Spotlight on Falls – The voices of lived experience at Peverel court care

 

Falls are one of the most feared health emergencies for older people and their families. In our three-part series, we are shining a spotlight on falls, the changes we aspire to make and the impact these will have in reducing falls. We continue this series by hearing from our residents, relatives and staff about their personal and professional experiences of falls.

We know that falls are something our residents and their families dread – and with good reason – as we looked at in our first blog in this series that detailed the impact and implications when a person has a fall.

It’s very important to us, as we explore the latest technology around falls detection and prevention, that we understand first-hand about our residents’ and relatives’ experiences of falls and how they feel about the technological solutions we are considering.

 

What our residents and relatives say about their experiences of falls

Don lives with us at Bartlett’s and told us:

I was a runner, I enjoyed running. I’ve always been willing to test myself, going a little further is always important for me, pushing boundaries, and that’s still there in walking.

My balance over the last year has been deteriorating. I started off by denying I needed a walking stick, then realised it was probably advisable to carry one. So, I carry a stick and try not to use it. I go out for a walk and carry it. I start with leaning on the stick, realise my balance is ok, then I pick the stick up and walk with it.

I have some consciousness of my vulnerability to falls. The most alarming is falling backwards. That doesn’t happen often… It’s when I get tired that my vulnerability to falls is raised. Yesterday I wanted to sit down on the edge of the bed and I missed it. I didn’t hurt myself; I fell on my backside, picked myself up and carried on. But it was a warning to be careful.

Andrea told us about her experiences of caring for her dad before he moved to Bartlett’s:

Dad had multiple falls, both in the house and out of the house, and I had no idea how to deal with that other than call 999. 

Dad calls falls ‘a slow sit down to the floor’. He doesn’t call them falls at all. He gets so tired that he can’t support his weight any more and falls. I don’t think he trips. One time on the drive at his house he fell and crawled on his hands and knees to his car to pull himself up.

I couldn’t be there 24/7 for him, and I would rely on him to either call me to tell me he’s fallen or dad’s pendant alarm company to ring me. But that’s obviously after the event, it’s not helping to prevent the fall.

Heather lives with us at Stone House and told us:

I don’t think of falling, I continue with life, then the beastly falls happen. Recently, I went across the room to take my phone off charge, I didn’t rush, I went quite slowly, but on the way I fell, got my foot trapped and I couldn’t get up. Two nurses who happened to be next door came and got me standing.

I’m not expecting to fall, but unfortunately I do. I lose my balance. I don’t think of it until I go down bang, which is pretty stupid. (Laughs)

Lynn’s mum lives with us at Bartlett’s and told us:

Mum has been getting increasingly unstable and we’ve had two reports now of mum being found on the floor. She’s been fine, but there hasn’t been anybody to witness that (the falls). I don’t think she remembers it, so she can’t report it herself.

Mum used to be somebody who played tennis and badminton and did keep-fit and dog walked two or three times a day. To see her with this frailty and worry about the thought of her lying or sitting on the floor… I feel for her vulnerability and her safety.

Following her mum’s falls, Lynn told us:

Mum’s gait has changed. She definitely needs an arm to lean on, and has a general sense of imbalance and isn’t confident on her feet anymore.

 

What our staff say about how falls impact our residents

Connie is an Administrator at Bartlett’s and told us:

People don’t deliberately fall. You don’t necessarily have that reaction time to think ‘I’ll grab something’. I’ve been on reception, heard a commotion and later found out that it was someone who had a fall in the corridor. It’s quite hard knowing that’s what I heard and later discovering they had an injury, that’s quite tough. Then seeing the knock in their confidence in the coming days. It’s not nice to experience.

Naturally I think some of the residents who are less mobile are more cautious when they are walking. One resident who recently had a fall and was found on the floor, in the coming days she was a lot more hesitant and wary with her steps. Whether she remembered the fall, and on some level emotionally she did, you see that within her. She was almost looking for extra support from staff and had that uncertainty about what to do next.

 

Falls in a person’s own home

As part of our work into falls detection and prevention, we are looking at many different environments – not just those within our Peverel Court Care homes – to understand the challenges for all older people who are vulnerable to falls.

