A Comprehensive Guide On How to Reduce Risk of Falls in Elderly

Approximately 60% of people living in care homes experience recurrent falls each year (DH 2009). There are multiple factors that can affect the increasing rate of falls in the elderly. We believe it is important to understand these varying risk factors so preventative measures can be put in place.

In order to properly understand the full extent of the different factors which affect falls in the elderly and prevention surrounding this, we have created the case study below. The study features Mrs S and her experience of falling in a care home, highlighting the benefits of care planning and fall risk assessment.

Case Study Example

Mrs S lives in a care home, her mobility had decreased and her vision is impaired due to cataracts. She has had several minor falls over the past year before moving into the care home, one resulted in a cut to her head and bad bruising, after tripping on the rug at home when answering the door. Sadly, 25% of falls in care homes result in fracture, laceration or the need for hospital care (MacLean 2007).

There are a number of different reasons why older people may fall, including;

  • Dementia
  • Parkinson’s
  • Stroke
  • Diabetes
  • Other long term health conditions
  • Balance and muscle problems
  • Poor vision and/or hearing
  • Unsafe footwear
  • Loose fitting clothing
  • Some medications
  • Dizziness and drowsiness

Often, falls are caused by a combination of these risk factors.

Mrs S regularly gets up during the night to use the toilet. She started restricting her fluids in the evening to avoid this, but found she had to still frequently pass urine. There is a light beside her bed however she had got up in a hurry to use the toilet and had not turned her light on.

As a result, she had turned to use the toilet in the dark and had misjudged the space, resulting in her falling heavily to the floor on her left hip. Mrs S is not alone, with 70,000 people suffering an osteoporotic hip fracture due to falling each year (British Orthopaedic Association 2007). After she was assessed, she was then helped back to bed, the following day a risk assessment was revisited and her care plan was updated as a preventative measure.

Care Plan and Risk Assessment Post Fall

The post assessment showed that Mrs S had rushed to the toilet, experiencing urgency to go because she was restricting her fluids, which resulted in a possible urinary tract infection (UTI). Drinking plenty of fluids can help reduce falls by up to 50%, it also reduces risk of UTI and bladder problems. However, Mrs S was worried that she will need to get up in the night after her previous falls and therefore decided to decrease her fluid intake.

Mrs S was referred to the GP for assessment and treatment of the possible UTI. The care home also bought her a new cup that Mrs S found easier to drink from and staff encouraged fluids.

A commode was also placed by her bedside for use during the night. Her night lighting was re-evaluated and some glow in the dark lights installed. In addition, staff reinforced their support towards Mrs S and encouraged her to use her call button when needed. They also considered a wireless sensor mat, to monitor her movements overnight.


How to Reduce Risk Factors for Falls in the Elderly

Just like with Mrs S, there are ways you can help to prevent falls from happening with the use of fall prevention systems. Identifying what the problem is and then putting in the proper measurements to prevent it, is the best way to help reduce fall rates in patients.

We have put together a list of preventative measures that can be, to help reduce the risk of falling in future.

  1. Drinking Plenty of Fluids and Getting the Correct Nutrition

As we previously mentioned in the case study, drinking water has many positive benefits, particularly for the elderly. It also has a positive impact on the sleep pattern of the person in question, thereby helping elderly people to wake up less throughout the night.

Nutrition and food is also really important for reducing falls in the elderly. Not receiving the right amount nutrients from certain foods may cause drowsiness, dizziness, weakness and medical problems, making someone more susceptible to falling. Read our previous post, to learn the best ways to ensure the correct hydration and nutrition for the elderly.

  1. Consider their Environment

A safe environment that caters to an elderly person and their needs is essential for reducing falls. It’s important that the space is well lit at night, so they can find their way to a bathroom much easier.

Questions such as, are there any trip hazards on their route? Is their call button within easy reach? Do grab rails need to be added in the bathroom? The list goes, so be sure to really think about every situation during different times of the day, in order to really reduce risks of falls.

  1. Appropriate Footwear and Clothing

As people tend to lose weight in later life, particularly if they have medical conditions, it’s important to ensure their footwear and clothing fit appropriately. If shoes are too big it can put them in a more vulnerable position, increasing the possibility of a fall.

Slippers are worn quite frequently in care homes, so make sure they have an appropriate level of grip on the bottom and are comfortable for those wearing them. Likewise with baggy clothing, if trousers, skirts and robes are so big they are trailing on the floor, this could be a major trip hazard.

  1. Updating Solutions and Equipment

Remember that things change over time and it’s always beneficial to reassess solutions already put in place, in order to prevent a fall from happening. For example, worn ferrules on walking aids may need to be replaced to ensure stability. In addition, if sensor mats are being used in a bathroom, wireless mats or even a PIR system could be considered, again depending on the needs of each individual.

If erratic or unusual behaviour is occurring from medication, causing side effects that are putting someone at risk of falling, be sure to inform a doctor of this. Sometimes some medicines can cause dizzy spells and other symptoms, putting someone in a more vulnerable position. We find it’s always a good idea to properly research the side effects of any medication, preferably before the medication is taken, in order to carry out a thorough risk assessment of that persons current environment and routine.


What to do when Falls Happen

Everyone has a role to play in fall prevention, however it’s important to remember that falls cannot always be prevented. The measures and solutions you put in place are ways in which to reduce them as best you can, not to stop them happening completely.

If you are unsure you can help the patient without hurting them if they fall, then we recommend you seek medical attention immediately, rather than trying to move them yourself and causing more pain.

If a fall does occur that you are able to help with, it’s important to use methods which stop the patient feeling embarrassed or uncomfortable. Products such as an Elk or Camel lifting cushion are a less invasive, dignified way of assisting a resident from the floor.

Beaucare offer a wide selection of fall prevention aids from leading brand names. For more information and tailored advice on which products are best suited to your patients’ needs, contact our knowledgeable team today. Or alternatively, read our previous blog posts to learn more about fall prevention in the elderly community.