An in-depth review identifies
key ways to improve a falls
alls present one of the most significant health risks
for residents of long-term care homes. Unfortunately,
they are unpredictable by nature.
In his first few weeks in long-term care, John, an 86-yearold resident with dementia, frequently got out of bed
without staff assistance, resulting in numerous falls. The
staff lowered his bed closer to the ground, put a soft mat
on the floor and gave him a hip protector to wear during
the day to prevent a hip fracture, should he fall again.
Krista Griffin, National Director of Recreation and
Rehabilitation, says this is a common approach to falls
prevention in long-term care. Unfortunately, strategies like
these are focused on reducing injuries, rather than
That distinction was one of the key findings of a comprehensive analysis and review of falls programs
across the country, which began in 2015. The improvements the organization has made as a result of the study
have led to a 50% drop in the number of falls in the homes
involved in the pilot study.
At the cornerstone of the new approach is a screening
tool used to identify a risk of falling that is more
sensitive and comprehensive than what is currently used
by many homes. This new tool is particularly important
with a growing population of residents with dementia who
cannot directly communicate their needs.
tend to make assumptions about why residents are
says Griffin. need to make sure we understand
the root causes of each fall based on evidence, not assumptions. That allows us to develop timely, personalized,
and resident-specific Griffin asserts that
the new assessments, when done at key times, provide
John, for example, may be restless at night because he is
in pain. He may be experiencing side effects from his medications. Or he may be thirsty and want a drink of water.
Using the new approach, staff would first do a thorough
clinical assessment and address the reasons that John frequently gets out of bed. Once they were confident that all
his needs had been met, they would implement personalized fall prevention and injury reduction strategies to help
keep him safe should he decide to get out of bed.
improved environmental assessment is a key component of fall prevention says Griffin.
screening tool now looks at factors such as adequate
LONG TERM CARE TODAY
Behind every fall is a story: Revera used images and
slogans to help communicate the program
lighting, whether important personal items are within
reach, whether the room is too cluttered and if safety
hazards Additionally, Revera now ensures all staff
who work in the rooms, including housekeeping,
are aware of the environmental risks identified through
Revera has also revised the use of the logo as
a visual management tool in its homes. This small poster,
used to identify residents at risk, was associated with
80% of residents in the pilot homes and had lost its
effectiveness as a reminder for staff. The team changed
the criteria so that the falling star logo is only used for the
The project is still in its early stages, involving eight homes
across the country, but has yielded promising results. After
all the data has been evaluated from each phase of implementation, the plan is to roll the new program out to all
Revera homes across Canada.
Griffin says Revera found value in using quality improvement methodologies. the biggest she says,
that important to include all interdisciplinary frontline
staff. They have the answers. You just need to provide the
opportunity for their voices to be LTCT