Wheelchair Discontinuity in Nursing Homes Linked to Fracture Risk

Research indicates that switching wheelchairs in nursing homes may elevate the risk of dangerous fractures among residents. A study published in the JMA Journal highlights the importance of matching wheelchairs to the physical capabilities of individuals requiring long-term care. In Japan, under the long-term care insurance system, multifunctional wheelchairs—equipped with various supportive features—are available for rental at a low cost for home use. However, once residents enter nursing homes, access to these rental services is often cut off.

This discontinuity can result in individuals who previously relied on multifunctional wheelchairs having to use standard, facility-owned models that may not cater to their specific functional needs. The study analyzed data from 215 older adults in Ibaraki Prefecture who utilized wheelchair rental services before their admission to nursing homes. Notably, around 40% of these residents had been using multifunctional wheelchairs prior to their transition.

Study Findings and Implications

Among the participants who had previously relied on multifunctional wheelchairs, five experienced fractures after admission to nursing homes. In contrast, no fractures occurred among those who had used standard wheelchairs before entering the facilities. While these findings suggest a potential connection between the discontinuation of multifunctional wheelchairs and an increased fracture risk, the study could not confirm the specific models of wheelchairs used after admission or the circumstances surrounding the fractures. Thus, establishing a direct causal relationship remains inconclusive.

This research marks the first quantitative assessment to underscore the potential influence of wheelchair continuity on fracture risk among nursing home residents. As the authors, led by Ai Suzuki, indicate, further investigation is necessary to fully understand the implications of wheelchair provision practices within these facilities.

Future Research Directions

Upcoming studies will involve questionnaire-based surveys aimed at comprehensively exploring wheelchair provision practices in nursing homes. Researchers intend to delve deeper into the broader health outcomes associated with disrupted wheelchair use. The ultimate goal is to develop care systems that ensure residents have continued access to appropriate wheelchairs following their admission.

The findings from this research are critical for informing policy and practice in long-term care settings. By addressing the needs of residents and ensuring continuity in wheelchair provision, nursing homes can potentially reduce the risk of falls and fractures, thereby enhancing the safety and well-being of their residents. For further reading, see Ai Suzuki et al.’s study titled “Type of Wheelchair Used before Nursing Home Admission and Fall-Related Fractures after Nursing Home Admission,” published in the JMA Journal in 2025 (DOI: 10.31662/jmaj.2025-0194).