Although more than a quarter of patients in chronic care facilities are believed to be at high risk for falling, falls in this population are poorly understood. In a retrospective study, researchers examined falls experienced by frail elderly patients in a 104-bed Canadian chronic care facility. Demographic data and information about mobility, balance, cognition, and other variables were recorded for consecutive patients admitted and discharged between December 1, 2012, and July 31, 2016. Fall characteristics were identified using fall data, which were recorded by nurses, and the reported level of harm from the fall. Patients were grouped into two cohorts: faller (fell at least once during admission) and nonfaller.

The researchers identified 1,141 falls for 366 admissions during the study period. The overall rate of falls was 8.48 per 1,000 occupied-bed days, and the overall injury rate was 37.2 per 100 falls. Men were 1.6 times more likely to fall than women. Patients who weren't independent ambulators at admission (with or without a mobility aid) were 1.7 times more likely to fall than independent ambulators. Compared with nonfallers, those who fell were frailer, had more impaired balance or cognition, and had a higher falls risk score. Patients with impaired cognition fell more often outside their room, whereas those with impaired mobility and balance fell more often in their room. The researchers observed that most falls occurred between 8 am and 8 pm, peaking between 2 pm and 4 pm, and the majority of falls occurred in the patients' rooms.

The study was conducted in only one facility, limiting the generalizability of the findings, according to the authors.

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