Data drives Help at Home’s multi-faceted approach to fall prevention

By Angie Wolff, Vice President of Clinical Quality

For older adults, falls are both common – and extremely dangerous. Each year, accidental falls kill about 36,000 Americans over 65, prompt about 3 million trips to the ER and result in $50 billion a year in health care costs – most of it paid from Medicare and Medicaid.  

Those are the stats from the Centers for Disease Control, but many of us have also had anecdotal experiences that speak to the danger of falls. Often, we have seen a bad fall as a precipitating event that causes a healthy senior to lose some of their vitality, confidence and independence.  

Help at Home is taking a multi-faceted approach to fall prevention that starts with better data. 

Falls are one of the most common types of “incident” reports we receive. Falls are an area where we feel we can make a big impact, because many falls are preventable. 

As we increased our focus on falls, we developed a more formal process that tracks and notifies relevant team members when a client has suffered multiple falls. Often, when we flag a case the care team is already aware that something is happening and have already started taking action to prevent future falls. Caring and paying attention to clients is what we do! But formalizing the process has still proven valuable – because it prompts more intense case management and pulls multiple team members together to collaborate on solutions. We are now going deeper into these cases, to better understand what can be done to help the client.  

For example, in multiple cases, the fall-based reassessment resulted in the client qualifying for more hours of care or different types of care. In one case, the investigation found that while the client in question was adamant that they would not use a walker, he would agree to use a cane. The team was able to get him one. In another case, a client was often falling in a small bathroom. The bathroom could not accommodate the client, the client’s walker and the caregiver – so the caregiver was not able to effectively protect the client. The bathroom needed to be reconfigured to keep the client safe. This was a more ambitious project that the caregiver could not have tackled alone. 

While clients with multiple falls may need special attention, we also recognize the need to prevent the first fall. There are many common causes of falls that are preventable – from tripping hazards in the home to ill-fitting shoes. We use videos, flyers, even phone-based “games” – that help caregivers become more practiced at spotting and addressing these kinds of falling risks.  

Part of this includes educating the clients as well as the caregivers – so that the client is protected even when our caregiver isn’t there. For example, a recent video we made for caregivers talked about conducting a walk-through of the home before leaving for the day to ensure common walkways were clear and clutter free and always being aware of where a pet is before they start to walk. (Pets can get under your feet easily!) 

There is currently no formal benchmark for falls in this industry. When we started compiling the data on a company-wide level, we had no baseline to compare to. We also face other challenges – clients may not want report falls, because they are embarrassed or may not think it is important to report a fall. So we often don’t know about falls that caregivers didn’t personally witness.  

We continue to focus on establishing those baselines and benchmarks – and we hope that preventing falls and taking action when a client does have a fall will remove some of the fear and stigma about reporting them.  We are confident that the work we are doing now is not only benefiting clients today – but will benefit future clients even more.