The phone call
"Your mum had a fall, we got her up, she's fine." You thank them, hang up, and the question you did not ask stays with you: how did it happen?
Then it happens again. And by the third time you realise nobody ever told you what changed after the first.
Start from something honest: falls happen in homes that are doing a good job. An older person who walks sometimes falls; one who never falls is often one who no longer gets up, and that is not a good outcome. The question is not the fall — it is what happens next.
The number reported every quarter
This is the Australian advantage. Falls and major injury is one of the measures providers must collect and report under the National Aged Care Mandatory Quality Indicator Program, alongside pressure injuries, unplanned weight loss, medication management and restrictive practices. Those results feed the star ratings on My Aged Care.
So you can arrive at the meeting already knowing something: "What has this home reported for falls and major injury in recent quarters, and how does that compare with the national average?"
The provider has the figure — it is required to collect it. A home that walks you through its numbers and its falls program is working on the problem. A home that changes the subject has answered you too.
What should follow every fall
- An immediate assessment: consciousness, pain, weight-bearing, suspected head injury — with particular care if she takes blood thinners, where even a modest knock needs assessing.
- An incident record: date, time, place, what happened, who was present, what was done.
- A search for the cause. Most causes are modifiable: a sleeping tablet started recently, a drop in blood pressure on standing, a urinary infection, unsuitable footwear, out-of-date glasses, a call bell out of reach, an unlit route to the bathroom.
- A revised care plan, provided to you in writing afterwards. If the plan is unchanged after a fall, nothing was learned from it.
- Telling the family — not just a courtesy call.
The six questions to send
- "Where and how did the fall happen, and who was present?"
- "What assessment was done immediately afterwards, and by whom?"
- "Has a medical cause been excluded — blood pressure, infection, a recently started medicine?"
- "What is her falls risk assessment, and when was it last updated?"
- "What changed in the care plan as a result?"
- "How many falls has she had in the last six months?"
The last one changes everything. One fall is an event; three falls in two months is a number, and a number calls for something other than reassurance.
The link nobody makes
If the fall followed soon after a sleeping tablet, sedative or antipsychotic was started, both belong in the same email. In older people those medicines increase falls — and the first thing to ask for is an RMMR, the pharmacist medication review arranged on GP referral, not a bed rail.
The answer not to accept
The most common is a restraint: a bed rail, a lap belt, a chair she cannot rise from. It is the quickest response and the worst. Restraint does not prevent falls — it moves them and makes them worse, alongside immobility, loss of strength and distress.
And in Australia it is not a nursing decision: any such measure is a restrictive practice, requiring last-resort justification, a behaviour support plan and informed consent from the nominated substitute decision-maker. Ask to see both documents before agreeing to anything.
Ask instead what alternatives were tried: a low bed, a floor mat, sensor lighting, a clear path to the bathroom, a medication review, physiotherapy for strength and balance, proper footwear.
If the fall caused serious harm
- Ask whether it was reported under the serious incident scheme, on what date, and request written confirmation. Neglect falls within that scheme, and the question has a paper trail behind it.
- Request the records, including the incident report and the care plan before and after.
- Have her assessed outside the home and get it in writing.
- Photograph and date any bruising.
- Bring in a free, independent aged care advocate, and complain to the Aged Care Quality and Safety Commission — confidentially if you prefer.
The practical point
Check the home's reported falls figure before you meet. Do not ask whose fault it was: ask what changed in the care plan and how many falls there have been in six months. Get falls and medicines reviewed together through an RMMR. And treat any proposed restraint as a restrictive practice — with a plan and a consent you can read.
If the answers show the risk is not being managed, Curalune Care Help gives you the starting point: 3 to 5 suitable homes matched to the real situation within 24 working hours, with contact details, links and a ready-to-send message to all of them at once. A$109, one-off. If you don't receive at least 3 homes matching the area and criteria you gave us, we refund you in full. Start here
The quality indicators collected, star rating methodology, restrictive practice and consent requirements, serious incident reporting obligations and complaint pathways are set by Australian Government aged care legislation and are revised regularly. Never stop or change a medicine yourself: speak to the GP and the pharmacist. Free help is available from an aged care advocate and the Aged Care Quality and Safety Commission. This article is general information and is not medical or legal advice. Curalune does not allocate places and does not guarantee availability.