Falls Among Residents Living in Care Homes Using Real-Time Data Collection: A Large UK Case-Control Study

Falls are common among older residents living in care homes and have significant associated morbidity and mortality. These incidents negatively impact quality of life and pose a substantial financial burden on healthcare systems.

This case-control study explored fall patterns and identifiable risk factors for falls using real-time data collected via the Mobile Care Monitoring (MCM) app across 1,700 care homes in England. Care home staff continuously recorded data for 1 year on a matched cohort of 6,006 residents who experienced at least one fall and 6,006 who had no documented falls, aged 75 years and older.

The fall incidence rate was 1,249 per 1,000 residents per year and among those who had already experienced at least one fall, 45% had three or more falls. Advancing age was significantly associated with increasing fall risk (Incidence Rate Ratio (IRR): 1.11; 95% CI: 1.04-1.17; p < 0.001). Residents who experienced a fall were significantly more likely to have at least one hospitalisation than those who had no documented falls (54% vs. 34% respectively, p < 0.001). Falls with injury were significantly higher for males than females (IRR 1.79; 95% CI: 1.44-2.14; p < 0.001). 98.5% of falls occurred indoors, mostly in the bedroom, lounge, and bathroom. Logistic regression analysis identified nine variables significantly and independently associated with fall risk, including exercise frequency and fluid intake. There was no significant relationship between fall rates or hospitalisation rates, and Care Quality Commission (CQC) ratings of the care homes.

The use of real-time electronic data collection through the MCM app offers a robust foundation for addressing the challenges associated with falls in this population.