How to reduce falls in a care home? Expert strategies and evidence-based interventions

Oct 21, 2025 4 min read •

senior care Health Patient Safety

According to the Centers for Disease Control and Prevention (CDC), between 50% and 75% of nursing home residents experience a fall each year, a rate twice as high as older adults living independently. To address this significant risk, implementing a multi-faceted approach is essential for any facility concerned with how to reduce falls in a care home and improve resident well-being.

Quick Summary

This guide outlines a comprehensive approach to mitigating fall risks in care homes, covering resident assessments, environmental modifications, medication management, and staff training to promote resident safety and independence.

Key Points

Identify Risk Factors: Implement comprehensive risk assessments using standardized tools like the Morse Fall Scale to identify residents most at risk due to medical history, medication, or mobility issues.
Modify the Environment: Conduct regular safety audits to identify and remove environmental hazards, such as inadequate lighting, clutter, uneven flooring, and lack of grab bars.
Manage Medications: Ensure a pharmacist reviews resident medications regularly, especially those affecting the central nervous system, to minimize side effects like dizziness and reduce fall risk.
Provide Targeted Exercise: Develop individualized exercise programs focused on improving resident strength, balance, and mobility, as exercise has been shown to reduce falls consistently.
Train and Educate Staff: Ensure all staff receive ongoing, hands-on training on fall prevention protocols, safe transfer techniques, and effective post-fall response.
Engage Residents and Families: Educate residents and their families about fall risks and prevention strategies to foster a shared responsibility for safety and improve overall outcomes.
Utilize Technology: Integrate fall-detection technology, such as alarms and sensors, to provide an additional layer of monitoring and ensure a quicker response to potential incidents.

Implementing a Multifactorial Fall Prevention Program

For care homes, reducing the risk of resident falls is a critical and complex challenge. An effective fall prevention program must address a wide range of intrinsic (resident-related) and extrinsic (environmental) factors simultaneously. The most successful interventions use a multidisciplinary team to assess and tailor strategies to each resident's unique needs, moving away from a one-size-fits-all approach.

Comprehensive Resident Risk Assessment

A robust prevention strategy begins with a thorough and ongoing assessment of each resident. This is not a one-time task but a continuous process integrated into regular care routines. Standardized, validated tools such as the Morse Fall Scale or the Timed Up and Go (TUG) test should be used to provide objective data.

Medical History Review: A crucial step is reviewing a resident's medical history for conditions that affect mobility, balance, and cognition, including past fall incidents, dizziness, and incontinence.
Medication Review: Many medications can increase fall risk, especially those affecting the central nervous system like sedatives, anti-anxiety drugs, and antidepressants. A pharmacist should regularly review all resident medications to minimize risk.
Physical Assessment: Regular checks for muscle weakness, gait instability, and balance problems are vital. This can include simple tests like the TUG test, which measures the time it takes for a resident to stand up, walk a short distance, turn, and sit back down.
Vision and Hearing Checks: Impaired senses can significantly increase fall risk. Ensuring residents have proper eyewear and hearing aids that are regularly maintained is a simple yet impactful intervention.

Environmental and Structural Modifications

The physical environment of a care home plays a major role in resident safety. Regular environmental audits can identify and rectify hazards that contribute to falls.

Improve Lighting: Inadequate lighting, especially in hallways, stairways, and bathrooms, is a common hazard. Installing brighter, glare-free lighting and motion-activated nightlights can dramatically improve visibility.
Secure Flooring: Loose rugs, uneven flooring, and slippery surfaces pose serious risks. All flooring should be well-maintained and non-slip, with non-slip mats used in wet areas like bathrooms and kitchens.
Install Assistive Devices: Grab bars in bathrooms and handrails in hallways provide essential support. Beds should be kept at an appropriate height, and bed and chair brakes should always be engaged when stationary.
Remove Clutter: Walkways must be kept clear of objects, furniture, and electrical cords to eliminate tripping hazards.

The Importance of Staff Training and Resident Engagement

Even with the best environmental safeguards, human factors are key to effective fall prevention. Staff must be properly trained, and residents must be involved in their own care.

