• Sanjay Gopal, PhD

Maximizing length of stay by preventing falls in assisted living

As we slowly emerge from the pandemic, innovative administrators and operators are fast evolving their environments to adapt to the growing realities of protecting their communities to ensure business continuity while balancing costs. With all communities being adversely impacted due to sub-optimal census and visitation restrictions, a focused approach to maximizing length of stay can become a strategic advantage for operators.

One factor which profoundly affects length of stay is resident falls. While resident falls is common occurrence in all communities and is the undisputed leader of the reason for incident reports, operators continue to struggle with developing a standardized approach to solving this problem.

Here are some important suggestions to consider in developing a successful program to prevent falls.

Make Environmental Improvements

Remove clutter in and around the resident, e.g., areas rugs, secure electrical cords, tape edges of carpet to floor, to avoid resident tripping. If not already done, install grab bars in all bathrooms, to help residents stabilize themselves as needed. Raise toilet seats to make it easier for residents - proximal extremity lower limb weakness is common in the elderly! Make shower chairs available and encourage use on shower days. Ensure visible lighting on the way to the bathroom as most falls occur during trips to the bathroom.

Physical Considerations

Ensure use of a suitable assistive device cane or walker as appropriate. Help residents wear appropriate shoes (no flip flops!) at all times to minimize fall risk. Right size clothing - many seniors lose height with age as well as osteoporosis. If they have not adjusted the length of pants to their current height, they could trip and fall, especially when they are in a hurry to go to the bathroom or when multi-tasking. Cognitively impaired residents will find it easier to wear pull on pants rather than ones with belts and buckles which are difficult to unfasten when they are in a hurry.

Resident Health & Wellness

Encourage regular eye checkups as macular degeneration is very common and ensure use of clean eye-glasses if applicable. Periodically review resident medications with primary physician as some are known to increase risk of falls. Seniors need to get adequate hydration as dehydration is a fall risk. As individuals age the thirst mechanism is impaired and regular prompting and reminders to hydrate may be required to prevent dehydration. Regular blood pressure measurements, especially for residents on specific types of medications such as anti-hypertensives and anti-depressants, may be required to lower the risk of falls.

Regular physical exercise and conditioning needs to be core component of any fall prevention program. Daily exercise for lower extremity strengthening, chair exercises, chair yoga, tai chi can be safe for seniors with varying levels of immobility, under supervision. Use of physical and occupational therapy as appropriate can help maintain limb function. Adequate pain management can make exercise easier and implementable.

While there is no magic pill to prevent falls, a structured fall prevention program which considers the above-mentioned elements can potentially minimize falls and help increase length of resident stay. Periodic observation and review by care teams for these factors can be made part of the program. These factors should also be considered when developing new-hire orientation and onboarding programs, as care-team execution is key determinant of successful program to reduce and/or prevent falls.

This information is provided by S. Sanjay Gopal, MBA., PhD., and Dr. Visa Srinivasan, MD. Sanjay is the founder & CEO of the CareSynchrony® platform for senior living. Dr. Visa Srinivasan, MD, is a recognized Alzheimer’s expert and leading geriatrician. As the Director of the Health-First Aging Services, Melbourne, Florida, Dr. Srinivasan has been serving the needs of seniors and caregivers in Florida for over 17 years. For more information, contact Sanjay Gopal Health at 321-282-7730 or via email at

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