Geriatric nursing home falls: A single institution cross-sectional study

Botwinick, Isadora; Johnson, Joshua H.; Safadjou, Saman; Cohen-Levy, Wayne B.; Reddy, Srinivas H.; McNelis, John; Teperman, Sheldon; Stone, Melvin E.

doi:10.1016/j.archger.2015.12.002

Cited by 8 publications

(3 citation statements)

References 20 publications

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“…Moreover, inappropriate footwear has been described as a risk factor for injurious falls of residents in nursing homes. [14,38] Our study suggests that 23.2% the elderly fell due to slipping and the consequences of a fall may be particularly severe if open slippers are worn as they can prevent evasive action, such as stepping, which would reduce potential injuries from falls. Therefore, managers and nursing staff should work together to assess the safety of the living environment of the elderly to eliminate risk factors.…”

Section: Discussionmentioning

confidence: 93%

“…[13] Although there have been many studies of falls in the elderly and the factors that influence them, there remains a lack of research on their epidemiological status and the factors influencing falls among the elderly in LTC institutions. [14–16] In particular, little existing research involves institutional-level considerations of falls such as gender differences in different residential settings or the attributes of institutions. [17] Therefore, this study aims to investigate the epidemiological characteristics and identify the factors influencing falls in LTC residents.…”

Section: Introductionmentioning

confidence: 99%

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Epidemiological characteristics and factors influencing falls among elderly adults in long-term care facilities in Xiamen, China

et al. 2019

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Falling in the elderly is an important social issue, especially for those who are in long-term care (LTC) facilities, in addition to being a significant economic burden. This study aims to investigate the epidemiological characteristics and identify the factors influencing falls in LTC residents. We enrolled 260 participants aged 60+ years by multistage sampling across 13 LTC facilities in Xiamen, China, in 2016. Epidemiological characteristics and falls were observed and recorded during a 12-month period using a revised FROP-Com Scale. Multiple logistic regression modeling was performed to determine the factors influencing falls. A total of 218 (83.8%) valid questionnaires were returned. 152 falls (range 1–7, mean 0.7 ± 1.3 falls/person/y) occurred in the previous year, with 69 residents (31.7%) experiencing 1 or more falls. Most participants who fell were female (71%), living in cities (85.5%), had a higher BMI (22.1 ± 4.2), and had a chronic disease (99.9%). Of all falls, 39.1% occurred in the bedroom and 26.1% in the bathroom, 58% during daytime hours between 6:00 am and noon. Thirty-six percent of falls resulted in an injury (e.g., bruises and fractures). The principal reason for falling was due to slipping (23.2%). There were 2 interactions on fall rate between ADL and feet and footwear (OR = 3.120, P <.001; OR = 3.010, P = .007 in Models 1 and 3), and between ADL and cognitive status (OR = 4.401, P <.001; OR = 4.101, P = .005 in Models 2 and 3). Multiple regression analysis indicated that ADL, balance and gait, medical conditions, cognitive status, living environment, feet and footwear and sensory loss were factors influencing falls among elderly adults in LTC facilities. Falls occur frequently and mostly unwitnessed among elderly adults in LTC facilities, highlighting the need for more effective and individualized fall prevention. Fall efficacy enhancing programs for nursing home residents should take degree of self-care, chronic diseases, sensory loss, foot injuries, cognitive impairment, living environment, and gender into account.

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Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Epidemiological characteristics and factors influencing falls among elderly adults in long-term care facilities in Xiamen, China

et al. 2019

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“…A limitation of our study is that we only included residents who had suffered a fall during the month prior to the baseline interview in the analyses so we cannot rule out that some residents died shortly after the fall but before the interview (post-fall in-hospital mortality has been reported as between 3.7% and 16% [15,16,18,40,41]). Furthermore, residents who had suffered a fall and survived the first month could be stronger than non-fallers.…”

Section: Plos Onementioning

confidence: 99%

Falls and long-term survival among older adults residing in care homes

et al. 2020

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Objectives To assess the association between having suffered a fall in the month prior to interview and long-term overall survival in nursing-home residents. Methods Retrospective cohort study conducting an overall survival follow-up of 689 representative nursing-home residents from Madrid, Spain. Residents lived in three types of facilities: public, subsidized and private and its information was collected by interviewing the residents, caregivers and/or facility physicians. Residents contributed to follow-up time from their baseline interviews until death or being censored at the end of the 5-year follow-up period. The association between suffering a fall during the month prior to interview and long-term overall survival was analyzed using Cox proportional hazards models. To adjust for potential confounders we used progressive adjusted models. We then repeated the analyses with severity of the fall (no fall, non-severe, severe) as the main independent variable. Results After a 2408 person-year follow-up (median 4.5 years), 372 participants had died. In fullyadjusted models, residents who had suffered any kind of fall in the previous month showed virtually the same survival rates compared to non-fallers (hazard ratio (HR) = 1.03; 95% CI = 0.75-1.40). There was a weak graded relationship between increased fall severity and survival rates for the non-severe fall group (HR = 0.92; 95% CI = 0.58-1.45) and the severe fall group (HR = 1.36; 95% CI = 0.73-2.53) compared with residents who had not suffered any kind of fall. The hazard ratios for severe falls were higher in men, residents with less comorbidity, fewer medications, and those functionally independent.

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