Falls

Older people who experience falls are frequently in contact with nurses in all sectors of health care. You can use these pages to find out about the falls-related projects the RCN is involved in and the guidance and resources available to you on falls and older people.

Falls and fractures in older people are a costly and often preventable health issue. Reducing falls and fractures is important for maintaining health, wellbeing and independence amongst older people.

A fall is defined as an event which causes a person to, unintentionally, rest on the ground or lower level, and is not a result of a major intrinsic event (such as a stroke) or overwhelming hazard. Having a fall can happen to anyone; it is an unfortunate but normal result of human anatomy. However, as people get older, they are more likely to fall over. Falls can become recurrent and result in injuries including head injuries and hip fractures.

Falls are events resulting from the presence of risk factors. The likelihood and severity of injury resulting from an event is related to bone health. People with low bone mineral density are more likely to experience a fracture following a fall. One of the main reasons why people have low bone mineral density is osteoporosis.

Over 3 million people in the UK have osteoporosis and they are at much greater risk of fragility fractures. Hip fractures alone account for 1.8 million hospital bed days and £1.9 billion in hospital costs every year, excluding the high cost of social care.

Causes of falls

The causes of having a fall are multifactorial – a fall is the result of the interplay of multiple risk factors. These include:

• having a history of falls
• muscle weakness
• poor balance
• visual impairment
• polypharmacy - and the use of certain medicines
• environmental hazards and a number of specific conditions.

Please see Public Health England's Falls- applying All Our Health.

The RCN is involved in the following projects:

• The National Falls Prevention Coordination Group (NFPCG) Progress Report 2019/20- 2020/21 has been published. This is the first National Falls Prevention Coordination Group (NFPCG) progress report. It summarises activity during 2019/20 and 2020/21 and notes areas for future focus.
  
  
• The RCN is a member organisation of the National Falls Prevention Coordination Group Public Health England and has produced Falls and fractures: consensus statement. This document outlines approaches to interventions and activities helping prevent falls and fractures to improve health outcomes for older people.

• The RCN Society of Orthopaedic and Trauma Nurses have created a Development of Competence Framework for Orthopaedic and Trauma Practitioners which references falls in many of the competency levels.