Fall Risk and Prevention: Dementia

Course Summary
Falls are a major and recurring safety issue for older adults and other at-risk populations in licensed residential care. The Centers for Disease Control and Prevention reports that falls are a leading cause of injury among older adults, and a meaningful portion of falls result in serious injury such as fractures or head injury. This course prepares RCFE and ARF administrators to manage fall risk as an operational responsibility through compliant systems for environmental safety, supervision, staffing practices, documentation, communication, and follow-through after falls and near-falls.

Residents living with dementia may have increased fall risk due to changes in judgment, perception, mobility, sleep-wake patterns, and the ability to communicate needs. In dementia care, falls and fall-related actions may occur in the context of confusion, restlessness, or attempts to meet an unmet need, which underscores the importance of person-centered, least-restrictive supports that protect safety while preserving dignity and quality of life. The RCFE dementia care regulation updates effective January 1, 2025 reinforce person-centered care expectations, training and operational requirements, and the need to reassess and adjust care and supervision when resident needs change.

The course also addresses fall risk among adults with developmental disabilities served in ARFs, including individuals aging with lifelong mobility impairments such as cerebral palsy, where balance, coordination, fatigue, pain, and environmental fit can significantly affect safety across the lifespan.

Course Objectives

• Administrator-level understanding of the prevalence and consequences of falls in residential care populations, including common injury outcomes and facility-level impacts on supervision and service delivery.
• The ability to describe how dementia-related changes in cognition, perception, and communication can increase fall risk, and how to apply person-centered, least-restrictive approaches when supporting residents who are at risk.
• Knowledge of common fall risk contributors that staff may observe and report within scope, such as medication side effects, vision and hearing changes, and symptoms consistent with orthostatic hypotension, along with clear expectations for documentation and escalation to licensed providers.
• An understanding of practical environmental modifications and day-to-day operational strategies that reduce fall risk, including safe routines, supervision planning, staff training, and post-fall follow-through.
• Awareness of administrator responsibilities under California RCFE and ARF requirements, including maintaining compliant dementia care-related operational practices and ensuring staff training and care adjustments occur when resident needs change.