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Fall Prevention in Frail Elderly Nursing Home Residents: A Challenge to Case Management: Part I

Theodos, Phyllis MSN, MPH, MBA, BSN, CCM


Parts I and II of this article examine the impact of a falls prevention program on the fall incidents among the residents in a nursing home. It was hypothesized that a diagnostic, therapeutic, and preventive approach should be used for nursing home residents identified as being at high risk for falls in order to reduce the number of fall incidents and to improve quality of life for this vulnerable population. The program effectively targeted both intrinsic and extrinsic factors to reduce risks facing the residents. The effectiveness of the program was evaluated by examining changes in the rate of falls after the program was implemented. The results identified that a multifaceted program, one that utilized multiple personalized interventions, was effective in reducing the falls rate of frail (those with complex medical and psychosocial problems) nursing home residents, and that muscle-strengthening interventions may be beneficial for this vulnerable population. Program outcomes verified that case managers can impact quality of life for frail elderly nursing home residents by promoting their independence and safety, and postponing problems resulting from inactivity. Part I discusses the background and process of a falls program and factors contributing to the occurrence of falls. Part II will examine the interdisciplinary team approach to assessment, method, and implementing strategies for an effective fall prevention program. Tools used for prevention, monitoring, and investigation of falls will be detailed in Part II.

Phyllis Theodos, MSN, MPH, MBA, BSN, CCM, is a case manager and education coordinator for quality management at Victory Memorial Hospital in Waukegan, Illinois. She is also an associate professor in the Masters of Public Health program at Benedictine University, Lisle, Illinois, and a CNA clinical instructor for McHenry County College, Crystal Lake, Illinois. She has over 30 years experience in a variety of healthcare areas and is interested in improving processes that impact patient care and safety. A complete packet of the program’s policies, tools, and forms is available on request via e-mail:

Address correspondence and reprint requests to Phyllis Theodos, 6306 Hidden Oak Drive, Crystal Lake, IL 60012 (

© 2003 Lippincott Williams & Wilkins, Inc.