Researchers explore methods of injury prevention to keep patients healthier and happier.
The COVID-19 pandemic demanded our attention throughout the first half of 2020, and our work in long-term/post-acute care to control and overcome the spread of the infectious disease is far from over. However, other challenges remain in senior living communities that we are capable of both addressing and overcoming, one of which revolves around falls and the injuries associated with them.
Falls cause more than 95 percent of the hip fractures that occur in older adults. They often require surgery, months of recovery time, and a reduction in both independence and physical activity. Complications are also very common – approximately 25 percent of long-term care patients who fracture a hip die within six months of the accident. It’s a high-risk injury in a high-risk care setting, but it’s also one that researchers are prioritizing.
A team at Simon Fraser University in British Columbia recently concluded their study on a group of seniors exploring how we can not only prevent falls, but also prevent falls that result in hip fractures specifically. Study lead Steve Robinovitch, a biomedical physiology and kinesiology professor at the university, has partnered with two long-term care homes since 2007, recording and analyzing video footage of falls in the community’s common areas. Using this footage for the study, he and his team of researchers analyzed 2,377 falls experienced by 646 residents.
Only 30 of the falls in the data set caused a hip fracture, representing a little more than 1 percent of the total recorded falls. “But the problem is that falls are so common, with the average resident in long-term care falling three times per year, that the cumulative toll is enormous,” Robinovitch said in a statement.
The research team observed that all the hip fractures were caused by falls from standing height with direct impact to the pelvis. Interestingly, backward falls were safest, and forward and sideways falls reported similar incidences of hip fracture. But when a wearable hip protector was introduced, the risk of hip fracture was reduced twofold, and the use of mobility aids like walkers reduced the likelihood of hip fracture during a fall by over threefold.
“Our study shows that older adults in long-term care in British Columbia are wearing and benefitting from hip protectors,” Robinovitch said in a statement. “Hip protectors were worn in over 70 percent of falls, and they halved the risk for hip fracture. But across Canada, there’s evidence that only 10 to 20 percent of people in long-term care are wearing hip protectors.”
Now, the research team is working with new partners based in Ontario to develop strategies that will help increase the use of hip protectors in long-term care homes. Once they achieve success regionally, they plan to share their model with long-term care facilities internationally to encourage similar efforts. Study co-author Fabio Feldman, the director of clinical quality and patient safety for Fraser Health, implemented a successful hip protector program as well in one of his long-term care facilities.
The researchers are also continuously reevaluating the video-based data to understand with better precision the loads that pelvic bones experience during these falls. They hope to use these metrics to inform smart design updates to hip protectors and make them even more effective in the future.
“There are many ways that you can reduce the risk of having a fall, but in the senior population, especially long-term care, quality of life is important,” Feldman said in a statement. “There are different ways to make people safe without restricting their activities.”
With this focus in mind, the researchers encourage seniors to use their mobility aids and hip protectors as tools that enable them to not just stave off injury, but maintain their independence and overall quality of life. In that vein, they also encourage long-term care facility staff to promote the use of such tools among their patient populations.
The study was published in the Journal of Bone and Mineral Research.
Curious to learn about other ways you can improve patient care? Consider these expert tips on utilizing telemedicine.