How To Prevent Falls In Assisted Living Facilities

According to the CDC, one in four people over age 65 falls each year, totaling 32,000+ deaths. This makes falls the leading cause of serious injuries and injury-related death in this age group. Robin Lee, an epidemiologist at the Injury Center of the CDC, warns that we can expect to see more deaths from falls as the population ages.

With that in mind, it stands to reason that fall prevention is a top priority in residential care facilities like nursing homes and assisted living facilities. Fortunately, most age-related falls are preventable once you take steps to minimize the risk for your patients. The following five strategies can help reduce falls and improve the quality of life for residents in your assisted living facility.

1. Conduct a fall risk assessment

For senior citizens, falling once doubles the chances of falling again. Therefore, a good fall prevention strategy starts with a fall risk assessment of each new resident in order to prevent that initial fall.

When an individual is first placed in your assisted living facility, work with a doctor or physical therapist to assess the person’s current needs and health history, including:

• Any past incidents of falling
• Any current or past mobility issues or chronic conditions and if the resident requires any assistive devices such as a wheelchair, walker, or a cane
• An evaluation of their muscle strength, balance, and gait
• An approach developed by the CDC called STEADI (Stopping Elderly Accidents, Deaths, and Injuries) that is used by many health care professionals. STEADI uses the following exercises for assessing fall risks:

• Timed Up-and-Go (Tug): Assesses gait and mobility
• 30-Second Chair Stand Test: Checks for strength and balance
• 4-Stage Balance Test: Assesses balance

• Use of any medications that can cause side effects and interactions or sedatives such as sleeping pills that may increase their risk of falling
• Any mental or physical health conditions that increase the risk of falling, including vision problems, heart conditions, dementia, Alzheimer’s, and a history of seizures

2. Promote regular physical fitness

All adults can benefit from a regular exercise program, but for seniors, exercise is essential for improving their stability and strength. In fact, exercise can reduce the rate of falls by 23%.

We recommend organizing exercise programs that target strength, gait, and balance, which are all important in helping reduce the risk of resident falls. These could be formal exercise groups or individual programs based on a physical therapist or doctor’s assessment.

According to Lora Stutzman, a physical therapist with the Johns Hopkins Rehabilitation Network, sit-to-stand exercises and balance exercises “can help improve balance and build strength to help prevent future falls.”

In addition, the British Journal of Sports Medicine found that Tai Chi may reduce the rate of falls by 19%. Tai Chi helps improve balance because it involves slow, purposeful movements in coordination with breathing and muscle activity.

When it comes to the exact amount of exercise needed, keeping up a consistent schedule is key to fall prevention. A World Health Organization study found that an exercise dose of more than three hours per week that included balance and functional exercises led to an estimated 42% reduction in the rate of falls.

3. Leverage technology

Caregivers are increasingly turning to technology to monitor the health of older adults. But much of this comes in the form of wearables, such as alarm pendants and wrist blood pressure monitors, that many residents avoid out of fear of stigmatization from their peers. For example, some studies have found that some older adults believe that wearable technology users “are very elderly people with serious cognitive or physical impairments.”

However, an AI-driven technology like Exer’s is discreet and non-invasive. Nothing is strapped to residents or is even physically close to them. Instead, Exer apps are powered by artificial intelligence and computer vision that uses just the camera on any staff member’s normal phone or tablet.

Through the app, you can conduct fast and accurate gait analysis during a fall risk assessment - with further tests like Timed Up-and-Go coming soon. The results are documented in real time in an easy-to-read dashboard, so you can quickly identify at-risk individuals and continuously measure improvements or weaknesses in your patient’s gait.

Regular assessments with the app can help produce more accurate metrics over time because caregivers can compare gait metrics against normative real-time data. For example, a study utilizing embedded sensors found that a 2.54 cm/s slower gait speed measured over just three weeks led to a 400% increase in a resident’s fall risk.

Exer’s Gait app helps residential staff identify potential problems before they happen and reduce the number of falls in a facility. Taking proactive measures to prevent falls, including Exer Gait, helped Salus Physical Therapy decrease the number of falls in their partner facilities by 60% in 2021.

The Exer app can also be used as part of a resident’s regular exercise program. All residents need to do is walk, stretch, or perform motion exercises in front of a camera, and Exer’s “body pose tracking” will capture their image at 24 points across the body.

This data can be seen and used by a physician or physical therapist to identify mobility deficits, assess progress or decline over time, and create data-driven care plans tailored to their patient’s real-time progress.

4. Identify and eliminate environmental hazards

According to the World Health Organization, the most common cause of falls in older people (about 30 to 50%) is factors related to the physical environment. And when combined with other risk factors, such as poor vision or balance, environmental hazards can increase the risk of nursing home falls and fall-related injuries such as hip fractures.

Undertaking an environmental audit of the nursing home can reveal problematic areas that may cause assisted living residents to lose their footing and fall. The CDC has a Home Fall Prevention Checklist for Older Adults, which can easily be adapted for use by assisted living facilities. With this checklist, facility staff can look out for risk factors such as loose carpeting, poor lighting, slippery or wet floors, clutter, poorly fitted handrails, and high or narrow steps.

Once you’ve identified high-risk areas, you can then take steps to remedy these problems, such as by using non-slip rugs, improving lighting in dark or dim areas, and installing safety rails throughout the residence.

5. Consider vitamin D supplementation

Vitamin D is vital for human bone health, and research suggests that vitamin D maintains the function of type II fibers preserving muscle strength and preventing falls. Yet almost 50% of the world’s population is deficient in vitamin D. In addition, because nursing home residents have limited sun exposure, they are at higher risk of deficiency than younger adults.

In several trials of older adults at risk for vitamin D deficiency, supplementation improved strength, function, and balance. These benefits resulted in a reduction in falls in some of the same trial participants. Consult a physician to determine if residents require vitamin D supplementation based on their individual assessments.

The American Geriatrics Society recommends that healthcare providers review older patients’ vitamin D intake from all sources, including diet, sunlight exposure, and supplements, and work to achieve at least 1,000 international units (IU)/day.

Follow a multi-component fall prevention strategy

For the best chance of reducing the risk of falls in your assisted living facility, we recommend incorporating all the steps outlined in this article into your long-term care plan. In fact, a study from McMaster University shows that "fall-prevention strategies that include multiple components are effective at reducing fall rates and the total number of falls among older adults."

And to learn more about how Exer can help you develop the best strategies for recovery, prevent future injuries, and protect your residents’ overall quality of life, sign up for a free demo.