Falls remain a major concern in residential aged care, posing serious risks to health and well-being. For residents and their families, the consequences can be life-altering. For providers and staff, falls represent one of the most difficult challenges in delivering safe and high-quality care. Public reporting of falls through the My Aged Care website and the Australian Institute of Health and Welfare (AIHW) has provided greater insight into falls and injury rates across aged care services. University of Queensland research estimates the annual cost of falls in residential care at $325 million, or $1,798 per resident per year.
Currently, around 32 per cent of residents experience one or more falls each quarter, with two per cent experiencing major falls-related injuries such as fractures, head injuries or dislocations. Falls remain the leading cause of preventable death in aged care. Between October and December 2024 alone, over 70,000 falls were reported, with 3,717 resulting in serious harm. While the overall percentage of residents falling has not changed significantly in recent years, there is a positive trend towards fewer major injuries, according to the AIHW.
Proven Prevention Strategies
Although falls remain stubbornly frequent, Australia continues to lead the way in researching and testing effective prevention strategies. These studies demonstrate that strength and balance exercises, as well as nutrition that meets the needs of residents, are foundational to preventing falls and limiting their impact.
Led by Dr Jennie Hewitt, the SUNBEAM Program is based on progressive resistance training and balance exercises for aged care residents. In a large trial involving residents with an average age of 86, the results were striking, with a 55 per cent reduction in fall rates, fewer injuries and improved physical function. For the healthcare system, the result was also positive, with cost savings of up to $670 per fall.
Another exercise approach to falls prevention – the TOP UP program led by Dr Rik Dawson included residents of aged care homes in New South Wales – trialled a six-month telehealth-delivered physiotherapy exercise intervention, supported by on-site staff. Preliminary results disclosed reduced falls, less pain, improved mobility and better quality of life.
Dairy supplementation is another evidence-based and relatively simple way to help prevent falls. Research by Dr Sandra Iuliano investigated the impact of increased dairy intake for aged care residents, specifically high-protein, high-calcium foods such as milk, yoghurt and cheese. Supplementation (equivalent to 250ml milk and 20g of cheese or 100g yoghurt) resulted in 11 per cent fewer falls and 33 per cent fewer fractures, and preservation of bone density and muscle mass. The cost of added dairy averaged $0.66 per resident per day, with significant overall cost savings for each fracture avoided.
Emerging research continues to refine our understanding and guide action on medication risk. A 2025 study by Catherine Laird found 83 per cent of residents use medications that increase falls risk, with many taking three or more. Regular medication review and stopping unnecessary medications can help to reduce the risk of falls. The Laird study found that unfortunately, resident and family perspectives were often missing from deprescribing decisions, highlighting the importance of resident-centred communication.
Actions Providers Can Take
Falls prevention is everyone’s responsibility and there are many steps aged care providers and staff can take to help keep residents safe:
- Adopt the World Falls Guidelines which consider all residents at high risk. Undertake comprehensive risk assessments on admission and after any fall. Intervene based on findings and avoid unnecessary hospital transfers.
- A one-size-fits-all approach is rarely effective. Personalised strategies work best, so tailor care for individual residents.
- Consider adopting exercise-based programs like SUNBEAM or other proven initiatives as part of your health and wellbeing offerings.
- Boost calcium and protein intake through dairy foods to support better nutrition and reduce falls risk.
- Review medications regularly and involve residents in conversations about deprescribing drugs that increase fall risk.
- Engage all staff to gain buy-in from your team so everyone plays a role in falls prevention.
- Include respite care clients in your strategies and programs; they experience falls at higher rates and should not be overlooked.
- Advocate for consistent national and state-level falls prevention action.
- Stay informed by keeping up to date with upcoming Australian falls prevention guidelines and full results from new programs like TOP UP at the Australian and New Zealand Falls Prevention Society website (anzfallsprevention.org).
Falls prevention in aged care is not just about compliance, it’s about the dignity, independence and wellbeing of older people living in care. Australia is leading the world in falls research. Now it’s time to turn that knowledge into everyday practice – with consistency and compassion.
Frances Batchelor
Director Clinical Gerontology
National Ageing Research Institute