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Identifying nursing home residents at risk for falling
D K Kiely1, D P Kiel, A B Burrows
1Hebrew Rehabilitation Center for Aged Research and Training Institute, Boston, MA 02131, USA.
Journal of the American Geriatrics Society
|May 20, 1998
Summary
Fall history is the strongest predictor of future falls in nursing home residents. This finding can guide interventions to prevent falls and improve resident safety.
Area of Science:
- Gerontology
- Nursing Home Care
- Patient Safety
Background:
- Falls are a significant concern in nursing home settings.
- Identifying residents at high risk for falls is crucial for implementing preventive measures.
Purpose of the Study:
- To develop a predictive model for identifying nursing home residents at risk of falling.
- To investigate the influence of the nursing home environment on fall development.
Main Methods:
- A prospective study with 1-year follow-up of 18,855 nursing home residents across 272 facilities.
- Baseline Minimum Data Set items were analyzed as potential risk factors.
- Fall rates within facilities were used to estimate extrinsic environmental risk.
Main Results:
- Key predictors of falls included fall history, wandering, assistive device use, ADL decline, advanced age, gait instability, and gender.
- Residents with a history of falls were over three times more likely to fall again.
- Living in a high-fall-rate facility increased fall risk by over two times, independent of resident factors.
Conclusions:
- Fall history is the most significant risk factor for subsequent falls in nursing home residents.
- Fall history should be prioritized for fall intervention screening.
- Further research is needed to identify specific facility characteristics contributing to fall risk.