Falling for hip protectors

Ridge Care, headquartered in Kernersville, N.C., is a regional assisted and independent living provider with 13 communities across North Carolina and West Virginia and another seven sites under development. Ridge Care was established nearly 20 years ago and serves 850 residents, including assisted living and independent living communities, as well as a private home care agency and memory care units.

Regulatory agencies in North Carolina survey Ridge Care communities annually, and while the communities do very well, the surveys stress the importance of reducing fall-related injuries. To help mitigate the risk of hip fractures for ambulatory residents in its assisted living communities, while helping residents stay active and independent, Ridge Care developed criteria for identifying residents at risk for hip fracture and implemented next-generation, high-tech hip protectors for those who could benefit.

The use of hip protectors was recently named among key fracture prevention strategies in new guidelines for long-term care published in the Canadian Medical Association Journal, mirroring recommendations from AMDA—The Society for Post-Acute and Long-Term Care Medicine. 

The new criteria and innovative technology are now being used in nine of Ridge Care’s communities, resulting in a number of benefits for residents and the facilities, allowing them to reduce the risk of fall-related hip fractures in a streamlined and economical way while helping to increase confidence for active residents.

Reducing Fall-Related Hip Fractures

Falls are common among seniors—one in three adults over the age of 65 falls each year—resulting in potentially devastating and costly consequences for residents and facilities alike. About 20 percent of hip fracture patients die within one year of the injury, and half of patients who survive never regain their independence. With that in mind, Ridge Care developed the Fall-Safe Hip Protectors Criteria List to help identify residents who may benefit from the use of hip protectors, assessing areas such as history of fractures, heredity (frame size, weight, etc.), nutrition, medication use, and other diagnoses that may contribute to an increased fall risk.

The communities evaluate residents at admission, or as needed, to assess fall risk. If, based on the criteria list, it is determined that a resident could benefit from the use of hip protectors, a meeting is scheduled with the family and the resident to discuss options. Although residents may decline, most have been receptive to using hip protectors, especially with family encouragement.

Next-Generation Hip Protectors

Along with the comprehensive criteria list, staff and residents receive an information sheet about the benefits and use of the recommended hip protectors, focusing on areas such as comfort, durability and pricing.

Fall-Safe Hip Protectors feature technology advances that overcome the limitations of earlier generation hip protectors. The high-tech pads are made from D3O—a unique shock-absorbing material that is soft and flexible in its natural state, but becomes instantly rigid when struck by an outside force. As a result, the hip protectors offer the unique combination of rigidity when needed—to absorb the shock and disperse the energy of a fall—yet softness and comfort at all other times, even while sleeping. D3O pads are lightweight and low profile, fitting easily into pockets in custom-designed undergarments that hold them in position for maximum protection and comfort. Unique grooves and “breathing” holes allow heat and moisture to escape.

Ridge Care teams researched different types of hip protectors, eventually choosing the Fall-Safe Hip Protector developed by UK-based Hip Impact Protection Ltd. The slim design was different from the standard, bulky pads that residents are reluctant to wear. The device’s durability—it doesn’t need to be replaced after a fall—made it the best choice for Ridge Care’s residents and finances.

Accepted by Staff and Residents

Ridge Care implemented the hip protectors in nine assisted living communities, beginning in early 2015. Some of the nurses and staff were skeptical initially about the introduction of hip protectors. Many of them came from other senior-care facilities that used older-generation hip protectors and had negative feelings about them, but once they realized how easy the new hip protectors are to put on and care for, everyone became much more receptive to implementing them and embraced the program.

Some residents also were hesitant about wearing hip protectors at first. Many seniors don’t want to be seen wearing a bulky undergarment—especially women. After trying them, residents have no complaints about the look or feel of the hip protectors because they are comfortable and almost unnoticeable under clothing.

Resident care team members learn how to use and care for the hip protectors through an in-service training before they are implemented into each building. In addition to educating staff, the process and benefits also are reviewed with the residents and families.

Families often play a large part in encouraging residents to wear the hip protectors because they realize that a fracture can be a life-altering and costly injury for everyone involved. The average cost for inpatient hip fracture care is approximately $29,000 per episode, not including the significant additional cost of skilled nursing care, and there are more than 250,000 hip fractures among adults 65 and older in the United States per year. As a result, assisted living communities must provide residents with greater protection.

Benefits of Next-Generation Hip Protectors

It has been nearly one year since the program implementation b began, and the communities have experienced several important benefits associated with the new technology.

Experience shows that the new pads provide ease of use, greater comfort and improved confidence for residents. Fear of falling is a problem for many residents, but the new hip protectors provide residents with the confidence to be more active, which Ridge Care strongly promotes.

The hip protectors also have proven to be economical. Over time, the high-tech hip pads help reduce costs, because it is not necessary to replace them every couple of months or after every fall. In addition, they allow residents to “age in place,” which improves wellness and quality of life, benefitting both residents and their families.

Ridge Care has been very pleased with the implementation of the new hip protectors in conjunction with the new risk assessment protocol. It is not possible to prevent every fall, but the new program makes the outcome of a fall less impactful on the residents’ health and overall lifestyle.

KenZee Vestal, RN, is Director of Clinical Services at Ridge Care, headquartered in Kernersville, N.C. She can be reached at 336-993-7555.