Ruth supports her mum who lives in her own home. Ruth’s mum has had a series of falls, and Ruth recounted her feelings about her mum’s first fall to us:

I was pretty shocked, there was a lot of blood. The hearth was marble, so mum had fallen down on something very hard….. the unsteadiness, there was a trip involved as well… I was very frightened for her. I think we all know that head injuries can result in life changing events and a risk to life, and because of the amount of blood that was there, I felt very shaky… I felt a bit all over the place if I’m honest.

Following her mum’s first fall, Ruth told us:

We felt that mum’s memory had declined. She was finding it quite difficult to recall dates and facts about things. She lost confidence, she didn’t want to leave the house… she didn’t really want to walk. Emotionally, mum is a very strong woman… but what I did notice 6 months later is that mum couldn’t remember having a fall.

 

How can we support older people with earlier detection of falls risks?

Ideally we’d like to be able to prevent every fall, but experts agree that such aims are unrealistic. The focus of current technological solutions is around detecting falls risks, particularly when someone starts to move around, for example by getting out of bed at night. 

Sensor monitoring in resident’s bedrooms is one solution we are considering for Peverel Court Care homes. Sensor monitoring detects changes in noise, picking up when someone starts to move, which could be particularly helpful at night in reducing the number of night-time checks staff do that can disturb residents. We asked our residents and relatives who participated in our research interviews on falls what they thought of this technology.

Don said:

So long as it’s not obtrusive, I won’t notice it. I’m trusting the technology to help me.

Andrea, Don’s daughter, told us:

I wouldn’t want it (sensor monitoring) to totally replace any human checks, but if it could reduce the number of checks staff make that would be useful. It’s not a mistrust of the technology, it’s just nice to see someone in the night if you’re unsure and you’ve woken up. Sometimes dad gets a bit disorientated.

I remember my grandmother, she had a fall and broke her hip, and that was life changing for her. So anything that helps to prevent falls is good.

Lynn echoed Don and Andrea’s views. She said: 

It just seems a real benefit to have some sort of monitoring that is there… overnight in rooms, because who knows when somebody gets out of bed and decides they want to wander around the room or go to the toilet. To have that constantly monitored has got to be a good thing. I know staff pop in every now and again, but things happen in between visits so I think that can only lead to a better outcome.

 

What are the key considerations when introducing new falls detection technology?

Whilst we are keen to explore new falls technology, we know there are many considerations to implementing this to ensure our core values of providing the highest standards of care and support for our residents are upheld.

We explored this topic with Connie who told us:

When we’re looking at the sensor* technology we definitely need to keep the level of privacy, making sure that it’s non-intrusive. 

I think for residents especially, they need to know that there are no trip hazards. For instance, the mats that go on the floor (that we currently use to detect movement), they are potentially a trip hazard. I’ve always wondered why they are used, because I don’t think they’re that effective in preventing falls, which they are designed to alert (us to) if they are on the floor. 

I think with the sensor* monitoring, keeping the autonomy of the resident is really important, that’s one that the residents would say themselves. 

Removing the need for nighttime hourly checks would be really beneficial for residents, especially those with dementia. Sleep is incredibly important, it has an effect on their day-to-day moods, their balance, their lives. I think that would be the main benefit.

 

What’s next?

In our third and final blog of this series, we will look at the future of falls prevention and how different digital solutions and advancing technology can assist us at Peverel Court Care.

 

About Peverel Court Care

Peverel Court Care is a group of one residential and two nursing homes, located in Buckinghamshire and Oxfordshire. Bartlett’s Residential Care Home and Stone House Nursing Home in Aylesbury, and Merryfield House Nursing Home in Witney. We are a long-standing family business. Providing exceptional, personalised care, delivered by talented and compassionate people, in exclusive and idyllic settings.

With happiness at the heart of our homes, we recognise and respect the contribution made by our residents to society during their lifetimes. Valued by residents and their families; our reputation, investment in each property, and approach to appointing and developing our staff makes each home unique and the benchmark in premium care.

 

*Sensor monitoring/technology is also referenced as acoustic monitoring/technology by some of our interviewees.

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