Tom Katofiasc headshot
Tom Katofiasc

“It takes a child one year to acquire independent movement and 10 years to acquire independent mobility. An old person can lose both in a day,” said Bernard Isaacs, MD, one of the great innovators in geriatric medicine.

Every second of every day, an adult aged 65 or more years in the United States falls. That makes falls the leading cause of injury (36 million each year) and death (more than 32,000 each year) in this age group, according to the US Centers for Disease Control and Prevention. At least 300,000 older adults are hospitalized for hip fractures each year, and broken bones and head injuries are common as well.

Those statistics indicate that falls need to be taken seriously in senior living.

My team at Omnicare and I have taken significant steps toward improving our falls prevention program for our assisted living customers, ensuring that they’re equipped with whatever means necessary to help reduce and prevent resident falls in their communities.

Starting in 2021, we executed a two-year pilot program in four assisted living communities owned by one Omnicare customer to identify and mitigate falls risk for residents. The program was designed to assess falls risks before a fall happens and offer proactive solutions for intervention. It included use of CDC STEADI (Stopping Elderly Accidents, Deaths and Injuries) tools to create care plans, expanded training for staff members and residents, and established consistent pharmacy medication reviews for existing residents, new residents and, as needed, for residents who experienced a fall. During the pilot, this provider was able to reduce falls in its communities by 44%, from a baseline of 11.41 to an average of 6.35 falls per 1,000 resident days.

If you’re looking to reduce your resident falls, here are some strategies to consider pursuing:

  1. Recognize common risk factors for falls.
  • According to the CDC, most falls are caused by the interaction of multiple risk factors. The more risk factors a person has, the greater his or her chances of falling.
  • Intrinsic risk factors can include poor vision, vitamin D deficiency and balance problems, whereas extrinsic risk factors can include poor footwear and home hazards.
  • In addition, any medication potentially can increase fall risk, and some create higher risk than others due to potential side effects (dizziness, confusion, blurred vision, etc.). Common medications that increase risk for falls include some antidepressants, antipsychotics and opioids, according to the CDC.

2. Collaborate across departments.

  • Preventing falls is a multidisciplinary responsibility. Your nursing and caregiving team, consultant pharmacists and operations team all should work collaboratively to improve safety and provide support if an incident does occur.
  • Many staff members aren’t aware of how their observations and interactions can help prevent falls, so it’s important that all are involved and aware of their unique points of impact.

3. Consider falls prevention in medication reviews.

  • Simple changes to a resident’s medication regimen, such as alternate therapies, adjustment of administration time and increasing monitoring, can significantly affect falls risk. Through our pilot, though, we found that medication discontinuation was most impactful.
  • Omnicare consultant pharmacists make more than 138,000 fall-related recommendations each year, with more than 28,000 medications being discontinued or decreased in dose in response to those recommendations.

4. Partner with a provider that has a great falls program in place.

  • If a provider isn’t prepared to assist your community in decreasing and preventing falls, then it might be time to explore alternative partners.
  • Look for a vendor that is willing to adapt to meet the needs of your community and residents and develop unique solutions to create a program that works.

Continuing momentum from our successful falls prevention pilot, we plan to expand the program this year, re-introducing it to more assisted living partners and promoting those positive results as proof points of the benefit of undergoing a more formalized falls prevention program. My recommendation to all providers would be to follow suit. It’s time to prioritize falls prevention for our most vulnerable population.

Tom Katofiasc is senior manager of quality long-term care at long-term care pharmacy services provider Omnicare, a CVS Health company.

The opinions expressed in each McKnight’s Senior Living marketplace column are those of the author and are not necessarily those of McKnight’s Senior Living.

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