Introduction The purpose of this study was to addresses a gap in the fall prevention literature with a focus on Assisted Living Residences (ALRs) – a new community housing option for a rapidly growing number of older persons that are at high risk falls. The result of the 1-year collaborative study was the development of Best Practice Guidelines for integration into routine care.

Methods A 6-month prospective, action research intervention was conducted at two ALR sites, with 161 residents. Measures included focus groups, pre/post staff and resident surveys, pre/post measures of balance and gait, and 6-month fall/injury surveillance. Interventions included staff and resident training on fall tracking, fall prevention education for staff and residents, and physical activity interventions.

Results Over 6 months, 155 falls were recorded, with 38% (N=73) of residents identified as having at least one fall and 43% (N=72) of falls resulting in injury. There was a statistically significant reduction in the rate of falls per 1000 resident days between the first and second three-month periods (X²=11.98; p=0.001). Fall risk reduction was demonstrated by a significant difference (t=3.16, p=.002) in pre/post Timed-Up-and-Go scores. Focus group findings included the need to tailor prevention to joiners and non-joiners of group intervention activities.

Conclusion The study demonstrated that fall prevention guidelines can be implemented within routine service delivery in ALRs with a positive effect on fall risk reduction.