Understanding contextual factors in falls in long-term care facilities

Purpose - Despite the growing area of research involving falls in the residential care setting, the link between contextual and environmental factors in falls is poorly understood. This paper aims to draw upon existing research being undertaken in long-term care (LTC) in Metro Vancouver, Canada, with a particular focus on identifying contextual factors contributing to fall events. Design/methodology/approach - This paper presents the results of a qualitative observational analysis of video-captured data collected through a network of high-quality video systems in two LTC facilities. The research comprised workshops involving experienced researchers who reviewed six video sequences of fall events. The outcome of the workshops was a written narrative summarizing the discussion and researchers' interpretation of fall sequences. Findings - The analysis indicates that there are a broad range of environmental, behavioral and situational factors that contribute to falls in LTC. This suggests that a limited conceptualization of a fall as an outcome of the person's impairment and environmental hazards fails to convey the complexity of potential contributory factors typical of most fall incidents. Research limitations/implications - Broadening our understanding of falls provides the potential to make recommendations for falls prevention practice across multiple levels, including the individual, social and organizational context. Originality/value - The paper evaluates the potential of video-based data in fall analysis and points to the development of a case study approach to analyzing fall incidents to capture the complex nature of contributory factors beyond research that focuses solely on intrinsic and extrinsic risk factors.