Ongoing Education: Staff should receive regular training on identifying fall risks, proper transfer techniques, and the use of mobility aids. This includes consistent refreshers to keep knowledge current.
Post-Fall Protocols: Clear protocols for responding to a fall are crucial. Staff should know how to assess for injuries, document the incident, and perform a root-cause analysis to prevent recurrence.
Team Communication: Open communication between nurses, caregivers, and therapists ensures a cohesive and informed approach to resident care.
Resident and Family Education: Empowering residents to participate in their own safety and educating families on how to support fall prevention efforts creates a more robust safety culture.

Comparison of Fall Reduction Strategies

A multifactorial approach is often the most effective for fall prevention in residential care settings, addressing multiple risk factors simultaneously rather than focusing on a single intervention.


Strategy	Target Factors	Effectiveness in Care Homes	Key Implementation Steps	Limitations
Multifactorial Programs	Intrinsic & Extrinsic	Highly Effective	Comprehensive risk assessment, individualized care plans, staff training, environmental mods	Requires coordination across disciplines and significant resources
Targeted Exercise Programs	Strength, Balance, Mobility	Consistently Effective	Regular physical activity, Tai Chi, balance exercises tailored to resident ability	May not address other risk factors like medication side effects or environmental hazards
Environmental Modifications	Extrinsic Hazards	Effective for specific risks	Improved lighting, non-slip flooring, grab bars, clutter removal	Does not address resident's physiological or medication-related risks
Medication Management	Pharmacology	Effective, especially for polypharmacy	Regular pharmacist reviews to minimize psychoactive and other high-risk drugs	Does not prevent falls caused by mobility issues or environmental factors
Technology (Sensors, Alarms)	High-Risk Residents	Can be effective as a supplement	Bed/chair alarms, motion sensors, wearable devices for alerts	Effectiveness depends on prompt staff response; can be costly

The Role of Technology and Continuous Improvement

Technology can serve as a powerful tool to augment fall prevention efforts. Automated reminders for medications or therapy sessions, pressure-sensitive floor pads, and wearable fall-detection devices can provide an extra layer of protection, particularly for high-risk residents. Cloud-based platforms can help track and analyze fall data, allowing facilities to identify trends and continuously refine their strategies. This data-driven approach is crucial for ongoing quality improvement.

A culture of safety must be embedded throughout the organization, involving all levels of staff in identifying and reporting hazards. Regular meetings of an interdisciplinary team to review fall incidents, discuss root causes, and adjust care plans ensures a proactive rather than reactive approach.

Conclusion: A Holistic and Proactive Approach

Learning how to reduce falls in a care home requires a comprehensive, resident-centered strategy that integrates risk assessment, environmental safety, medication management, and ongoing staff training. The combination of targeted interventions, effective communication, and a commitment to continuous improvement offers the most effective defense against resident falls. By taking a proactive, multifaceted approach, care facilities can create a safer environment, reduce the incidence of falls and associated injuries, and significantly enhance the quality of life for their residents.

Frequently Asked Questions

The most common causes of falls include muscle weakness and gait problems (responsible for about 24% of falls), environmental hazards like wet floors or poor lighting (16–27% of falls), side effects from medications, and cognitive impairments like dementia.

A multifactorial program addresses multiple risk factors simultaneously, rather than focusing on a single cause. It typically involves comprehensive resident assessments, environmental modifications, medication reviews, and tailored exercise programs.

Fall risk assessments should be conducted on admission and regularly re-assessed based on a resident's changing condition or following a fall incident. This ensures that care plans remain current and effective.

Effective environmental changes include improving lighting, ensuring floors are non-slip and clutter-free, installing grab bars in bathrooms, providing sturdy handrails in hallways, and maintaining equipment like wheelchairs and beds properly.

Proper staff training equips caregivers to identify risks, use assistive devices correctly, and follow post-fall protocols. It also promotes a safety-conscious culture and enhances team communication, which is vital for effective prevention.

No, research indicates that physical restraints, such as vests or lap trays, are not effective for preventing falls and can actually increase the risk of fall-related injuries. They are not recommended as a fall prevention strategy.

Certain medications, especially psychoactive drugs, can cause dizziness or drowsiness and significantly increase fall risk. Regular medication reviews by a pharmacist can help minimize their use or adjust dosages to reduce side effects and enhance safety.

Technology like bed and chair alarms, motion-sensor lighting, wearable fall-detection devices, and software for data analysis can help monitor residents and provide timely alerts, aiding in a quicker response.

References

Medical Disclaimer

This content is for informational purposes only and should not replace professional medical advice. Always consult a qualified healthcare provider regarding personal health decisions.