Fall could happen even after we have used various measures to prevent it. It is particularly difficult to avoid among the oldest older adults, and those who are physically frail or have a number of underlying health problems.
Falls are common events among nursing home residents with dementia or confusion (may be affected by medication), who forget or are unable to use the call bell. These residents often will get out of bed without assistance, or roll out of bed and hurt themselves.
Although most falls only result in minor injuries such as bruises and lacerations, some falls lead to more serious consequences such as hip fractures, head injuries, and intracranial bleeding.
How do we prevent injury should a fall occur?
To reduce the severity of fall injury, some innovative solutions have been introduced, for example, fall mat, compliant flooring (force reduction flooring) and hip protector.
Fall mats are specially designed floor mats made from different materials. They are placed on the floor at the bed or chair side to protect the elderly from serious physical trauma resulting from falls.
Fall mat is useful for cushioning a fall and reducing the impact when the elderly accidentally rolls out of bed at night. It is also helpful for elderly who are unsteady on their feet and lose their balance as they are getting out of bed or standing up from a sitting position.
In laboratory tests, the risk of severe head injury is reduced to about 1% when falling from a low bed position onto a fall mat. This is compared to approximately 40% of injury risk occurring at normal bed height over bed rail onto unprotected flooring (Bowers et al., 2008).
Fall mat is one of the recommended interventions by The Institute for Healthcare Improvement (Boushon et al., 2012) and national guidelines for hospital fall prevention programs (Ganz et al., 2013; NCPS, 2014) to protect patients from fall‐related injury.
How to select and use fall mats correctly
There are many kinds and makes of fall mats in the market. When choosing a fall mat, we must take into consideration the older person’s physical and health condition, for example, gait, balance, vision, and if he/she is using a walking aid. If you are not sure, it is prudent to get advice from a health professional to avoid accidents.
Helpful information could be found in the Floor Mat Resource and Implementation Guide. The most important points to consider are:
- Impact Attenuation: the degree in which the mat reduces the impact force during a fall.
- Stability: How well a person can stand on the mat without losing their balance
- Friction: The mat surface slipperiness
- Thickness: The overall thickness of the mat
- Weight: The overall weight of the mat
- Overall Size: Refers to the mat’s length and width.
In addition, you should also take note of the following:
- Because the mat is usually stored away when the patient is not in the bed, mat constructed with fold lines may be easier to store than ones that cannot be folded.
- The thickness and edge characteristics of the mat are potential tripping hazards when it is placed next to a bed or chair. Thicker mats will produce a higher risk for tripping. Beveled edges reduce tripping risks. However, make sure the edges are not curled up.
- Glow-in-the-dark strips around the mat’s edges increase visibility of the bedside floor mat at night, and may decrease trip hazard.
- The length of the mat should extend beyond the head of the bed and is at least 44 inches wide.
- The fall mat is placed at the side of the bed where the patient exits the bed from. Only place the mat on the floor when the patient is resting in bed. Stow the fall mat away when the patient is standing and ambulating.
- Fall mats are for elderly who you worry will get out of bed without calling for help and are at risk for injury. It is also suitable for those with poor balance.
- For older adults who walk around their room at night, for example going to the bathroom, bedside mats are actually a fall hazard.
- Caregivers who want to be notified of the movements of the elderly might be interested in floor mat alarms. These floor mats are installed with sensors that give off beeps when stepped on or fell on.
Quigley, PA. (2015) Evidence Levels: Applied to Select Fall and Fall Injury Prevention Practices. https://onlinelibrary.wiley.com/doi/abs/10.1002/rnj.253
Boushon, B., Nielsen, G., Quigley, P., Rutherford, P., Taylor, J., Shannon, D., & Rita, S. (2012). How‐to guide: Reducing patient injuries from falls. Cambridge, MA: Institute for Healthcare Improvement.
National Institute for Health and Care Excellence (NICE). (2013). Falls: Assessment and Prevention of Falls in Older People (Guideline 161).
Ganz, D.A., Huang, C., Saliba, D., Shier, V., Berlowitz, D., Lukas, C.V., … Neumann, P. (2013). Preventing falls in hospitals: A toolkit for improving quality of care. Rockville, MD: Agency for Healthcare Research and Quality. AHRQ Publication No. 13‐0015‐EF.