Dr Frances Batchelor, Director of Clinical Gerontology at the National Ageing Research Institute, has told the Royal Commission into Aged Care Quality and Safety that there is an urgent need for more high-quality research to learn what can effectively prevent falls in residential care, especially for people living with dementia.
Dr Batchelor said that while there is strong evidence exercise that includes strength and balance training for two hours a week over 25 weeks – for a total of 50 hours – is effective at reducing falls in the community, the same could not be said for residential aged care.
There is little evidence-backed data to support common preventive measures such as exercises, medication reviews, bed and chair alarms or a combination in residential aged care, and more research and clinical data is needed urgently, according to Dr Batchelor.
However, she said that until findings from new research become available, the sector needed to be proactive and come up with a comprehensive falls risk assessment and management plans. These include: increasing the number of staff involved in direct resident care, increasing falls prevention training for all staff including personal care workers, improving how data is collected, particularly in real-time, and implementing person-centred care.
According to Dr Batchelor, accidental falls are the tenth leading cause of death for people in residential aged care and the eighth leading cause for people receiving aged care packages. On average 50% of aged care residents will have one or more falls in any given year. This is higher in residents with dementia, with estimates of up to 90% of people with dementia associated with Parkinson’s disease falling at least once in a year.
“We shouldn’t just say that falls are an inevitable part of ageing and that they are all going to happen,” she said.
Dr Batchelor said that most residents are only assessed for their falls risk when they enter residential care and then on a three-monthly basis or when a fall occurs.
“But it’s not responding in a dynamic way to the changes that we might see in residents’ functional and health status, Falls aren’t in isolation, from other issues such as nutrition, even oral care. They’re all interrelated and if we can support staff to offer truly person-centred assessment and care, then I think that will go a long way to prevention of falls but also joining the dots for those other issues,” she added.
Thanks for your insights Frances. Falls, and subsequent physical and psychological injury cause huge distress to residents, their carers and care staff alike. Falls and the fear of falling frequently contribute to functional disability and the social cost urgently warrants research to achieve a greater understanding of this issue and practical management advice to limit as best we can the risk. Great work esp the comparative work done in subacute care at Austin and Royal Melbourne Hospital. Maybe something along these lines could be adapted to RAC. A/Prof Michael Murray, Divisional Medical Director & Head of geriatric Medicine, Austin Health