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Premature deaths report puts focus on falls

There are fresh calls for a coordinated national falls prevention strategy in light of new figures showing falls accounted for the vast majority of premature deaths in aged care.

One of Australia’s leading falls experts Professor Keith Hill, Head of the School of Physiotherapy at Curtin University, said he was not surprised by a new analysis showing falls caused 82 per cent of premature deaths in residential care from 2000 to 2013.

The research published on Monday in the Medical Journal of Australia, led by Monash University Professor Joseph Ibrahim, reviewed coronial reports to examine the causes of preventable deaths in residential care.

It found that of the 21,672 deaths examined, 15 per cent (or 3,289 cases) were premature and potentially preventable. Falls were the most frequent cause of these deaths (82 per cent, or 2,679 cases) followed by choking (8 per cent, or 261 cases) and suicide (4 per cent, or 146 cases).

Keith Hill

Professor Hill, who is a long-time advocate for a national falls strategy, said there were still gaps in the evidence around what interventions worked.

“We still don’t have anywhere near enough research,” said Professor Hill, who is part of the team updating the Cochrane review of research into falls in residential aged care.

While there was some good evidence supporting falls prevention initiatives in community care, “the evidence is very light in residential aged care,” he said.

A coordinated strategy should also address staffing issues in residential care – specifically the greater active involvement of allied health professionals in delivering programs for residents, he said.

While falls remain a key issue for seniors living in their own homes, Professor Hill said there are “extra challenges” in residential aged care given the increasing complexity and acuity of residents and greater cognitive impairment.

“All those things increase the risk of falls,” he said.

Responding to Professor Ibrahim’s research, Aged and Community Services Australia CEO Pat Sparrow said it was worth noting that falls are the highest cause of hospitalisation from injury across the whole community.

“This is an area in in which the dignity and rights of the older person must be balanced with safety concerns,” she added.

Leading Age Services Australia chief Sean Rooney said residential care providers work with residents and their families to ensure a safe environment while not limiting a resident’s independence or freedoms.

“A good quality of life requires a certain degree of autonomy so residents may make choices that enhance their quality of life, but may also increase the risk of potential harm,” he said.

Professor Ibrahim’s research paper is available to read here

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4 Responses to Premature deaths report puts focus on falls

  1. Andrew May 31, 2017 at 3:07 pm #

    Interesting article. I think everybody working in residential aged care should be aware of the Australian Commission on Safety and Quality in Health Care’s publication: “Preventing Falls and Harm from Falls in Older People; Best practice guidelines for Australian residential aged care facilities 2009.” If not follow the hyperlink, https://www.safetyandquality.gov.au/wp-content/uploads/2012/01/Guidelines-RACF.pdf

  2. Louise June 1, 2017 at 9:38 am #

    I think the biggest cause of an increase in falls in aged care facilities is the poor staffing levels. It takes time to shower, toilet and dress residents; and while staff are attending one resident, other residents are left waiting, and so take unnecessary risks, or are unsupervised when they should be. Often residents are left without staff checking on them for long periods, just because the staff are so busy. Yes, some residents will fall no matter what you do, and no, tying them into position is NOT the answer – a life with dignity, is not a life without some risk.

  3. colin burger June 3, 2017 at 3:06 pm #

    I am only 72 but I know a few older people who died 2 days after a fall, other people had 2 or 3 falls then a couple of weeks later they died. They’re not people who were sick… just in here because they had trouble looking after themselves.

  4. I Manson June 15, 2017 at 3:47 pm #

    All the literature points to the fact that there is an increased fall rate in Aged Care facilities.
    This why it is important to keep the aged in their own homes & local support networks.
    It should be noted that once a person goes into this time of care it must be difficult to maintain a positive outlook as the only way out is probably not one that is look forward to.

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