No, it’s not a typo, fall-risk-increasing drugs in senior living are a real and growing concern. These medications, often referred to as FRIDs, include everything from certain cardiac drugs to first-generation antihistamines like Benadryl. According to epidemiologist Thomas Farley, they may be playing a key role in why fall-related deaths among Americans over 65 have more than tripled in the last three decades.

For those over 85, the numbers are even more staggering: 339 fall-related deaths per 100,000 in 2023, up from just 92 in 1990. Farley points to America’s heavy and often inappropriate reliance on prescription medications for older adults. “Older adults are heavily medicated, increasingly so, and with drugs that are inappropriate for older people,” he explained. Unlike Japan and parts of Europe, this level of overmedication is uniquely American.

While physical decline, alcohol use, and environmental hazards certainly contribute to falls, Farley emphasizes the effect of medications like benzodiazepines, opioids, antidepressants, and gabapentin. These drugs tend to cause dizziness or drowsiness, which significantly increases the risk of falls. More details can be found in this HomeCare Magazine report on rising fall-related deaths.

The good news is that we are not powerless. The updated Beers Criteria offers current guidance on medications that may no longer be suitable for older adults, along with nonpharmacological alternatives. Dr. Steinman, co-chair of the Beers panel, put it plainly: “It’s a real tragedy when people have this life-altering event.”

So what can your community do? Start by asking a simple but vital question: Do any of our residents’ medications increase the risk of falls? Bring this into your next QAPI meeting with your Medical Director and pharmacy provider. Review current drug regimens, especially for residents who have recently experienced a fall. If patterns emerge, initiate a performance improvement project. But whatever you do, don’t ignore the issue. Fall-risk-increasing drugs in senior living are too important to overlook.

Stay well and stay informed!