Falls in Older People

Falls Statistics in the Older Population

Identifying the risk factors for falling can help care staff in their assessments and assist them to prevent falls whilst preserving and promoting independence.

Risk Factors

Some of the most common risk factors include: 

Risk Factors for the older person:

  • Continence issues
  • Dizziness & blackouts
  • Weak muscles
  • Cognitive impairment
  • Slower reaction time
  • Problems with legs/feet
  • Sensory problems (Vision/Hearing)
  • Pain
  • Fear of falling
  • Postural hypotension
  • Medical conditions

Environmental Risk Factors:

  • Unsuitable footwear
  • Uneven surfaces
  • Cluttered environment
  • Unfamiliar surroundings
  • Poor lighting
  • Lack of or unsuitable equipment

Other Factors:

  • Medication
  • Alcohol intake

Falls are not an inevitable part of ageing.

In many cases, taking preventative steps can reduce the likelihood of falls and enable an older person to continue a physically active life.

Care home teams have a key role to play in falls prevention, but they need to have the knowledge and understanding to be able to apply these measures.

Measures include: 

Exercise for Residents

This can take many forms including encouragement to stay mobile, chair based exercises and activities by the activities team.

Environment Modification

Care home staff should be risk assessing and checking the environment for their residents.

Staff should be:

  • Advising that a heavily cluttered bedroom could increase the chance of falls
  • Ensuring that they do not leave equipment for residents to fall over
  • Clearing walkways and making handrails available
  • Checking resident’s footwear and encouraging them not to walk around barefoot

Domestic staff should be routinely helping residents to reduce clutter in their rooms to minimise risk of falls.

Medication Reviews

If a resident is becoming unsteady or has had a fall it is good practice to have them reviewed by a GP and their medications reviewed. 

Taking four or more medications significantly increases the risk for falling because: –

  1. There are a greater number of side effects associated with multiple medication use and the side effects are often more intense.
  1. Interactions between medications can also cause side effects.
  1. Medications react differently in the body as a person ages which can increase the risk for falling.

Reviewing & Auditing Falls

Good care home managers will audit the falls that happen in the home and look for patterns, triggers and possible ways to reduce them.

It may transpire that there is a peak in falls at certain times and this may lead the care home manager to increase the staffing levels, which in turn may result in a decrease in falls.

Staff Training & Education

Falls risk can be increased by:

  • Medical conditions
  • Medication
  • Dementia
  • Physical or sensory impairment
  • Poor balance

Raising staff awareness about this can help care staff to be proactive in falls prevention.

Also, an understanding into the resident’s need to access a toilet urgently because of incontinence or sometimes a side effect of a medication is required. Staff can then demonstrate empathy and respond appropriately.

Simple measures can also be useful in reducing falls, such as making sure that a resident’s important things are in reach including their call bell, a drink, mobility aids etc.