[Frequency of falls among clients of home care services : The importance of care-related and social risk factors].
BACKGROUND
Among the elderly falls frequently result in injuries, increase the need for long-term care and pose a challenge for the quality assurance in nursing care. We describe the frequency and risk factors of falls among care-dependent persons using home care services in Germany.


METHODS
The participants of the study "Nursing-related health problems in home care" (n = 880) were recruited based on a list of the officially accredited nursing services. Data collection followed a standardized study protocol. Proportions were calculated and adjusted odds ratios and predicted probabilities were estimated using binary logistic regression.


RESULTS
Falls are a frequent occurrence among care-dependent persons who are cared for by home care services: Almost every tenth care-dependent person suffers from a fall within a period of 2 weeks. Falls are mainly associated with social and care-related factors. Besides a low educational status this comprises certain living and care arrangements: People living alone or having infrequent contact to their nursing service as well as clients that, according to their carers, should receive more support have a significantly higher chance of falling. Multimorbidity is a medical risk factor while neurological diseases as well as polypharmacy present increased risks only in interaction with living and care arrangements.


CONCLUSIONS
Nursing staff and physicians should maintain an overview of the social and health conditions of people in need of long-term care. If care-dependent persons live alone or are infrequently cared for, additional medical problems considerably increase the risk for falling; therefore, preventive interventions and follow-up assessments of actual need levels should be promptly considered if health conditions or living arrangements change.
Abteilung 2: Epidemiologie und Gesundheitsmonitoring, Robert-Koch-Institut, Postfach 65 02 61, 13302, Berlin, Deutschland. RommelA@rki.de.
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A
Rommel
Klinik für Dermatologie, Venerologie und Allergologie, Clinical Research Center for Hair and Skin Science, Charité - Universitätsmedizin Berlin, Berlin, Deutschland.
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J
Kottner
Stiftung ZQP, Zentrum für Qualität in der Pflege, Berlin, Deutschland.
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R
Suhr
Forschungsgruppe Geriatrie, AG Pflegeforschung, Charité - Universitätsmedizin Berlin, Berlin, Deutschland.
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Lahmann
D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data; D000368:Aged; D005858:Germany; D006699:Home Care Services; D006801:Humans; D008134:Long-Term Care; D012307:Risk Factors
Accidental falls; Aged; Home health nursing; Long-term care; Quality of health care