17 July 2019

Dr Frances Batchelor, Director of Clinical Gerontology at the National Ageing
Research Institute, has told the Royal Commission into Aged Care Quality and
Safety that there is an urgent need for more high-quality research to learn what can
effectively prevent falls in residential care, especially for people living with dementia.

Dr Batchelor, said that while there is strong evidence exercise that includes strength
and balance training for two hours a week over 25 weeks – for a total of 50 hours –
is effective at reducing falls in the community, the same could not be said for
residential aged care.

There is little evidence-backed data to support common preventive measures such
as exercises, medication reviews, bed and chair alarms or a combination in
residential aged care, and more research and clinical data is needed urgently,
according to Dr Batchelor.

However, she said that until findings from new research become available, the sector
needed to be proactive and come up with a comprehensive falls risk assessment
and management plans. These include: increasing the number of staff involved in
direct resident care, increasing falls prevention training for all staff including personal
care workers, improving how data is collected, particularly in real-time, and
implementing person-centred care.

According to Dr Batchelor, accidental falls are the tenth leading cause of death for
people in residential aged care and the eighth leading cause for people receiving
aged care packages. On average 50% of aged care residents will have one or more
falls in any given year. This is higher in residents with dementia, with estimates of up
to 90% of people with dementia associated with Parkinson’s disease falling at least
once in a year.

“We shouldn’t just say that falls are an inevitable part of ageing and that they are all
going to happen,” she said.

Dr Batchelor said that most residents are only assessed for their falls risk when they
enter residential care and then on a three-monthly basis or when a fall occurs.

“But it’s not responding in a dynamic way to the changes that we might see in
residents’ functional and health status, Falls aren’t in isolation, from other issues
such as nutrition, even oral care. They’re all interrelated and if we can support staff
to offer truly person-centred assessment and care, then I think that will go a long way
to prevention of falls but also joining the dots for those other issues,” she added.

Dr Batchelor has over 30 years of experience as a Clinical Physiotherapist and also
leads a program of research in falls prevention and physical activity. She is the
research program lead of the Melbourne Ageing Research Collaboration (MARC).