Wearing slippers, falls and injury in residential care

Risk factor studies for falls in residential care have not included factors related to the facilities themselves.

To identify risk factors for falls and injury related to the individual and the facility.

Cohort study with 1 to 17 months of followup.

A random sample of 14 residential care homes in Auckland, New Zealand.

All residents were approached and 606 (97%) participated, mean (SD) age was 83 (11) years. 114 (19%) residents died and 64 (11%) were transferred.

Rate of falls and injurious falls per resident year were measured.

The mean rate of falls and injurious falls was 2.75 and 1.75 per resident year respectively. Factors independently associated with increased falls included: increased mobility (IRR 1.25; 95% CI 1.14-1.37), and less problematic behaviours (IRR 1.09, 95% CI 1.02-1.17), while unexpectedly digoxin use (IRR 0.56, 95% CI 0.33-0.97) was associated with decreased falls. Factors associated with increased risk of injury included being born in the UK (IRR 2.89, 95% CI 1.24-7.19) and being more mobile (OR 1.15, 95% CI 1.06-1.25), whereas wearing soft-soled shoes compared with slippers (IRR 0.50, 95% CI 0.28-0.90) and unexpectedly visual impairment (IRR 0.52, 95% CI 0.33-0.80) was associated with decreased injury. No significant factors related to the facility were identified.

Falls are frequent in residential care facilities and risk factors related to footwear are potentially reversible.

Residents should be encouraged to wear shoes rather than slippers.