Physician Perspectives on Fall Prevention and Monitoring in Assisted Living: A Pilot Study

Objective: To investigate physician perspectives on their own role and the role of residential care/assisted living (RC/AL) staff in fall prevention and monitoring among RC/AL residents. Design: Exploratory cross-sectional study. Mailed questionnaire. Setting: RC/AL communities. Participants: Primary physicians (N = 36) for residents of 4 RC/AL communities in North Carolina. Measurements: Theory of Planned Behavior constructs were used to measure physician attitudes, perceived expectations, and perceived barriers to conducting fall risk assessments, medication reviews for potential side effects related to falls, and working with RC/AL staff to reduce falls and fall risks among RC/AL residents. Results: Physicians expressed strong support for conducting fall risk assessment of patients in RC/AL communities, believing that these assessments were likely to uncover risks that might be preventable; however, they reported conducting such assessments for only 47% of their RC/AL patients. They believed RC/AL staff had greater responsibility than they did for conducting these assessments, although they believed the staff had less expertise to do so. Further, they believed they were significantly (P < .05) more likely than RC/AL staff to take specific actions to reduce fall risks among individual patients. Physicians supported working with RC/AL staff to reduce fall risks, but expressed concerns about the usefulness and amount of communications from RC/AL staff about residents identified at high risk for falls. Conclusion: This study provides the first data on physician perspectives on an important issue of quality care and quality of life in RC/AL communities fall prevention and monitoring among RC/AL residents. Findings point to the need for greatly improved communications between primary physicians and RC/AL staff about residents at high risk for falls and responsibility for conducting fall risk assessments. (J Am Med Dir Assoc 2011; 12: 445-450)