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J Fam Pract. 2004 Jan;53(1):41-52.

Why the elderly fall in residential care facilities, and suggested remedies.

Author information

1
Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden. kristina.kallin@germed.umu.se

Abstract

OBJECTIVE:

To study precipitating factors for falls among older people living in residential care facilities.

DESIGN:

Prospective cohort study.

SETTING:

Five residential care facilities.

PARTICIPANTS:

140 women and 59 men, mean age +/- SD 82.4 +/- 6.8 (range, 65-97).

MEASUREMENTS:

After baseline assessments, falls in the population were tracked for 1 year. A physician, a nurse, and a physiotherapist investigated each event, and reached a consensus concerning the most probable precipitating factors for the fall.

RESULTS:

Previous falls and treatment with antidepressants were found to be the most important predisposing factors for falls. Probable precipitating factors could be determined in 331 (68.7%) of the 482 registered falls. Acute disease or symptoms of disease were judged to be precipitating, alone or in combination in 186 (38.6%) of all falls; delirium was a factor in 48 falls (10.0%), and infection, most often urinary tract infection, was a factor in 38 falls (7.9%). Benzodiazepines or neuroleptics were involved in the majority of the 37 falls (7.7%) precipitated by drugs. External factors, such as material defects and obstacles, precipitated 38 (7.9%) of the falls. Other conditions both related to the individual and the environment, such as misinterpretation (eg, overestimation of capacity or forgetfulness), misuse of a roller walker, or mistakes made by the staff were precipitating factors in 83 (17.2%) of falls.

CONCLUSION:

Among older people in residential care facilities, acute diseases and side effects of drugs are important precipitating factors for falls. Falls should therefore be regarded as a possible symptom of disease or a drug side effect until proven otherwise. Timely correction of precipitating and predisposing factors will help prevent further falls.

PMID:
14709266
[Indexed for MEDLINE]

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