I won't Fall for that Again!, Evidence based fall prevention in the Elderly, by Neila Shumaker (M.D.), as presented within the GWEP 2018 January Conference
Fall prevention for the Elderly Population | VITAS HealthcareVITAS Healthcare
Falls are the leading cause of injury for elderly adults. One in three adults over 65 falls each year, and falls are the cause of half of all trauma deaths among elderly patients. Nursing home residents are at especially high risk, with 30-40% sustaining significant falls. A comprehensive assessment identifies medical, environmental, and personal risk factors. A multidisciplinary team implements an individualized care plan with education, exercise, medication management, assistive devices, and environmental safety strategies to prevent falls and injuries among elderly patients.
This document provides information from a presentation on preventing falls for older adults. It discusses common risk factors for falls, statistics about falls, where falls commonly occur in the home, exercises that can help prevent falls, having medications and vision reviewed, and making home modifications like installing grab bars to reduce fall risks. The document emphasizes the importance of regular exercise, medication management, annual vision checks, and conducting a home safety assessment to help older adults prevent falls.
Falls are a major health issue for the elderly. They are the second leading cause of accidental death worldwide among adults over 65. Many factors increase the risk of falling, including increased age, living alone, visual impairment, arthritis, and alcohol use. Common places for falls are in the bathroom. Prevention strategies include removing home hazards, wearing sensible shoes, and using assistive devices like motion sensors, toilet seat risers, and grab bars in bathrooms.
Fall prevention is an important issue as 1 in 3 adults over 65 fall each year. Common causes of falls include medical issues like impaired mobility or balance, and environmental hazards. A thorough history, physical exam, and tests can identify risk factors. Exercise programs incorporating balance, strength, and flexibility training can reduce falls, as can medication modifications and vitamin D supplementation. Home safety evaluations and modifications can address environmental hazards.
This document discusses falls in the elderly, including risk factors and nursing interventions. It begins by defining a fall and noting that risk increases with age. Environmental factors like inadequate lighting and behavioral factors like multiple medications increase risk. Nursing interventions include exercises to improve strength and balance, environmental modifications like grab bars, and managing risk factors such as reviewing medications. The goal is to prevent injuries through risk assessment and effective interventions.
This document discusses falls among long-term care residents and strategies to prevent them. It notes that falls are a major issue, with approximately 1800 residents dying annually from fall-related injuries. The document then outlines risk factors for falls and a fall risk assessment tool. It emphasizes that falls are preventable and reviews the nursing process for assessing and addressing fall risk. Finally, it discusses equipment, policies, and innovative ideas that facilities can implement to reduce falls and improve resident safety and quality of life.
This video is a talk by Dr. Prakash Khalap on 19 Mar 2016. Topic "Falls in Elderly". This is part of the HELP Talk series at HELP,Health Education Library for People, the worlds largest free patient education library www.healthlibrary.com.
This document discusses reducing patient harm from falls in 3 key areas:
1) It defines a patient fall and lists factors that can contribute to falls, such as previous fall history, impaired mobility, confusion, and certain medications.
2) It outlines specific nursing interventions for fall prevention, including risk assessments, education, and safety measures near the bed and in bathrooms.
3) It describes post-fall nursing actions like ensuring safety, documenting the incident, and reviewing circumstances to prevent future falls.
Fall prevention for the Elderly Population | VITAS HealthcareVITAS Healthcare
Falls are the leading cause of injury for elderly adults. One in three adults over 65 falls each year, and falls are the cause of half of all trauma deaths among elderly patients. Nursing home residents are at especially high risk, with 30-40% sustaining significant falls. A comprehensive assessment identifies medical, environmental, and personal risk factors. A multidisciplinary team implements an individualized care plan with education, exercise, medication management, assistive devices, and environmental safety strategies to prevent falls and injuries among elderly patients.
This document provides information from a presentation on preventing falls for older adults. It discusses common risk factors for falls, statistics about falls, where falls commonly occur in the home, exercises that can help prevent falls, having medications and vision reviewed, and making home modifications like installing grab bars to reduce fall risks. The document emphasizes the importance of regular exercise, medication management, annual vision checks, and conducting a home safety assessment to help older adults prevent falls.
Falls are a major health issue for the elderly. They are the second leading cause of accidental death worldwide among adults over 65. Many factors increase the risk of falling, including increased age, living alone, visual impairment, arthritis, and alcohol use. Common places for falls are in the bathroom. Prevention strategies include removing home hazards, wearing sensible shoes, and using assistive devices like motion sensors, toilet seat risers, and grab bars in bathrooms.
