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Original Study
Epidemiology of Falls in Residential Aged Care: Analysis of More Than 70,000 Falls From Residents of Bavarian Nursing Homes

https://doi.org/10.1016/j.jamda.2011.06.011Get rights and content

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.

Section snippets

Methods

Bavaria is a federal state with 12.5 million inhabitants in the south of Germany. In Bavaria, more than 12% of the 551,000 citizens aged 80 years or older are residents of one of about 1400 nursing homes. Persons live in a nursing home of their own choice. In 2007, Germany's largest health insurance company (AOK) started to implement a statewide fall prevention program (The Bavarian Fall and Fracture Prevention Study) in nursing homes in Bavaria.

Participating nursing homes committed to document

Results

Falls were documented over one calendar year in 528 nursing homes with a median of 88 beds. The estimated person-years of exposure were 33,503 years in women and 9340 years in men. The distribution over different age groups and in different levels of care is shown in Table 1.

The fall rate was higher in men (2.18 falls per person-year) than in women (1.49 falls per person-year) (Table 2). The pattern of the age-dependent fall rate differed between the genders. In women, fall rates decreased

Discussion

The study presents detailed descriptive data about falls and fall rates in nursing homes. We found lower fall rates in women than in men and decreasing fall rates with increasing care need (level of care). Prevalence of falls peaked in the morning between 10 am and midday and in the afternoon and the early evening between 2 pm and 8 pm. Most of the falls occurred in the residents' rooms and only less than a quarter were observed in the homes' common areas. Residents with less functional

Acknowledgments

We thank Regina Merk-Bäuml, Ralf Brum, Markus Gindl, and Stefanie Büttner from the Allgemeine Ortskrankenkasse (AOK), and Ulrich Rissmann from the Robert-Bosch-Hospital Stuttgart. Furthermore, we thank Andrea Kleiner from the Institute of Epidemiology and Medical Biometry, Ulm University, for the preparation of the figures.

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  • Cited by (0)

    The evaluation of the study was funded by the Bundesministerium fur Bildung und Forshung (Forderkennzeichen: 01EL0702, 01EL0717, 01EL0718). All authors declare that they have no conflicts of interest.

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