title: Wearing slippers, falls and injury in residential care.
abstract: BACKGROUND
  Risk factor studies for falls in residential care have not included factors related to the facilities themselves.
  
  
  OBJECTIVE
  To identify risk factors for falls and injury related to the individual and the facility.
  
  
  METHODS
  Cohort study with 1 to 17 months of followup.
  
  
  METHODS
  A random sample of 14 residential care homes in Auckland, New Zealand.
  
  
  METHODS
  All residents were approached and 606 (97%) participated, mean (SD) age was 83 (11) years. 114 (19%) residents died and 64 (11%) were transferred.
  
  
  METHODS
  Rate of falls and injurious falls per resident year were measured.
  
  
  RESULTS
  The mean rate of falls and injurious falls was 2.75 and 1.75 per resident year respectively. Factors independently associated with increased falls included: increased mobility (IRR 1.25; 95% CI 1.14-1.37), and less problematic behaviours (IRR 1.09, 95% CI 1.02-1.17), while unexpectedly digoxin use (IRR 0.56, 95% CI 0.33-0.97) was associated with decreased falls. Factors associated with increased risk of injury included being born in the UK (IRR 2.89, 95% CI 1.24-7.19) and being more mobile (OR 1.15, 95% CI 1.06-1.25), whereas wearing soft-soled shoes compared with slippers (IRR 0.50, 95% CI 0.28-0.90) and unexpectedly visual impairment (IRR 0.52, 95% CI 0.33-0.80) was associated with decreased injury. No significant factors related to the facility were identified.
  
  
  CONCLUSIONS
  Falls are frequent in residential care facilities and risk factors related to footwear are potentially reversible.
  
  
  CONCLUSIONS
  Residents should be encouraged to wear shoes rather than slippers.
authors.affiliation: Department of General Practice and Primary Health Care, School of Population Health, University of Auckland, New Zealand. kerse.n@auckland.ac.nz
authors.forename: Ngaire
authors.initials: N
authors.lastname: Kerse
authors.forename: Meg
authors.initials: M
authors.lastname: Butler
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Robinson
authors.forename: Maree
authors.initials: M
authors.lastname: Todd
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D009520:New Zealand / Q000453:epidemiology; D012775:Shoes; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000517:prevention & control