The effect of enhanced supervision on fall rates in residential aged care.
OBJECTIVE
To test the effect of a targeted falls prevention intervention involving risk factor reduction and enhanced supervision carried out by a falls prevention aide, on fall rates in older residents of a long-term aged-care facility.


METHODS
The participants were residents 60 yrs or older (mean age, 86.6 yrs) of a residential care facility in Japan. The intervention was carried out by two falls prevention aides and involved supervision through recreational activities or conversation and environmental modifications to reduce the risk of falls. The intervention was carried out for 25 wks, two times per week, 8 hrs per day. Fall rates and number of fallers in 50 intervention days and 50 nonintervention days were compared. Scores on the Fall-Related Behavior scale, the Gottfries, Brane & Steen scale, and the Troublesome Behavior scale were compared before the commencement of the intervention and after its completion. Baseline scores were compared between the participants who experienced a fall/falls only on nonintervention days (n = 10) and those who experienced a fall/falls on intervention days as well (n = 7).


RESULTS
Introduction of a falls prevention aide significantly reduced the total number of falls (P = 0.046) and the total number of fallers (P = 0.012). Scores on the Fall-Related Behavior scale and the Troublesome Behavior scale also decreased significantly (P = 0.02 and P = 0.002, respectively) after intervention; however, there was no change in the overall Gottfries, Brane & Steen scale score. Emotional impairment (P = 0.041) and symptoms that are common in dementia (P = 0.035) in the Gottfries, Brane & Steen subscale before the intervention commencing were higher in the residents who experienced a fall/falls on intervention days than the residents who experienced a fall/falls only on nonintervention days.


CONCLUSIONS
A falls prevention aide can reduce the risk of falling in institutionalized older people through enhanced supervision that targets falls-risk factors.
Research Team for Promoting Independence of the Elderly, Tokyo Metropolitan Institute of Gerontology, Itabashiku, Tokyo, Japan.
Hiroyuki
H
Shimada
Anne
A
Tiedemann
Stephen R
SR
Lord
Takao
T
Suzuki
D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D018576:Home Health Aides; D006707:Homes for the Aged; D006801:Humans; D007564:Japan; D008134:Long-Term Care; D012307:Risk Factors; D012308:Risk Management; D012309:Risk-Taking