The impact of falls is alarming. Falls remain the main cause of unintentional injury among older Australians.
Anyone who works with seniors or has ageing family members needs to know about fall prevention in aged care. The risk is concerning in both community and facility settings. These falls can turn dangerous, causing injuries like cuts, hip fractures, and head trauma.
Fall management in aged care needs a complete approach to work. This piece outlines evidence-based prevention strategies used in aged care facilities. You’ll find assessment tools that identify at-risk individuals and practical ways to make spaces safer. These strategies don’t just help; they protect lives.
Understanding the Impact of Falls in Aged Care
Falls among older adults are one of the biggest health challenges in aged care today. These incidents do more than cause physical injuries; they can trigger a chain of events that touch almost every part of an older person’s life. Learning about these effects helps create better ways to stop falls in aged care.
Why falls are a major concern for older adults
Older people fall quite often. Falls are red flags that someone’s health might be getting worse. Your body changes as you age. Physical abilities, senses, and thinking skills can decline together. This makes you more vulnerable, especially in spaces that aren’t built for older people.
Falls can be deadly. For people at advanced ages, falls are a leading cause of injury-related deaths.
Injuries and hospitalisations after a fall
While many falls don’t cause major harm, some lead to serious trauma. Hip fractures are especially serious and can have long-term consequences.
The financial and system impact is also significant for Australia’s health sector.
Emotional and social consequences of falling
The emotional damage from falls runs deep. Fear of falling can start a harmful cycle (anxiety grows, confidence drops, and people start limiting their activities).
Falls can leave psychological scars, such as:
- Depression
- Constant worry and fear
- Lost confidence in everyday tasks
- Trauma-like stress symptoms
Many older adults develop “post-fall syndrome” and stop moving because they’re scared of falling again. This isolation makes muscles weaker and joints stiffer, which increases the chance of another fall.
The social impact spreads beyond the person who falls. Family caregivers face more stress as they need to provide more help. This pressure can change family relationships and sometimes lead to nursing home placement.
These wide-ranging effects show why preventing falls in aged care needs well-laid-out plans that protect both physical safety and mental health.
Identifying Risk Factors for Falls
You need to know what makes people fall to create better prevention strategies in aged care. When you understand these risks better, you can take specific actions that reduce how often and how badly older adults fall.
Intrinsic risk factors: age, mobility, cognition
Your physical and mental condition determine intrinsic risk factors. Age stands out as a major risk factor. This higher risk can come from age-related changes in the nervous system, which affect balance awareness, body sway, and walking patterns.
Physical weakness makes you more likely to fall. Strength and stamina decline with age, which makes it harder to catch yourself when you slip or trip. Problems with walking and balance also make falls more likely, whether they come from normal ageing or conditions like arthritis or Parkinson’s disease.
Your brain health plays a bigger role in falls than you might think. People with dementia tend to fall more often. Reasons include:
- The brain areas that handle thinking also help control movement, balance, and walking
- Even mild memory problems can affect judgment, reaction speed, and body control
- Mental decline often goes hand in hand with physical decline
Other personal risk factors include poor vision, a history of previous falls, dizziness, long-term health conditions, taking multiple medications, and drops in blood pressure when standing up.
Extrinsic risk factors: environment, footwear, lighting
The world around you can increase fall risk. Environmental hazards can turn small problems into big risks.
Common hazards include:
- Poor or glaring lighting
- Rough, uneven, or slick floors
- Clutter or trip hazards
- Missing handrails or grab bars
- Chairs, beds, and toilets at the wrong height
Your shoes make a big difference in your stability. Walking barefoot, in socks, or in unstable shoes increases risk. Good shoes should have flat heels, a good grip, a proper fit, and support your feet. Foot problems like corns, bunions, swelling, or pain can make walking harder and increase your chance of falling.
Good lighting helps prevent falls. Care facilities often have too little light in bedrooms and bathrooms. Ensuring consistent, adequate lighting supports safer movement.
How multiple risk factors increase fall likelihood
Your risk of falling increases when risk factors pile up. These risks work together and can make each other worse.
When you mix a history of falls with movement problems, medications, and hazards around you, things get dangerous fast. Small obstacles that healthy people handle easily can become big problems for those with personal risk factors.
You need a complete picture of both personal and environmental risks to manage falls in aged care well. Care facilities must tackle multiple risks at once, since fixing just one rarely helps much.
A good fall prevention plan starts with understanding each person’s specific risks. Once you know what puts someone at risk, you can create targeted solutions that keep them safe while letting them stay independent and enjoy life.
Assessment Tools for Fall Risk in Aged Care
Healthcare professionals need reliable assessment tools to identify seniors who might fall. These tools work across different care settings. A well-laid-out fall risk assessment is the lifeblood of preventing falls in aged care.
FROP-Com: Falls Risk for Older People – Community Setting
The Falls Risk for Older People in the Community (FROP-Com) is a complete assessment tool created specifically for older adults living in communities. It looks at a range of fall risk factors and gives a thorough analysis of what might cause falls.
The full FROP-Com assessment looks at:
- History of falls
- Medications
- Medical conditions
- Sensory loss
- Feet and footwear
- Cognitive status
- Continence factors
- Nutritional status
- Environment
- Functional behaviour
- Balance
- Gait/physical activity
There is also a shorter FROP-Com Screen for quick checks, focusing on fall history, daily activities, and balance.
