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

Gerontology. 2020;66(6):523-531. doi: 10.1159/000510469. Epub 2020 Oct 6.

Abstract

Introduction: 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.

Objective: This study aimed to explore the epidemiological characteristics of falls in LTCFs in central Shanghai.

Methods: 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 χ2 test was used in data analyses.

Results: 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 (χ2 = 4.066, p = 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.

Conclusions: 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.

Keywords: Elderly people; Epidemiology; Falls; Injury; Long-term care facility.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidental Falls / statistics & numerical data*
  • Aged
  • Aged, 80 and over
  • China
  • Female
  • Humans
  • Long-Term Care / statistics & numerical data*
  • Male
  • Nursing Homes
  • Recovery of Function*
  • Walking / statistics & numerical data
  • Wounds and Injuries