Falls among residents in UK care homes are commonplace. A new study examined whether multiple medications and drugs that act on the brain may contribute to the risk. The research, which included 84 UK care homes, found that residents taking multiple medicines had an increased risk of falling. Risk was also increased with a regular prescription for antidepressants or benzodiazepines (sedative or 31%) had one or more falls; the risk was higher in those taking antidepressants and sedatives; older residents were more likely to fall than their younger counterparts; men had more falls than women; residents with dementia had 75% more falls than those without dementia.
(Edited publisher abstract)
Falls among residents in UK care homes are commonplace. A new study examined whether multiple medications and drugs that act on the brain may contribute to the risk. The research, which included 84 UK care homes, found that residents taking multiple medicines had an increased risk of falling. Risk was also increased with a regular prescription for antidepressants or benzodiazepines (sedative drugs). Two-thirds of the residents in the study were living with dementia. Researchers suggest that care homes should emphasise non-drug approaches such as massage, music or art therapies. These interventions could help residents with depression and common symptoms of dementia such as agitation or sleep disturbance. Over a three-month period, the study found that: almost one in three residents (519 or 31%) had one or more falls; the risk was higher in those taking antidepressants and sedatives; older residents were more likely to fall than their younger counterparts; men had more falls than women; residents with dementia had 75% more falls than those without dementia.
(Edited publisher abstract)
Help the Aged commissioned a consultant to advise on what the Charity could do to support action to prevent falls; this brief report is one of the outcomes. It is widely acknowledged that falls in care homes for older people is a complex issue. To find out what homes are doing to prevent falls, a questionnaire was sent to practitioners with an interest in falls. Eighty people responded from the NHS, social services and private and voluntary sector care homes. This report distils their experience of working to reduce falls among older residents and is intended to support and encourage others taking action. It begins with an overview of the risks and costs of older people falling in care homes. It then looks at what care homes can do to reduce the risk and the consequences of falls. From the management perspective this covers: policies and practice, assessment, training and awareness, and records and audits. A section on support for residents covers: exercise, increasing bone density and reducing the impact of falls, vision, foot care and wear, and clothing and dressing. The final section discusses improving the environment. Appendices cover policy and inspection, understanding the jargon, and list resources and organisations to help manage the risk of falls.
Help the Aged commissioned a consultant to advise on what the Charity could do to support action to prevent falls; this brief report is one of the outcomes. It is widely acknowledged that falls in care homes for older people is a complex issue. To find out what homes are doing to prevent falls, a questionnaire was sent to practitioners with an interest in falls. Eighty people responded from the NHS, social services and private and voluntary sector care homes. This report distils their experience of working to reduce falls among older residents and is intended to support and encourage others taking action. It begins with an overview of the risks and costs of older people falling in care homes. It then looks at what care homes can do to reduce the risk and the consequences of falls. From the management perspective this covers: policies and practice, assessment, training and awareness, and records and audits. A section on support for residents covers: exercise, increasing bone density and reducing the impact of falls, vision, foot care and wear, and clothing and dressing. The final section discusses improving the environment. Appendices cover policy and inspection, understanding the jargon, and list resources and organisations to help manage the risk of falls.
Subject terms:
older people, prevention, risk management, care homes, falls;
Aging and Mental Health, 24(12), 2020, pp.1968-1976.
Publisher:
Taylor and Francis
Background: Fear of falling is a major health concern among older adults. Although several studies have addressed general fear of falling in relation to personal factors, little is known about the specific relationship between fear of outdoor falling and perceptions of the outdoor environments. Purpose: This study is to identify perceived environmental factors and outdoor exposure associated with fear of outdoor falling among assisted living residents aged 65 or older stratified by the amount of time spent outdoors. Methods: This study used survey data collected from a multiregional study conducted in 2007 that surveyed residents in 68 assisted living facilities in Houston, Texas; Chicago, Illinois; and Seattle, Washington. Out of 1,043 total participants, this study used a subset of 907 residents who used outdoor areas at least five minutes a day. Multivariate logistic regression was used after controlling for covariates. Results: Approximately 31% of the participants reported having worried about falling while using the outdoor areas in their assisted living community. Multivariate analyses showed that adequately designed walkways (OR = 0.614, 95% CI = 0.405–0.931), comfort levels in using outdoor areas (OR = 0.657, 95% CI = 0.437–0.989), and frequency of outdoor usage (OR = 0.538, 95% CI = 0.368–0.787) were associated with decreased fear of outdoor falling after adjusting for individual factors (i.e. age, sex, health condition, fall history, vision problems, mobility aids). Conclusion: Improved walkways and comfort levels when using outdoor areas, as well as the amount of time spent outdoors, would be helpful in reducing fear of outdoor falling, which can help promote healthy lifestyle among assisted living residents.
