Up to 50% of all nursing home residents suffer a fall every year; 40% fall repeatedly. When the elderly fall, around one third suffers injuries as a result. Sometimes serious injuries, such as fractures near the hip joint, craniocerebral injuries and bone fractures are the consequence. Residents often lose confidence in their mobility after a fall. Since they are afraid of falling again, they restrict their activities, seclude themselves and thus have a reduced quality of life. Negative consequences Many studies have examined the effectiveness of interventions with regard to prevention of falls. One can roughly differentiate between personal, staff-related and environment-related interventions. Retirement and nursing homes in Austria are not consistently barrierfree, either construction-wise or visually. Unfortunately this is a fact that promotes falls by the very elderly. Additional risk factors that vary as far as concrete effects of health limitations are concerned increase the risk of falls significantly. The living environment of persons with orientation, perception, mobility, vision or coordination impairment must, however, be safe, because residents can no longer adapt to structural barriers. Lacking awareness for prevention of falls by way of structural solutions During their visits, commissions observed that in Vienna and Lower Austria it was not ensured that access to terraces, balconies or gardens is barrier-free even for newly constructed or remodelled buildings. On one hand, such obstacles are tripping hazards that can cause mobility-impaired persons to fall; on the other, they make it impossible for users of wheelchairs to access outdoor areas independently. If in a nursing home, which was opened in 2014 and which also has living areas for persons with dementia, access to the dementia garden via a door that is difficult to open and a path that is too steep becomes a hazard, planning errors have been made. In summer 2015 Commission 4 found that the attractive green spaces were hardly being used for this exact reason and accompanying the mobility-impaired outdoors was only possible to a very limited extent due to staff capacity. The necessity for structural remodelling to prevent falls was not denied. It should be noted that it is not the facility management that is responsible for such deficiencies, but the entity that owns and operates the facility. Outdoor access is not barrier-free even for new construction or remodelled buildings In the case of older buildings, the deficiencies are sometimes much more serious and relate to residential and communal rooms as well as sanitary facilities. A nursing home in Vienna, which was visited twice by Commission 4, is considered to be no longer suitable for its purpose due to the fact that it is largely not barrier-free. The recommendation of the NPM to make it barrier-free was not complied with. In the absence of a legal basis, the responsible municipal department (MA40) may not subsequently prescribe any official requirements in this case. In this context, the NPM criticises that the Viennese Nursing Home Act (Wiener Wohn- und Pflegeheimgesetz) has granted all operator institutions periods of transition until the end Serious deficiencies in older buildings 35