Home > Aged Care > Falls Prevention Programs
Falls Prevention Programs
Falls are a leading cause of morbidity and mortality in older adults. In fact, falls are the leading cause of hospitalisations for people over 65 years of age.
Aged care residents are up to five times more likely to fall than those who live in the community. Whilst many falls are preventable, up to 50% of older people living in residential aged care services fall every year, with 40% experiencing recurrent falls. The proportion of residents with a diagnosis of dementia who fall has been reported as even higher.
Guide’s falls prevention programs are designed to use the latest research on exercise-based interventions to control falls risk coupled with a ‘common-sense’ approach to managing extrinsic falls risk factors. We have been successful in reducing falls rates within our homes by up to 48% in common areas and 79% in dementia-specific areas.
Read the article about our falls reduction success published by QPS Benchmarking here.
Assuming Falls Risk
It is safe to assume that all residents living in residential aged care are at an increased risk of falls. This is due to the intrinsic risk factors associated with ageing and the general acceptance that most residents living in aged care have higher care needs and multiple comorbidities.
As such, we must take a proactive approach to falls prevention.
Residents should be encouraged to participate in falls prevention programs regardless of whether they have experienced falls or are classified as “high risk”. As always, prevention is better than cure. There can be catastrophic consequences of falls, so working to reduce falls risk or falls incidence should always be our priority.
Why Should We Care About Falls?
Recording and monitoring fall rates and trends is a great way to proactively manage falls. During our service implementation phase, we establish our falls reporting system in every one of our homes. This system records key statistics such as who fell, location, date and time, contributing factors and management strategies.
Falls statistics are automatically translated into useable graphs and charts which assist homes in identifying falls trends. It also allows our clinicians to identify frequent fallers who are highlighted each month and targeted for falls prevention programs.
We advocate for and assist in the establishment of falls management committees in each of our homes. These committees assist in driving cultural change within the home and in implementing strategies to reduce falls incidence and risk. Our reporting systems play a key role in identifying trends and formulating action plans.
Educating Care Staff and Achieving Cultural Change
Guide Healthcare provides comprehensive falls management training to aged care organisations. These education programs can assist homes to create the cultural shift needed to effectively manage falls. Falls prevention needs to be an “all-staff” approach.
You can check out our education program here:
Fall Risk Assessment
Whilst we advocate for a proactive approach to falls prevention that includes all aged care residents, we recognise the value in identifying residents at a high risk of falls.
There are validated falls risk assessment tools such as the Berg Balance Scale or the Tinetti Test that can be used to determine a rating of an older persons falls risk.
Importantly, these outcome measures can also identify the reasons why someone is at risk. We can then use this information to create an individualised treatment plan which targets their specific deficits. Typical impairments include reductions in performance when a person’s base of support is narrowed, when their vision is removed or when they try to complete dynamic balance tasks such as a 360 degree turn without support.
Falls Risk Factors
A proactive approach to falls prevention requires knowledge of potential risk factors. Most aged care residents will present with various risk factors that can create an interplay exponentially increasing their falls risk. We can divide risk factors into intrinsic (personal) and extrinsic (environmental). Whilst we can provide interventions, equipment and education to control some personal risk factors, many of these are unable to be managed or reversed. However, all environmental factors can and should be managed effectively.
Common intrinsic risk factors which contribute to why older people fall:
Many chronic diseases and disease processes increase an older persons’ risk of falls. These include osteoarthritis, rheumatoid arthritis, diabetes, Parkinson’s disease, multiple sclerosis, hypertension, cardiovascular disease and respiratory disease
Older people experiencing cognitive decline due to a diagnosis of dementia or Alzheimer’s disease are known to be at a significantly increased risk of falls. Falls risk also increases during periods of acute delirium. Cognitive impairments are often associated with high-risk behaviours such as impulsivity or reduced insight into risks.
Whilst falls are not considered a ‘normal’ part of ageing, the ageing process is associated with increasing falls risk factors such as decreased strength, reduced balance, sensory loss and neuromuscular decline. This functional loss often results in gait changes such as reduced step length and foot clearance which can result in trips.
Progressive sensory loss such as reduced vision and reduced vestibular function is known to increase falls risk. Vision loss is generally associated with diagnoses such as glaucoma, cataracts or macular degeneration. Reduced vestibular function generally leads to impaired balance and feelings of dizziness or vertigo.
5. Incontinence has been well documented to increase falls risk due to a variety of factors. Urge incontinence can lead to things like rushing and non-use of aids. Incontinence is linked to an increased risk of environmental-related falls like slips. Even incontinence aids can increase falls risk if not worn correctly. 2/3 of residents at RACFs experience urinary or faecal incontinence that is not part of the normal aging process
6. A person with a documented history of falls is known to be at an increased risk of future falls.
7. Poor footwear is a particularly significant problem in the residential aged care setting. Ill-fitting footwear is known to increase falls risk, however, it can be difficult to convince residents to swap their slippers, thongs, raised heels or socks for a firm fitting, lace-up, low heel, rubber sole shoe.
8. Polypharmacy and certain medications can significantly increase residents fall risk. Medications such as sedatives, antidepressants, antipsychotics, antihypertensive medications, diuretics, NSAIDs and vasodilators can all cause side effects that increase falls risk.
9. There are also some acute health conditions that can increase an older person’s falls risk such as urinary tract infections, transient ischaemic attacks, delirium, dehydration and constipation.
Contact us.
General Enquiries
admin@guidehealthcare.com.au
02 9663 0387