Michael Fragala, Ph.D., RN

While sitting with my wife’s 79-year-old grandmother we discussed why she did not go to her annual physical this year. Her answer was she was afraid to fall and that is when I realized that my work has officially come home. She is not alone as a recent study found older women living alone fear falling the most (Dhar M, 2022).

Inquiring into more details about her fear of falling, we were able to identify factors such ramps, handrails and assist devices that would aid in her ability to confidently enter her doctor’s office. It was evident how much she wanted to move but how discouraged she was with her diminished abilities.

This personal story relates to what we have seen in the past few months with injuries from falls continuing to rise among U.S. seniors. This in part can be associated with the effect social isolation had on seniors during the pandemic. What are the ongoing effects going to be and how do we as an industry combat looming concern, while managing all other obstacles being thrown our way?

There are many articles and research studies out there to reference that offer suggestions around falls, but how often do we speak to those at risk of falls? For that matter how often do we as an industry look to those at the bedside for their thoughts and opinions?

Caregivers’ role

Those working in home care want to be feel safe and supported while providing care. This is positively associated with staff retention as well (Qing Zheng Ph.D., May 7 2022). Similarly, reduction in injuries related to falls is associated with caregivers’ opinions (Fragala, 2018), so why are we not asking more questions to those at risk of falls, as well as those who spend the most time with those at risk of falls? Could this be one of those “two birds, one stone” moments? Promoting a line of communication between bedside caregivers and those with decision-making power can not only promote those at bedside to feel they have stake, but those in decision-making positions can get valuable insight to what is working and what is not.

Could we take it a step further? Is there an avenue for patients or families of patients to productively share what is working and what is not? These thoughts may not always be realistic or rationale, but being heard can go a long way in compliance and complacency.

With the advances in technology that make the bedside more accessible and as we continue to recover and rehabilitate this industry, let’s take an opportunity to reevaluate how we assess those at risk for falls. Understanding barriers may reduce or eliminate them, with the possibility of predicting them. Which in turn will allow for confidence to continue their mobility journey.


Dhar M, K. N. (2022). The Prevalence and Associated Risk Factors of Fear of Fall in the Elderly: A Hospital-Based, Cross-Sectional Study. Cureus 14(3): e23479. doi:10.7759/cureus.23479.

Fragala, M. (2018). Effect of Caregiver Attitude and Beliefs on Fall Management within an Industrialized GeriatricPopulation.TridentUniversityInternational ProQuestDissertationsPublishing 10786490.

Qing Zheng PhD, C. S. (May 7 2022). Association between staff turnover and nursing home quality – evidence from payroll-based journal data. American Geriatrics Society.

Michael Fragala Ph.D., RN, clinical director for Joerns Healthcare, is also an adjunct professor for comparative health systems at New England College, healthcare administration at River University, and program design and evaluation at Southern New Hampshire University.