(Edited publisher abstract)
Background: Fear of falling is a major health concern among older adults. Although several studies have addressed general fear of falling in relation to personal factors, little is known about the specific relationship between fear of outdoor falling and perceptions of the outdoor environments. Purpose: This study is to identify perceived environmental factors and outdoor exposure associated with fear of outdoor falling among assisted living residents aged 65 or older stratified by the amount of time spent outdoors. Methods: This study used survey data collected from a multiregional study conducted in 2007 that surveyed residents in 68 assisted living facilities in Houston, Texas; Chicago, Illinois; and Seattle, Washington. Out of 1,043 total participants, this study used a subset of 907 residents who used outdoor areas at least five minutes a day. Multivariate logistic regression was used after controlling for covariates. Results: Approximately 31% of the participants reported having worried about falling while using the outdoor areas in their assisted living community. Multivariate analyses showed that adequately designed walkways (OR = 0.614, 95% CI = 0.405–0.931), comfort levels in using outdoor areas (OR = 0.657, 95% CI = 0.437–0.989), and frequency of outdoor usage (OR = 0.538, 95% CI = 0.368–0.787) were associated with decreased fear of outdoor falling after adjusting for individual factors (i.e. age, sex, health condition, fall history, vision problems, mobility aids). Conclusion: Improved walkways and comfort levels when using outdoor areas, as well as the amount of time spent outdoors, would be helpful in reducing fear of outdoor falling, which can help promote healthy lifestyle among assisted living residents.
(Edited publisher abstract)
Subject terms:
environment, older people, supported housing, care homes, falls, safety;
A guide to help care home staff to manage and prevent falls and risk of fractures, with an emphasis on person centred care and continuous improvement. It looks a preventing falls through activity and exercise; risk factors in falls, risk assessment and screening, management following a fall, and the importance of education. The guide includes key references to national falls prevention in care
(Edited publisher abstract)
A guide to help care home staff to manage and prevent falls and risk of fractures, with an emphasis on person centred care and continuous improvement. It looks a preventing falls through activity and exercise; risk factors in falls, risk assessment and screening, management following a fall, and the importance of education. The guide includes key references to national falls prevention in care homes best practice and NICE quality standards. It also provides links to wider resources and tools. The resource can be used to benchmark existing policies and procedures with care homes to ensure the care given reflects evidence-based practice.
(Edited publisher abstract)
Subject terms:
care homes, falls, injuries, prevention, older people, risk assessment;
The aim of this study was to evaluate whether existing provision of recreational activities would reduce the incidence of falls and aggressive behaviour. Over a two-month period, residents of a UK dementia care home were provided with recreational activities on some evenings (activity evenings) and no recreational activities on other evenings (control evenings), as per usual care. Activities provided included music sessions, board games, singing, entertainment and light exercise. Anonymised case reports were retrospectively examined by a researcher to compare the incidence of falls and aggressive behaviour on thirty evenings when recreational activities were provided and thirty evenings when recreational activities were not provided. The findings from the research contradicted previous findings and suggested that there was no effect of providing recreational activities on aggressive behaviour but an increase in the incidence of falls. Possible explanations for the contrast in findings could be because the activities were group-based and not specific to the individual needs of residents. A sub-analysis also suggested that falls may only be increased among those that chose not to engage
(Edited publisher abstract)
The aim of this study was to evaluate whether existing provision of recreational activities would reduce the incidence of falls and aggressive behaviour. Over a two-month period, residents of a UK dementia care home were provided with recreational activities on some evenings (activity evenings) and no recreational activities on other evenings (control evenings), as per usual care. Activities provided included music sessions, board games, singing, entertainment and light exercise. Anonymised case reports were retrospectively examined by a researcher to compare the incidence of falls and aggressive behaviour on thirty evenings when recreational activities were provided and thirty evenings when recreational activities were not provided. The findings from the research contradicted previous findings and suggested that there was no effect of providing recreational activities on aggressive behaviour but an increase in the incidence of falls. Possible explanations for the contrast in findings could be because the activities were group-based and not specific to the individual needs of residents. A sub-analysis also suggested that falls may only be increased among those that chose not to engage in the activities provided, meaning that additional care is required for those who disengage from group-based activities.
(Edited publisher abstract)
Subject terms:
care homes, leisure activities, falls, aggression, dementia, prevention, intervention;
Purpose: Falls and their associated injuries represent a significant cost and care burden in long-term care (LTC) settings. The evidence base for how and why falls occur in LTC, and for the design of effective interventions, is weakened by the absence of objective data collected on falls.
Design and Methods: This article reflects on the potential use of video footage in fall investigations. In particular, it reports on findings from a Canadian Institute for Health Research-funded research project entitled “Technology for Injury Prevention in Seniors,” detailing four distinct methodological approaches where video footage of real-life falls was used to assist in identifying the circumstances and contributory factors of fall events in (LTC) settings: questionnaire-driven observational group analysis; video-stimulated recall interviews and focus groups; video observations of the resident 24hr before the fall; and video incorporated within a comprehensive systemic falls investigative method.
Results and Implications: The various ways in which video footage offers potential for both care providers and researchers to help understand the cause and prevention of falls in LTC are described.
(Edited publisher abstract)
Purpose: Falls and their associated injuries represent a significant cost and care burden in long-term care (LTC) settings. The evidence base for how and why falls occur in LTC, and for the design of effective interventions, is weakened by the absence of objective data collected on falls.
