SCIE Research briefing 1: Preventing falls in care homes

Published April 2004

Updated April 2005

Introduction - What is the issue?

Older people (aged 65 years and older) frequently fall, especially when resident in long-term care: up to 35% of falls here result in serious injury and up to 8% in fractures. A fall is defined as "... an event in which the resident unintentionally came to rest on the ground or floor, regardless of whether an injury was sustained..." and may be "... other than as a consequence of sudden onset of paralysis, epileptic seizure, or overwhelming external force ...". Falls in care homes may lead to increases in death rates, fall-related injuries (particularly hip fractures), individual physical and psychological damage, loss of independence and health costs. Fall prevention strategies and interventions need to take into account the fact that falls can have a number of causes, such as frailty, confusion and the effect of certain prescribed drugs, that require many different interventions. There are also implications for care staff with likely increases in anxiety, workload and complaints.

What are the implications?

All care homes need to have falls prevention strategies in place and use them. This should include:

  • Forging good links with primary/community/secondary health care. In particular, Primary Care Trusts need to include care homes in their Health Improvement and Modernisation Plans.
  • Having a simple screening process to identify residents at high risk of falling who may require specialist assessment.
  • Training and ongoing awareness for staff especially in relation to individualised assessments and multiple activity programmes. Consideration needs to be given to developing effective systems for disseminating up-to-date information on evidence and practice ideas to care home staff.
  • Good systems to monitor and learn from falls occurring within the care home.

More research is also needed on areas including environmental hazards and preventing falls, economic evaluations of intervention programmes, individual evaluation of components in multiple programmes and the influence of hip protectors on activity levels. Effective falls prevention strategies are likely to have economic benefits as fewer falls means a saving in high health care costs.

For further ideas, see the related briefings on The Use of Assistive Technology for People With Dementia Living in the Community and Aiding Communication With People With Dementia.


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