FRAT: Falls Risk Assessment Tool
Peninsula Health Falls Prevention Service in Victoria, Australia, created the Falls Risk Assessment Tool (FRAT). The FRAT has three main parts: falls risk status (which can work on its own as a screening tool), a risk factor checklist, and an action plan.
Part 1 looks at major risk factors such as recent falls, medications, psychological status, and cognitive status. Those at higher risk need immediate fall-prevention actions.
When and how to use these tools effectively
The timing of fall risk assessments matters. Care facilities should assess patients promptly on admission. Community health consultations should include these assessments early. After that, reassessments happen during patient reviews or when health status or medications change.
Different healthcare professionals can use these tools:
- Nurses often use the FRAT in hospitals and residential care
- Physiotherapists, occupational therapists, or exercise physiologists use FROP-Com in community settings
- General practitioners may use shorter screens during check-ups
These tools work best as part of a bigger plan. After identifying high-risk individuals:
- High FRAT results may need Fall Alert protocols, clear visual reminders, and notes in handover documents
- High FROP-Com results need targeted support based on specific risks and specialist referrals
Screening is just the start. Healthcare facilities need processes to review patients again, especially when their condition changes. Keeping good records of assessments and interventions is vital for preventing falls in aged care facilities and ensuring continuous care.
Evidence-Based Fall Prevention Strategies
Evidence-based strategies remain the gold standard to reduce fall incidents among seniors in care settings. Specific interventions have shown strong results to minimise falls and their severity. These strategies help preserve independence and quality of life.
Exercise programs: balance, strength, Tai Chi
Physical activity stands out as one of the best ways to prevent falls in aged care. Programs that include strength and balance exercises, along with walking plans, are widely used.
Effective programs typically include:
- Balance training that progressively challenges stability
- Resistance exercises targeting lower-body strength
- Functional movements that mirror daily activities
Tai Chi is another powerful option for improving balance and stability.
Vitamin D supplementation: who benefits most
Vitamin D can play a role in fall prevention by supporting muscle function and bone health. Supplementation may help people with low levels or limited sun exposure. Decisions about supplements should be made with a healthcare professional.
Multifactorial interventions: combining approaches
Most falls happen because of multiple factors working together. That’s why comprehensive interventions usually get the best results. Success depends on identifying risk factors that can be changed and tailoring strategies to each person. Common components include exercise, environmental changes, education, and medication reviews.
Each person needs a unique approach. A tailored assessment and plan based on each person’s risk profile creates the foundation for successful fall prevention in aged care settings.
Environmental and Facility-Level Interventions
Your physical surroundings can make all the difference in preventing or causing falls among seniors. Simple changes to the environment can help reduce fall incidents in aged care settings.
Modifying flooring, lighting, and furniture layout
Smart lighting upgrades are among the most effective ways to improve facility safety. Good lighting helps older adults spot hazards and judge distances better. Lighting that supports natural day-night rhythms also helps.
Flooring should be slip-resistant and well-maintained. Keep surfaces dry and avoid finishes that become slippery. Arrange furniture to create clear walking paths with enough space for walkers and wheelchairs. Choose chairs that are the right height with strong armrests to help people sit and stand safely.
Use of assistive devices and handrails
Handrails are crucial safety features in areas where falls often happen. Install them along stairs, corridors, bathrooms, and toilet areas. Bathrooms also need grab bars near showers, baths, and toilets to make moving around safer, where water creates slippery conditions. Shower stools, raised toilet seats, and handheld shower hoses can further reduce risk.
Universal precautions for safer environments
Safety needs constant attention. Regular checks and quick responses to hazards build a strong foundation for safety.
Remove or secure loose rugs. Use non-slip treatments on hard floors. Keep paths bright and clear. Lock wheels on furniture, wheelchairs, and mobility equipment during transfers.
Night-time safety improves with well-placed nightlights in hallways, bathrooms, and bedrooms. Clean and dry spills straight away, and use warning signs until areas are fully dry.
Implementing and Monitoring Fall Prevention Plans
Falls prevention programs work best when staff apply them consistently and track progress. These programs must blend smoothly into daily care routines.
Staff training and communication protocols
The core team needs solid education to start things right. Every clinical team member should complete falls prevention training. Staff working with residents who have cognitive impairments benefit from specialised instruction. Many facilities do well with “fall champions” who act as on-site experts and reinforce best practices in real time.
Clear communication plays a crucial role. Safety huddles or brief meetings after handover help teams respond quickly to residents’ changing needs. These short sessions enable shared learning and improve safety.
Post-fall assessments and care planning
The team should take these steps after a fall:
- Check airway, breathing, and circulation
- Record vital signs
- Use an appropriate neurological assessment (e.g. Glasgow Coma Scale for unwitnessed falls)
- Arrange a prompt medical review
A multidisciplinary team should meet as soon as possible to discuss what happened. They analyse the cause and plan ways to prevent future falls. This shared approach treats falls as opportunities for improvement rather than inevitable events.
Tracking outcomes and continuous improvement
Good records are the foundation of improvement. Systems that track incidents capture fall-related data. Regular reviews show how well the team follows protocols. Ongoing analysis and performance checks support accountability and safer care.
