Vitamin D supplements have long been used as a way of treating and preventing osteoporosis in order to reduce the risk of fractures in older people. However, a review of over 80 trials, recently published in the Lancet Diabetes and Endocrinology Journal, has found that these supplements made no significant difference and has called for national guidelines to be changed.
The researchers, based at the University of Auckland, New Zealand and University of Aberdeen, Scotland, studied the findings of 81 randomised trials and found the supplements did not improve bone mineral density in adults or prevent fractures or falls. The study also found there was no difference in effect between a higher or lower dose of vitamin D, meaning there was little justification in prescribing it to maintain or improve musculoskeletal health other than in rarer cases where it was needed to prevent rickets or osteomalacia in high risk individuals.
The news that vitamin D offers little or no protection from fractures resulting from falls means that your falls prevention measures take on extra significance in protecting the people in your care from serious harm and potential hospital admission. Read on to learn more about falls prevention and ensure you’re doing as much as possible to reduce the risk of falls within your service.
30% of people aged over 65 fall each year and amongst those over 80, this figure rises to 50%. For those with chronic health problems, sensory impairment or dementia, many of whom live in care homes, the risk is even higher.
Although preventing every fall is simply not possible, once a person is in your care, you have a responsibility to take all reasonable measures to reduce the risk to a reasonable level. By following guidelines produced by the National Institute for Health and Care Excellence (NICE) and adopting a comprehensive and well-planned approach to falls prevention, you can drastically reduce the risk of serious injuries to the people in your care.
5 NICE-approved Steps to Reduce the Risk of Falls Amongst Your Service Users
- Assess the risk: NICE recommends carrying out a multi-factorial falls risk assessment taking into consideration factors such as previous falls history, gait and muscle strength, visual impairment, cognitive impairment and the presence of hazards. By carrying out a falls risk assessment for all service users, you can begin to identify potential risks which you can then take steps to reduce.
- Promote exercise: Strength and balance training has been shown to reduce the risk of falls, particularly amongst older people with a greater degree of mobility. Programmes can be provided in a number of ways, such as seated exercise, tai chi and Pilates, most of which can also provide an opportunity for socialisation and fun.
- Reduce trip hazards: Common hazards such as ill-fitting shoes, loose rugs, trailing cables or slippery floors can all increase the risk of falls as can inadequate lighting. By assessing the personal space and belongings of each service user, as well as the communal areas within your home, you can put in place personalised measures to reduce their falls risk.
- Address poor vision: Most older people in your care will have a degree of visual impairment which inevitably increases their risk of falling. However, by understanding the steps you can take to minimise their impairment, you can reduce this risk. These steps can be as simple as ensuring the right glasses are worn, providing help to clean them regularly, or providing additional lighting at night.
- Review medication: Although they may be medically prescribed, drugs such as diuretics, analgesics and psychotropics have all been shown to increase falls risk in older people. In cases where a person in your care is falling on a regular basis, asking the GP to carry out a medication review may allow the total number of items taken to be reduced and, in turn, lower the frequency of falls.
For more on the latest research and what your care service can do about it, make sure you read Care Quality Matters. In every monthly issue – and six special editions each year – we provide the best advice for Registered Managers.