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Falls and fall prevention in the nursing home
L Z Rubenstein1, K R Josephson, D Osterweil
1University of California, Los Angeles, School of Medicine, Los Angeles, California, USA.
Clinics in Geriatric Medicine
|November 1, 1996
Summary
Nursing home falls are common, often caused by gait issues and environmental hazards. Multifactorial prevention strategies focusing on strength, function, and hazard reduction are most effective for fall prevention.
Area of Science:
- Gerontology
- Nursing Home Care
- Patient Safety
Background:
- Falls are a significant issue in nursing homes, with a mean incidence of 1.5 falls per bed annually.
- Common causes include gait and balance disorders, weakness, dizziness, environmental hazards, confusion, visual impairment, and postural hypotension.
Purpose of the Study:
- To review the causes and risk factors for falls in nursing home residents.
- To evaluate the effectiveness of various fall prevention strategies.
- To identify optimal approaches for reducing falls and injuries in this population.
Main Methods:
- Focused history and physical examinations to identify immediate causes and risk factors.
- Review of existing fall prevention strategies and their outcomes.
- Emphasis on multifactorial interventions targeting resident status and environment.
Main Results:
- Successful prevention requires addressing multifactorial causes, including improving strength, functional status, and reducing environmental hazards.
- Regular resident evaluations help identify high-risk individuals for targeted interventions.
- Restraint use to reduce mobility is counterproductive and should be avoided.
Conclusions:
- Multifactorial fall prevention strategies are most effective in nursing homes.
- Interventions should focus on improving resident's physical and cognitive status, and mitigating environmental risks.
- Ongoing evaluation and targeted interventions are key to successful fall prevention programs.
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