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May 2016

Falls Prevention

Introduction

Approximately 14.8% of Ontario residents and 15.3% of Canadian residents living in LTC have a history of at least one fall in the last 30 days. This discussion guide is designed to help providers assess falls risk and manage residents in long-term care to prevent falls and the associated co-morbidities. This guide integrates best-practice evidence, clinical experience, and makes reference to relevant existing tools and services where possible. 

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Information

About the Tool

The Centre for Effective Practice (CEP) developed a discussion guide and caregiver supplement to help providers and care staff assess fall risks and manage residents in long-term care to prevent falls and associated co-morbidities. Both tools emphasize the principles of:

  • Being resident-centered
  • Being mindful of benefits, risks and safety concerns
  • Using an inter-professional team approach and validated tools
  • Prescribing conservatively
  • Reassessing regularly for opportunities to deprescribe medications that are no longer needed

Long-Term Care Tool

The Falls Prevention Discussion Guide

The tool was developed as part of the Centre for Effective Practice’s academic detailing service for LTC homes. It was designed to help providers engage in meaningful discussions with the academic detailers about assessing fall risks and managing residents in LTC to prevent falls and associated co-morbidities. As always, efforts must be made to individualize any treatment decisions for the resident, with consideration for caregivers, family and LTC staff.

The Falls Prevention Discussion Guide was developed by CEP’s academic detailing service team, with clinical leadership from Dr. Sid Feldman and Dr. Andrea Moser. Health care providers and other relevant stakeholders were engaged throughout the tool development process, using a user-centred design methodology to test the usability of tools from a provider perspective. This edition was funded by the Province of Ontario as part of CEP’s Appropriate Prescribing Demonstration Project.

Supplement for Care Staff

Falls Prevention Supplement for Care Staff

The Supplement for Care Staff was developed as part of the Centre for Effective Practice’s academic detailing service for LTC homes. The content was adapted from the Falls Prevention Discussion Guide under the clinical leadership of Dr. Sid Feldman and Dr. Andrea Moser.

Clinical Lead

  • Dr. Andrea Moser

    MD, PhD

    Dr. Andrea Moser is a family physician with a clinical practice is in long term care and home visits for housebound frail seniors at Baycrest Health Services. She is an Assistant Professor in the Department of Family and Community Medicine, University of Toronto; Associate Medical Director, Apotex Nursing Home at Baycrest; and is a Certified Medical Director through the American Medical Directors Association. At Baycrest she is also co-chair of the Apotex Quality Subcommittee and a member of the Quality Steering Committee. She also has extensive experience in rural practice. Dr. Moser has a particular interest in dementia care and is involved with the Behavioural Supports Ontario (BSO) program through her clinical work at Baycrest on the Transitional Behavioural Support Unit and the LTC Behavioural Support Outreach Team and is the BSO primary care lead for Central LHIN. Dr. Moser is the chair of the OMA Section of Care of the Elderly and LTC, and a member of the Board of Directors of the Long Term Care Medical Directors Association of Canada.

  • Dr. Sid Feldman

    MD, CCFP, FCFP

    Dr. Sid Feldman is a community family physician affiliated with the North York Family Health Team. He also works as attending physician in the Toronto Central LHIN Behaviour Support Unit at Baycrest for residents with behavioural symptoms of dementia. His academic and administrative roles at Baycrest include Medical Director, Home for the Aged, Executive Medical Director Residential and Aging at Home Program and Chief, Family and Community Medicine. He is an Associate Professor and Coordinator, Care of the Elderly Program in the Department of Family and Community Medicine, University of Toronto and serves as the Ontario representative on the CFPC Health Care of the Elderly Program Committee.

Target End User Feedback

We also sought target end user input to inform the content and would like to thank these individuals for their time and expertise.


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