Design and Methods: This article reflects on the potential use of video footage in fall investigations. In particular, it reports on findings from a Canadian Institute for Health Research-funded research project entitled “Technology for Injury Prevention in Seniors,” detailing four distinct methodological approaches where video footage of real-life falls was used to assist in identifying the circumstances and contributory factors of fall events in (LTC) settings: questionnaire-driven observational group analysis; video-stimulated recall interviews and focus groups; video observations of the resident 24hr before the fall; and video incorporated within a comprehensive systemic falls investigative method.
Results and Implications: The various ways in which video footage offers potential for both care providers and researchers to help understand the cause and prevention of falls in LTC are described. The limitations of using video in fall investigations, including the logistical, practical, and ethical concerns arising from such an approach are also discussed.
(Edited publisher abstract)
Subject terms:
falls, videos, long term care, older people, care homes, prevention;
This article demonstrates the effectiveness of using workshop based education and service improvement models in care homes. The models were designed around both threshold and predictive modelling and were intended to raise awareness of the symptoms that may result from a fall, pressure ulcers or urinary tract infections. The project exceeded targets. Preventive assessments, care planning and timely referrals resulted in a reduction in avoidable hospital admissions and district nurse and GP visits.
(Publisher abstract)
This article demonstrates the effectiveness of using workshop based education and service improvement models in care homes. The models were designed around both threshold and predictive modelling and were intended to raise awareness of the symptoms that may result from a fall, pressure ulcers or urinary tract infections. The project exceeded targets. Preventive assessments, care planning and timely referrals resulted in a reduction in avoidable hospital admissions and district nurse and GP visits.
(Publisher abstract)
Subject terms:
training, care homes, prevention, hospital admission, falls, staff, standards;
... their care environment is and overarching design principles for creating more supportive environments for people with dementia in hospital. The programme evaluation found that making the physical environment more dementia friendly resulted in a range of positive outcomes on falls, incidence of violence and aggression, staff sickness and absence. However, it is acknowledged that, as yet, too few staff
This publication describes the work of 23 NHS trusts that took part in the latest phase, dementia care, of the King’s Fund’s Enhancing the Healing Environment (EHE) programme. The projects were run in mental health and community units and acute trusts. Their outcomes show how relatively straightforward and inexpensive changes to the design and fabric of the care environment can have a considerable and positive impact on the wellbeing of people with dementia. The publication is divided into three parts: Part one sets out the scope and purpose of the publication; part two describes the findings and outcomes from the latest stage of the programme; and part three contains five key resources. These include the EHE assessment tool designed to help carers and staff assess how dementia friendly their care environment is and overarching design principles for creating more supportive environments for people with dementia in hospital. The programme evaluation found that making the physical environment more dementia friendly resulted in a range of positive outcomes on falls, incidence of violence and aggression, staff sickness and absence. However, it is acknowledged that, as yet, too few staff understand the impact of the environment on people with dementia.
Subject terms:
hospitals, building design, challenging behaviour, care homes, dementia, falls, environmental factors;
Journal of Assistive Technologies, 6(3), 2012, pp.192-201.
Publisher:
Emerald
This study looked at whether new assistive technology (AT) systems in care homes for elderly residents, reduced the number of falls and demands for formal health services. The project collected retrospective data about the incidence of falls before and after AT systems were installed in two care homes in Norfolk, UK. These homes were selected purposefully because a recent assessment identified the need for upgrading their call system. They had different resident profiles regarding the prevalence of dementia. Standard incident report forms were examined for a period starting ten months before the upgrades to ten months after in Care Home 1 and from six months before to six months afterwards in Care Home 2. Overall there were 314 falls reported during the course of the study; the number reduced from 202 to 112 after the introduction of AT. The mean health care costs associated with falls in Care Home 1 were significantly reduced (more than 50%). In Care Home 2 there was no significant difference in the mean cost. The results suggest that installing an AT system in residential care homes can reduce the number of falls and health care cost in homes with a lower proportion of residents
This study looked at whether new assistive technology (AT) systems in care homes for elderly residents, reduced the number of falls and demands for formal health services. The project collected retrospective data about the incidence of falls before and after AT systems were installed in two care homes in Norfolk, UK. These homes were selected purposefully because a recent assessment identified the need for upgrading their call system. They had different resident profiles regarding the prevalence of dementia. Standard incident report forms were examined for a period starting ten months before the upgrades to ten months after in Care Home 1 and from six months before to six months afterwards in Care Home 2. Overall there were 314 falls reported during the course of the study; the number reduced from 202 to 112 after the introduction of AT. The mean health care costs associated with falls in Care Home 1 were significantly reduced (more than 50%). In Care Home 2 there was no significant difference in the mean cost. The results suggest that installing an AT system in residential care homes can reduce the number of falls and health care cost in homes with a lower proportion of residents with advanced dementia compared to those with more residents with advanced dementia.
Subject terms:
older people, assistive technology, care homes, costs, falls, health care;