Monday August 25, 2025
Stroke patients have a high tendency of experiencing falls. However, for many the real risk isn’t their balance, it’s their inability to communicate.
When Speech Pathologist, Dr Rebecca Sullivan began her PhD, she set out to explore the link between communication disability after stroke and patient falls.
Her PhD paper Clinical Implications for Management of Falls in Hospital Patients with Communication Disability After Stroke: A Qualitative Meta‐Synthesis brought together six studies, consolidating years of investigation into practical, evidence-based guidance for preventing and managing falls in patients whose ability to communicate had been affected by stroke.
“Communication disability is consistently excluded across stroke and falls prevention research because it’s generally an ‘invisible’ disability…It’s not something that’s so obvious until you get into a conversation,” Dr Sullivan said.
Over the course of her research, Dr Sullivan examined the experiences of more than 100 stroke patients, who collectively experienced over 300 falls during their hospital stays. She discovered a recurring pattern: many of these patients had difficulties in expressing basic needs, using a call bell, or understanding instructions.
Communication challenges were often central to these incidents but were rarely addressed in existing falls prevention policies or screening tools.
“When I reviewed the medical records, communication issues were sometimes noted but not always linked specifically to falls…You have to read between the lines to see the underlying communication disability, but if we documented it clearly, it would bring the issue to the forefront.” Dr Sullivan explained.
By integrating Dr Sullivan’s findings into clinical practice, health professionals could be better equipped to design tailored falls prevention strategies, ones that consider each consumer’s communication needs and help prevent not only falls but also other serious health consequences, like post stroke depression.
Her falls prevention and management strategies include; identifying the level of risk early, involving a speech-language pathologist for support in developing communication strategies, detailed documentation of the assessments, and in the case where a fall occurs, thoroughly reassess and prevent future incidents.
“We know falls prevention is best when it’s patient-specific, such as identifying a clear way to communicate with a patient during high-risk tasks like transfers. This could mean developing a simple sentence everyone uses and the patient can comprehend, to reduce the risk of them not following instructions, and adapting falls prevention education accordingly.”
“During the research, focus group participants were clear that families are essential in falls prevention plans, as supported by every policy I reviewed across Australia. Families can share valuable background information, reinforce strategies and prompt safe behaviours,” Dr Sullivan said.
Dr Sullivan’s research was made possible through the University of Technology Sydney’s Jumbunna Postgraduate Research Scholarship.