Falls in the institutionalized elderly

The reports on 72 of 190 accidents occurring among 189 nursing home residents during a 3-month period were drawn at random and reviewed. The majority of the accidents were falls, either major or minor. Personal data on the residents included age, sex, mental status, number of diseases, and number of drugs administered. Data on environmental factors included the time of day and location of the accident, and the concomitant nursing staff patterns. Women of advanced age were more likely to be involved in a major fall, whereas younger men were more likely to be involved in a minor one. Alert, wheelchair-bound elderly patients were at the highest risk, whereas those who used assistive devices were at the lowest risk. Falls were directly related to the number of diseases present and the use of drugs. Most accidents occurred at the bedside during the evenings and nights, with the greatest frequency during the changes in nursing shifts or when the patient was either rising or retiring.