How Family Involvement Can Help Reduce Falls in Assisted Living and Memory Care Eugene-Springfield, Oregon
28% of adults living in assisted living/residential care residents fall annually.
33% of older adults living at home fall annually…only slightly more.
So I ask myself: if the risk only drops slightly in assisted living, or even increases in memory care, are these communities worth the high monthly fees? Am I promoting a solution that doesn’t deliver on its promise?
The honest answer: Yes…and no.
You Can Still Play a Role in Supporting Your Loved One
Falls are one of the most common causes of injury among older adults, and they can happen anywhere. While assisted living and memory care communities are designed for safety, falls still occur. The good news: families who stay involved can make a significant difference.
Planning Ahead
According to available statistics, in Oregon, only about 2.7% of adults age 65+ live in senior care communities. That means 97.3% spend their later years at home.
In my Senior Living Options Class (recording available on my website here)
I discuss the importance of planning ahead for a potential move from home into a senior care community.
You might ask:
“Why plan for something that may never happen? Why not focus on retirement enjoyment, vacations, senior center classes, or hobbies?”
My answer: If you’re healthy and active, absolutely focus on the fun. But if you, or a loved one, are noticing changes in health, strength, or memory, it’s time for a gentle “what if” conversation.
A word from our clients:
I often rely on Ronit to assist me to understand which care communities are the best fit for our community’s elders. She has great depth of experience and knowledge as a healthcare expert.
Oriana Kahn Hurwit, Social Worker- Jewish Federation
Why Falls Matter
Key national statistics:
- 30 million adults fall each year
- 3 million are treated for fall-related injuries
- 300,000 older adults are hospitalized annually for hip fractures
- 30,000 adults die each year from falls
Oregon-specific data:
- 33% of older adults living at home fall annually
- 28% of assisted living/residential care residents fall annually
- 38% of memory care residents fall annually
- Injury rates: 45% of falls in memory care result in injury vs. 15% in assisted living
These numbers surprised me. One of the first questions I ask clients during my assessments is: “Have you fallen in the last 6–12 months? How many times?” I also explain that while falls cannot be completely prevented in care communities, they can be significantly reduced.
But now I ask myself: if the risk only drops slightly in assisted living, or even increases in memory care, are these communities worth the high monthly fees? Am I promoting a solution that doesn’t deliver on its promise?
The honest answer: Yes…and no.
You can read more about reducing fall risk at home here and here.
Falls in Assisted Living (AL)
Inappropriate Placement
Residents need enough cognitive awareness to:
- Recognize risk and request caregiver assistance during transfers
- Know how to call for help
- Wait patiently for assistance
If cognition is impaired, these steps may not be followed. Initial assessments can sometimes miss this, leading to residents being placed in AL when higher supervision is needed.
Staying Too Long in AL
A community that was appropriate at first may become unsafe as cognition declines with time. Residents who can no longer safely manage transfers may need memory care or an adult foster home.
Cluttered Apartment
Downsizing from a three-bedroom home to a studio or one-bedroom apartment can be both an emotional and physical challenge. However, bringing too much furniture into the new space can create clutter and limit safe movement. When pathways are tight or blocked, it becomes
difficult to navigate with a walker or wheelchair—significantly increasing the risk of falls.
Caregiver Factors
- Staffing shortages can delay response to call lights, prompting residents to move independently.
- Limited training, e.g., not using transfer belts, can increase fall risk.
How Families Can Help in Assisted Living
Assess Cognitive Awareness
Ask simple scenarios:
- “You need to go to the bathroom. What would you do?”
- “What happens after you press the call button?”
If safety awareness is limited:
- Request a thorough cognitive assessment
- Include scheduled checks and toileting assistance every 3–4 hours in the care plan
Caregiver Training
Advocate for ongoing caregiver training. Make sure there is a transfer belt in the room with your loved one’s name on it.
Outdated Care Plan
Participate in the quarterly meeting when the care plan is being reviewed. Ask questions, give your input, and make suggestions.
Create a Safe Space
One of the best ways to furnish an apartment so it feels both homey and safe is to use the help of a professional downsizing or moving service. If you’re handling the move yourself, make sure the space isn’t crowded, keep most furniture along the walls and leave plenty of room to move freely with a walker or wheelchair.
Falls in Memory Care (MC)
Layout Matters
Long hallways limit residents’ visibility. Communities with a central common area surrounded by bedrooms allow staff to monitor residents more effectively and respond quickly if someone attempts to get up unsafely.
Caregiver Training and Dementia Understanding
Residents may resist care. Caregivers lacking dementia-specific training can inadvertently trigger unsafe independent activity, increasing fall risk. Families can advocate for ongoing training.
Cognitive and Physical Decline
As dementia progresses, physical abilities decline. Tasks residents once did safely may now require supervision that isn’t always available since memory care does not provide one-on-one care.
Outdated Care Plan
If the care plan isn’t updated with changes in mobility or cognition, falls are more likely. Regular reviews with your participation are essential.
How Families Can Help in Memory Care
Find the Right Layout
Look for communities with a central common area surrounded by bedrooms for maximum visibility.
Update the Care Plan
Quarterly reviews of the care plan, with your participation, are essential.
- Schedule toileting assistance every 2–3 hours
- Encourage residents to spend time in common areas for supervision
- Request extra monitoring during nighttime if needed
- Ask for a motion sensor alarm if appropriate
Support Caregivers
- Advocate for transfer training.
- Ensure a transfer belt labeled with your loved one’s name is available in the room.
Bottom Line, and Most Important
Falls cannot be completely prevented, but families play a crucial role in minimizing risk. By staying involved, asking the right questions, and advocating for proper assessments and care planning, you can significantly reduce the likelihood of falls while keeping your loved one safe and supported.
My Personal Tip
I’ve seen many older adults, who were not my clients, accepted into assisted living communities even when it was clear they needed a higher level of supervision. Many of these individuals were my patients when I worked as a home health physical therapist, and I treated them for fall-related injuries.
When I work with my clients, I conduct a thorough assessment of their physical and cognitive abilities. This helps me recommend the right type of care community, assisted living, memory care, or adult foster home, so fall risk is minimized. I also make suggestions for fall prevention to implement into the care plan and guide the family what to pay attention to when visiting their loved one.
If your loved one lives at home and has experienced a few falls in the past 12 months, I would love to hear from you. I can help by suggesting safety measures to reduce fall risk at home, or by starting a conversation about the next steps in finding the right senior care community.
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