Abstract

Many elderly people suffer serious injuries from falls. In 2024, 119,000 elderly people ended up in emergency care after a fall, slightly more than in 2023. In addition to the resulting physical and emotional distress, these incidents place a significant burden on the healthcare system and lead to high medical costs. Due to the ageing population, the number of falls among elderly people is expected to increase in the coming years. The Fall Prevention chain approach has been set up to prevent elderly people aged 65 and older from suffering falls, make them more independent and to reduce the burden on the care system.

Every year, RIVM maps out the process, progress and results of the Fall Prevention chain approach. The chain approach describes the actions for elderly people and what municipalities and care providers can do to help. The approach consists of four steps: identifying which elderly people are most at risk of falling, examining the factors that increase the chance of falling, taking part in a fall prevention course and engaging in regular physical activity and exercise.

The third monitor shows that by 2024, almost all municipalities (98 per cent) had made a start on the chain approach. However the set goals have not been reached. For example, more and more elderly people are taking a test to estimate the risk of falling (fall risk assessment). Both municipalities and care providers offer this test. Currently, 76 per cent of municipalities provide the test, but it is not known how often care providers do this. The target was to assess 14 per cent of all elderly people living at home. Reaching elderly people with a high risk of falling remains particularly challenging. Additionally, the second step of the approach, examining the factors that contribute to an increased risk of falling has not been widely implemented.

In 2024, almost 15,000 elderly people participated in fall prevention courses organised by municipalities. Additionally, almost 100 elderly people participated after being referred by a doctor or general practice nurse. Together, this is not enough to reach the target of 3 per cent of all elderly people living at home. It is not clear how many elderly people continue to engage in regular physical activity after a fall prevention course, although this is receiving increasing attention.

Collaboration between care providers, municipalities and welfare organisations has improved, partly due to the establishment of more agreements between these stakeholders. However, it remains difficult to implement in practice. For example because of their different working methods or because they do not speak each other’s language.