How to Prevent Wheelchair Falls

Marco Aguiluz, director of home care, Parentis Health

Wheelchair falls are a growing concern for senior care facilities. According to the Annals of Long-Term Care, more than 80% of nursing home residents spend time in a wheelchair daily. Wheelchair falls and tips can result in serious injuries, and with nursing home residents predicted to reach three million by 2030, wheelchair fall prevention is a pressing concern.

Fortunately, there are multiple ways to help keep residents safe by preventing and reducing falls.

Identifying Causes of Wheelchair Falls

To effectively prevent falls, it’s important to identify the causes that are at work in a senior care community. Marco Aguiluz, Director of Home Care for Parentis Health, explains that there are many potential factors that contribute to falls.

“Some seniors have a history of falls, perhaps due to an illness or balance issue,” he explains. “They may fall more readily than others, and it’s important for their families to inform staff of this likelihood.”

Additionally, lack of sufficient staff training can contribute to wheelchair falls. “Occasionally, the problem will be a malfunctioning wheelchair, but, more often than not, it is due to incorrect settings, either by the patient or by a support person,” says Aguiluz.

“It is important to adjust the brakes or a rollback prevention device so they hold and the chair doesn’t rollback when the person goes to get into it because falls can result in many injuries, from minor cuts and bruises to serious issues like fractures and head trauma.”

Dr. Steve Hruby is a Doctor of Chiropractic and founder at Kaizen Progressive Wellness, a chiropractic care facility in Scottsdale, Arizona. He notes that wheelchair falls most commonly result in injuries including fractures, lacerations, and head injuries. It’s also possible for individuals to experience back or neck injuries from a fall.

Implementing Wheelchair Fall Prevention Changes

It’s important for senior care communities to focus on multiple elements that contribute to flal prevention. That starts with safety devices.

Aguiluz explains that one of the most devices available is an “anti-rollback system” consisting of a stopper hooked to the chair to prevent it from rolling back when a resident gets into the chair. “Some are also equipped with alarms,” says Aguiluz. “Since rollbacks are often the source of falls and injury, these are quite useful in preventing falls.”

He also notes that other devices, like alarms and drop seats, may also be useful, but they don’t prevent falls. A drop seat can help residents who have a hard time getting low when they sit, but they also often forget to lock the chair into place. Using an anti-rollback device is essential in these instances.

Dr. Hruby suggests that facilities focus on conducting a thorough resident evaluation to better anticipate the residents’ wheelchair fall risks. “This evaluation should include an assessment of the individual’s functional abilities, medical history, and home environment,” he says. “Based on this information, the facility can then determine the type of assistance each resident might need.”

Aguiluz emphasizes the importance of training staff to better anticipate challenges and to work with residents’ families to learn about the resident’s disabilities. He suggests using an intake questionnaire that identifies any fall history, imbalance conditions, or other elements that could make the resident more vulnerable to falls. “Make the staff more aware of those clients and then train both families and patients on the safe usage of the wheelchair,” he says. “Often it is new patients who may be unfamiliar with using wheelchairs and their safety mechanisms who are the most likely to have problems.”

Larger Changes in Preventing Wheelchair Falls                  

Changes like enhanced staff training and the use of wheelchair safety devices are relatively easy to implement. But in some cases, wheelchair falls may point at larger flaws in a senior care community’s structure. “Falls can become a common occurrence if a facility is understaffed or has no real system in place for safety procedures,” says Aguiluz. “Many locations need more people to keep an eye on patients. Family members need to ask about the ratio of caregivers to patients when placing their loved ones in large living facilities.”

He explains that having the right administrator who understand the challenges and can train staff to be cognizant of what to watch for may be the most important in preventing wheelchair falls. “This, along with having enough staff and enough training to deal with complex requirements, will make for a happier living condition and longer life for many older patients.”

Paige Cerulli

Paige Cerulli is a contributing writer to i Advance Senior Care.