Falls in Care Homes: “Let’s go and invent tomorrow, instead of worrying about what happened yesterday….”
Dr Jane Horne has spent over ten years as a Senior Research Fellow and Occupational Therapist at the University of Nottingham. She will be speaking at the virtual 21st International Conference on Falls and Postural Stability in Plenary session #3 and live for the Q & A’s. Her session will focus on embedding evidence-based falls resources into care homes to reduce falls. She tweets occasionally: @janechorne and @FinCH_Study.
There has been a significant focus on UK care homes following COVID-19. Care homes have had to quickly adapt their working practices, to keep their residents and staff safe. Approximately 400,000 older people are currently living in UK care homes. Care home residents remain one of the most vulnerable populations in our society with complex health and social care needs, including frailty, dementia and multiple comorbidities which infer together an elevated falls risk. Falls are not pleasant to experience, and can lead to loss of life, serious injury and pain. They are also not pleasant to witness, as care home staff will describe.
Care home residents are three times more likely to fall than people living in the community. Residents continue to fall, and in the current climate, with multiple changes required to best manage COVID-19, it is difficult to support care home staff to prevent, modify and manage falls.
A rehabilitation research team has been undertaking a programme of falls prevention research led by Professor Pip Logan for over ten years. The first known holistic Guide to Action Tool, which collected all the risk factors in one place, was developed and published (Robertson et al 2010). However, care homes wanted something specific to them and their residents and worked with us to develop the Guide to Action for Falls Prevention Tool – Care Homes (GtACH). Both are now being used extensively, in clinical practice.
The GtACH has currently been evaluated for its effectiveness in reducing falls as part of a systematic falls prevention programme. A randomised control trial (RCT) (which will be the biggest care home trial conducted in the UK) is complete, and we are awaiting the results.
However, it is also imperative to examine evidence-based resources, such as the GtACH, using our available technology. We need to ensure that they are sustainable and accessible to all care home staff in the longer term.
This talk will highlight the process of working with the care home community to develop a web-based resource. It will also explore the results of a qualitative study that captured the barriers and facilitators described by care home staff when embedding the evidence into current care home systems
There will be an opportunity to download and browse a new ‘React to Falls’ App. This is an evidence-based smartphone resource (based on the GtACH) that enables care home staff to tailor actions to support each individual resident. It includes practical tips and examples of what staff can do, whilst enabling residents to remain active and make their own lifestyle choices. The opportunity to reset services in care homes, as they move towards a more digital platform, is timely. The App has the potential for data to be sent to a central hub where it could then impact on direct care, using real time data, with further implementation funding. The plan would be to work with the App development team and partners, such as, NHS digital.
Our aim is to support care homes to use safe, and assessable evidence-based resources that are acceptable to care home staff. To use independently, to sustain good falls awareness practice based on current evidence. As Bunn (2020) asserts, there is an urgent need for specific care home evidence to improve the care of older residents.
You can download the free App, prior to the session, by going to the App store/Google play and searching: Recttofalls
Acknowledgements to the rehabilitation research team:
Pip Logan, Jane Horne, Katherine Jones, Kate Robertson, Wynne Williams, Maureen Godfrey; Marie Cook, Marie Ward, Katie Robinson, Adam Gordon, John Gladman, Janet Darby.
BUNN, E. A. 2020. Setting Priorities to Inform Assessment of Care Homes' Readiness to Participate in Healthcare Innovation: A Systematic Mapping Review and Consensus'. International Journal of Environmental Research and Public Health, 17(3), 987.
CAMERON, I. D., DYER, S. M., PANAGODA, C. E., MURRAY, G. R., HILL, K. D., CUMMING, R. G. & KERSE, N. 2018. Interventions for preventing falls in older people in care facilities and hospitals. Cochrane database of systematic reviews
LAING, W. 2017. Care homes for Older People market analysis and projections [Online]. Available: www.laingbuissonevents.com/wp-content/uploads/2017/05/William-COP.pdf [Accessed].
LOGAN, E. A. 2019. Evaluation of the Guide to Action Care Home fall prevention programme in care homes for older people: protocol for a multi-centre, single blinded, cluster randomised controlled trial (FinCH)
ROBERTSON K, LOGAN P, WARD M, POLLARD J, GORDON A, WILLIAMS W & J., W. 2012b. Thinking falls-taking action: a falls prevention tool for care homes. Br J Community Nurs. 17, 206-209.
ROBERTSON K, LOGAN PA, CONROY S, DODS V, GORDON A, CHALLANDS L, SMITH S, HUMPAGE S & A., B. 2010. Thinking falls - taking action: a guide to action for falls prevention. Br J Community Nurs., 15, 406-410.
WALKER, G. M., ARMSTRONG, S., GORDON, A. L., GLADMAN, J., ROBERTSON, K., WARD, M., CONROY, S., ARNOLD, G., DARBY, J., FROWD, N., WILLIAMS, W., KNOWLES, S. & LOGAN, P. A. 2016. The Falls In Care Home study: a feasibility randomized controlled trial of the use of a risk assessment and decision support tool to prevent falls in care homes. Clinical Rehabilitation, 30, 972-983.