Falls and Related Injuries in Residential Care: A Framework & Toolkit for Prevention


On average, approximately 1.7 falls occur per person‐year in long‐term care facilities (Rubenstein, 2006). Hip fractures occur almost four times more often in residential settings compared to the private home environment (Norton et al., 1998), and less than 15 percent of facility residents who sustain a hip fracture regain pre‐injury ambulation status (Folman, Gepstein, Assaraf, & Liberty, 1994). In addition, approximately 20 percent of all fall‐related deaths among older adults occur among the less than 8 percent of older adults living in RC settings (Health Agency of Canada, 2005; Rubenstein, 1997).

The purpose of this report is to facilitate the translation of fall prevention evidence into practice through the presentation of a Public Health Framework to fall prevention. A Public Health Framework is evidence–based, relying on a careful analysis of the problem and its causes in order to develop practical and effective solutions that are integrated into routine care. It is a staged approach, consisting five program planning steps that build upon each other in a dynamic process and that exist within a social and policy context that is influenced by the seniors who are at risk, their families and care providers, and by current policies and legislation. The five stages described in this report are:

  • Defining the problem;
  • Identifying the risk;
  • Implementing best practices;
  • Translating the knowledge; and
  • Evaluating the program.

Together, these steps represent a systematic approach to fall prevention that relies on organizational commitment, leadership, staff training, and collaboration among researchers, policy-makers and practitioners for successful and sustainable programming for the identification and reduction of risk.

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