I would lower myself slowly from my bed and scoot myself across the room to my shoes and attempt to put them on. Then, I would need to wait for someone to assist me up and will remain on ground until they come.

This is what happens to 30% of residents in memory care. They want something and they will attempt to do it on their own safely by self-lowering. Unfortunately they aren’t able to self recover and when they are found the care staff must assume they fell with a possibility of hitting their head. Most Memory Care communities have a protocol for unwitnessed falls that requires calling EMS if there is any possibility of head injury. This makes sense as we strive to provide the best possible care and have to make decisions with an abundance of caution when we are left without evidence about the reason a person ended up on the floor.

As we learn more from reviewing fall videos, we have come to refer to this type of event as an “intentional fall.” We define it as: Any intentional change in position where the individual ends up on the floor, ground, or lower level without injury.

Some of the most common reasons we have found that people intentionally lower themselves are:

• They want to leave the room, look for someone.
• They want to go to the bathroom.
• They see / are looking for something they need in the room or under the bed.
• They hear something and want to look under the bed.

We know that reducing falls is critical to improving the quality of care for our elders. We need to dive deeper to understand how they happen, where/when they happen, what happens before and after in order to reduce repeat incidents and prevent injury. Not all fall incidents are equal, and the more we know about how and why they occur, the more we can apply specific person-centered solutions based on what actually occurred instead of assumptions deduced from unwitnessed events.