Epidemiology of falls in residential aged care: analysis of more than 70,000 falls from residents of bavarian nursing homes

Abstract

Objective: Falls and fall-related injuries are leading problems in residential aged care facilities. The objective of this study was to provide descriptive data about falls in nursing homes.

Design/setting/participants: Prospective recording of all falls over 1 year covering all residents from 528 nursing homes in Bavaria, Germany.

Measurements: Falls were reported on a standardized form that included a facility identification code, date, time of the day, sex, age, degree of care need, location of the fall, and activity leading to the fall. Data detailing homes' bed capacities and occupancy levels were used to estimate total person-years under exposure and to calculate fall rates. All analyses were stratified by residents' degree of care need.

Results: More than 70,000 falls were recorded during 42,843 person-years. The fall rate was higher in men than in women (2.18 and 1.49 falls per person-year, respectively). Fall risk differed by degree of care need with lower fall risks both in the least and highest care categories. About 75% of all falls occurred in the residents' rooms or in the bathrooms and only 22% were reported within the common areas. Transfers and walking were responsible for 41% and 36% of all falls respectively. Fall risk varied during the day. Most falls were observed between 10 am and midday and between 2 pm and 8 pm.

Conclusion: The differing fall risk patterns in specific subgroups may help to target preventive measures.