rest of the nursing home. While no facility can prevent all nursing home falls, most will take steps to reduce the risk of tripping or falling. If the nursing home is messy or missing basic safety precautions like grab bars, it may suggest neglect.

Signs of Physical Abuse

Physical abuse does not always leave markings or other physical evidence. However, such abuse has psychological effects as well. Your loved one may be experiencing physical abuse if they:

  • Have no explanation for the injury, or seem reluctant to share
  • Make excuses or give explanations that don’t make sense
  • Have other visible injuries: bruises, swelling, cuts, burns
  • Flinch or pull away when you move unexpectedly or attempt to touch them
  • Appear subdued or fearful around nursing home staff
  • Use broken equipment like glasses or mobility aids or is unable to use them due to damage

While it may be difficult to determine the cause of your loved one’s fracture, it’s wise to investigate further if something feels amiss. Good nursing homes will provide the care and assistance your loved one needs, communicate with you about their well-being, and treat them with the dignity they deserve.