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Sep 29, 2023

Why full reviews can greatly reduce falls risk

Prevent falls with a full review and anticipate them before they happen

Falls and fall-related injuries are a common and serious problem for older adults living in care homes. Not only do falls represent a significant proportion of hospital admissions – falls are also estimated to cost the NHS more than £2.3 billion per year – but they also have a serious impact on the quality of life for any older adult because a fall can not only lead to serious injury or worse, but it can have lasting emotional and phycological effects. This is why regular falls risk reviews are so important for falls prevention.  

The main psychological effects of falls include:  

  • Loss of confidence 
  • Anxiety and/or depression 
  • Fear of further falls 
  • Low self-esteem 
  • Embarrassment 
  • Emotional distress 
  • Isolation and/or lack of independence

The importance of fall reviews 

These are just some of the emotional and psychological consequences of an older person experiencing a fall; it isn’t just distressing for them, but it is also distressing for their families and the staff who care for them. 

And when it comes to the families of care home residents, assuring them that every possible measure is being taken to make sure falls don’t happen unnecessarily (and ideally not at all) is critical for their peace of mind and general relationship with the people to whom they have entrusted the care of the person they love.  

Regular falls risk reviews are also so important because of the startling statistics behind how often falls occur for older adults; people aged 65 and older have the highest risk of falling, with 30% of people older than 65 and 50% of people older than 80 falling at least once a year. 

The factors that increase falls risk 

There are several factors that contribute to falls in older adults, such as a lack of fluid monitoring leading to dehydration or physical degeneration due to a lack of physical activity, but one of the major factors that put older adults at risk of falls is medication. 

It’s important to consider the fact that medicines contribute to falls because older people are more likely to experience polypharmacy (being prescribed 5 or more medicines). This is very common for those living in care homes, with some studies finding that older adults living in care homes can be prescribed on average as high as 7 medicines.  

The fall risk associated with polypharmacy 

There are a number of medicines that are deemed ‘high-risk’ when it comes to falls in older adults because side effects include drowsiness, slow reactions, impaired balance, and others.

These include: 

  • Sedatives 
  • Antidepressants 
  • Antipsychotics 
  • Anti-epileptics 
  • Opioids 
  • Parkinson’s disease medicines 
  • Antihypertensives 
  • Diuretics 
  • Anti-anginals 
  • Beta-blockers 

It’s not uncommon for an older person living in a care home to be prescribed a number of different medications such as these that all come with the side effects mentioned above, so taking every step possible to assess and find ways to narrow down medications if possible is key to preventing falls.  

How to assess and manage falls risk 

While being at a higher risk of falls and injuries relating to falls is unfortunately just a part of getting older due to a natural degeneration in mobility and balance that often comes with age, studies still show that a large portion of falls are nonetheless preventable.  

In order to identify what the risks are for falls and where they exist within a care home setting, and therefore develop an effective strategy for falls prevention, several factors need to be considered for both the environment itself and the residents living within. The best way to eliminate preventable falls is to examine the risk factors for an individual person and where possible, either try to remove them or find a way to mediate them. 

For example, we have already discussed that polypharmacy is a high-risk factor when it comes to falls in older adults; the proper monitoring of medicines, such as the real-time data provided by ATLAS eMAR on dosage, timing, medicine type and effect, as well as increased communication and integration between care homes and pharmacies, could potentially lead to a reduction or alteration of some medications or possibly even eliminate medications that aren’t deemed necessary.

Other factors for managing falls risk include:  

Staying active

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Encouraging an active lifestyle where possible for older adults in ways like engaging in exercise programmes that increase muscle strength, balance and mobility, can have a significant effect on reducing falls by improving coordination, balance, and muscle and bone strength.
 
This can reduce the chance of a fall and also reduce the chance of a serious injury if a fall should occur. 

Maintaining a healthy diet

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While it can be common that a person’s appetite tends to decrease with age, ensuring that care home residents get a healthy, balanced diet is essential not just for overall health, but it can also keep the immune system strong, it can keep energy stores topped up and it can reduce the risk of falls due to a lack of nutritious food.  

Fluid levels

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It is also important to ensure that care home residents are maintaining proper fluid levels to prevent dehydration or side effects of medications.

Whether care home residents are not getting enough fluids or whether their fluid intake needs to be capped, ensuring this can have positive outcomes when it comes to preventing falls.
 
So, ensuring that fluid intake is at the appropriate level, such as by using mCare’s Fluid Monitoring feature, is essential. Ensuring that care home residents are meeting their fluid and dietary needs is also a matter of detail – so ensuring that as many care notes are taken that covers real-time updates on needs and levels is crucial too to stay ahead of the risk of falls. 

Environment

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There are many ways that care home staff can ensure, through a comprehensive falls review, that they can reduce the risk of falls by promoting the topics mentioned above, but what is equally as important is ensuring that the home itself is free of any hazards.

For example, rugs and mats that sit on or at the bottom of stairs can easily be a fall risk, small steps in and out of doors that could be missed without adequate lighting or notices, or trailing wires from radios, night lights or TV stations that could pose a fall risk. These are just a few examples, so it is important to conduct a thorough survey of the home as part of the falls review to ensure no hazards are present that could lead to preventable falls. 

 

Whether it is reducing polypharmacy through better and more efficient medication management with ATLAS eMAR, ensuring appropriate nutrition and fluid intake and maintaining a higher standard and volume of care notes with mCare or helping care home residents to stay fit, strong and healthy through activities with Oomph! On-Demand, Person Centred Software’s Connected Care Platform is the only all-in-one, integrated platform that can be used to address all of these challenges to tackle the many risks that lead to falls in care homes.  

Click here to find out more about Person Centred Software’s Connected Care Platform 

September 29, 2023

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