Falls and Fall-Related Consequences among Older People Living in Long-Term Care Facilities in a Megacity of China

Abstract

<b><i>Introduction:</i></b> Falls are currently the top safety problem in long-term care facilities (LTCFs) in China. Due to the increasing number of residents living in LTCFs, more evidence is needed to give a foundation for fall prevention. <b><i>Objective:</i></b> This study aimed to explore the epidemiological characteristics of falls in LTCFs in central Shanghai. <b><i>Methods:</i></b> The study was conducted in 21 LTCFs in a central district in Shanghai, with a capacity of 3,065 residents. A two-stage sampling method was applied in participant recruitment. Falls were recorded by LTCF staff over a 12-month period. Details of falls were obtained by face-to-face interviews. The χ<sup>2</sup> test was used in data analyses. <b><i>Results:</i></b> The incidence of falls was 13.5%; 64.0% falls resulted in injuries, with 32.0% involving fractures. Women had a significantly higher incidence of injurious falls than men (χ<sup>2</sup> = 4.066, <i>p</i> = 0.044). Residents aged 80–89 years or in level 1 care had the highest incidence of falls with severe consequences. The incidence of falls was significantly higher at small- or medium-sized LTCFs, public LTCFs, and LTCFs with higher environmental risk levels compared to their counterparts. Most falls occurred when walking on a flat floor (28.9%) and rising up or sitting down (24.0%); 40.9% occurred during the night. Of those injured, 54.8% were treated in hospitals, and only 53.7% completely recovered. <b><i>Conclusions:</i></b> Though the average incidence of falls in LTCFs in Shanghai was relatively low, great variation was observed between LTCFs, and severe consequences occurred frequently. Fall prevention programmes should be evidence-based with applicable devices and individualized care services and supports. The roles of personal and institutional factors on falls warrant further study.

Injuries from falls by older adults in long-term care captured on video: Prevalence of impacts and injuries to body parts

“…The locations and types of injuries we observed were aligned to previous reports on injuries from falls by older adults who reside in LTC [ 41 – 44 ] and in the community [ 45 , 46 ]. A Finnish LTC study [ 41 ] reported injuries in 38.1% of falls, including head injuries in 19.3% of falls, and fractures in 3.1% of falls, most often to the hip (1.5% of falls).…”

“…In studies of falls in Swedish [ 43 ] and Bavarian [ 42 ] nursing homes, injuries occurred in approximately 25% of falls, with the latter reporting hospitalizations in 7.6% of falls in common spaces. Bruising/hematoma, followed by abrasions/cuts, were the most commonly reported injuries from falls in community-dwelling older adults in the Netherlands and United States [ 45 , 46 ], and in LTC facilities in Sweden and China [ 43 , 44 ].…”

Physical function decline predictors in nursing home residents using new national quality indicators

“…12,15 In addition, "not vocalizing reciprocal exchanges at will" and always "waking at midnight" were predictors of PF decline. Falls, which are often directly related to PF decline, are more likely to occur at night, 26 primarily owing to insufficient lighting and a limited number of nursing home staff. Because those with cognitive impairment and communication difficulty are unable to ask for help, staff may not notice anything unusual, leading to falls and other adverse events that may cause PF decline.…”

Treinamento em casa para idosos com prevenção de queda: Artigo de revisão

“…Considera-se que as incidências de quedas são um caso de saúde pública, pois podem resultar em lesões (como hematomas, cortes ou escoriações), fraturas, redução na capacidade funcional, hospitalizações, prejuízos psicológicos (como o medo de sofrer novas quedas), podendo culminar em óbitos (Teixeira et al, 2019;Jiang et al, 2020). De acordo com Carlini Junior et al (2021), a incidência de quedas pode afetar cerca de 20% -30% dos idosos com mais de 60 anos e a partir dos 75 anos ela aumenta 5%, resultando em fraturas ou hospitalizações.…”