Fall prevention is an important issue as 1 in 3 adults over 65 fall each year. Common causes of falls include medical issues like impaired mobility or balance, and environmental hazards. A thorough history, physical exam, and tests can identify risk factors. Exercise programs incorporating balance, strength, and flexibility training can reduce falls, as can medication modifications and vitamin D supplementation. Home safety evaluations and modifications can address environmental hazards.
This document discusses falls in the elderly, including risk factors and nursing interventions. It begins by defining a fall and noting that risk increases with age. Environmental factors like inadequate lighting and behavioral factors like multiple medications increase risk. Nursing interventions include exercises to improve strength and balance, environmental modifications like grab bars, and managing risk factors such as reviewing medications. The goal is to prevent injuries through risk assessment and effective interventions.
This document discusses falls among long-term care residents and strategies to prevent them. It notes that falls are a major issue, with approximately 1800 residents dying annually from fall-related injuries. The document then outlines risk factors for falls and a fall risk assessment tool. It emphasizes that falls are preventable and reviews the nursing process for assessing and addressing fall risk. Finally, it discusses equipment, policies, and innovative ideas that facilities can implement to reduce falls and improve resident safety and quality of life.
This video is a talk by Dr. Prakash Khalap on 19 Mar 2016. Topic "Falls in Elderly". This is part of the HELP Talk series at HELP,Health Education Library for People, the worlds largest free patient education library www.healthlibrary.com.
This document discusses reducing patient harm from falls in 3 key areas:
1) It defines a patient fall and lists factors that can contribute to falls, such as previous fall history, impaired mobility, confusion, and certain medications.
2) It outlines specific nursing interventions for fall prevention, including risk assessments, education, and safety measures near the bed and in bathrooms.
3) It describes post-fall nursing actions like ensuring safety, documenting the incident, and reviewing circumstances to prevent future falls.
2016: Falls in Older Adults Risk Assessment and Interventions-ShumakerSDGWEP
This document discusses falls in older adults, including risk factors, causes, assessments, and interventions. It notes that falls are a common threat to older adult independence associated with functional decline, nursing home placement, and increased medical costs. Causes of falls are usually multifactorial, involving intrinsic factors like chronic diseases as well as extrinsic hazards. Assessments include evaluating gait, balance, medications, home environment, and cognitive/neurological function. Effective interventions include home modifications, exercise programs, vision correction, and vitamin D supplementation. Gait disorders are predictive of further functional impairment and institutionalization.
Falls are the leading cause of injury for those over 65 years old, with over a third falling each year and two-thirds of those falling again within six months. The main causes of falls are osteoporosis, lack of physical activity, impaired vision, medications, and environmental hazards in the home like clutter, poor lighting, and a lack of handrails. Making changes such as exercise, home modifications, and medical reviews can help prevent falls.
The document discusses falls in the elderly from a physical therapy perspective. It provides statistics showing that 28-50% of elderly people fall each year, with rates increasing with age. Falls are the leading cause of injury and death for those over 55. Risk factors include both intrinsic factors like physical/functional limitations and extrinsic environmental hazards. A comprehensive falls risk assessment incorporates questionnaires, single-task tests like sit-to-stand and gait, and multi-task tests like Berg Balance Scale. Physical therapy can help prevention through multi-component exercise, whole-body vibration training, home hazard modification, and hip protectors for high-risk individuals. Urgent international action is needed for risk assessment and reduction.
Falls are a common and serious problem for older adults. They can cause physical injuries like hip fractures as well as psychological issues like a fear of falling. A multifactorial assessment and intervention is recommended to prevent falls, including reviewing medications, addressing vision problems, checking for home hazards, and encouraging exercise programs that improve balance and strength. Healthcare providers should routinely ask older patients about falls and refer them to prevention programs as needed.
This document outlines a fall prevention program for a hospital. It defines what constitutes a fall, notes that falls are common among elderly and confused patients and can result in serious injury. It stresses the importance of identifying patients at risk of falls through assessment tools like the Morse Fall Scale and implementing prevention strategies like hourly rounding, ensuring call lights and other items are within reach, and using devices to prevent falls for high-risk patients. The overall goal is to prevent falls and injuries to increase patient safety and reduce healthcare costs from fall-related injuries.
The Prevention of Falls Network for Dissemination (ProFouND) is an EC funded initiative dedicated to the dissemination and implementation of best practice in falls prevention across Europe. ProFouND aims to influence policy and to increase awareness of falls and innovative prevention programmes, amongst health and social care authorities, the commercial sector, NGOs and the general public. Through this work ProFouND will facilitate communities of interest and disseminate the work of the network to target groups across the EU.
This document outlines a fall prevention program with the goals of decreasing falls and fall-related injuries. It defines a fall and identifies intrinsic and extrinsic risk factors. The program involves comprehensive patient assessments to determine individualized fall risk levels, monitoring, care plans, staff education, and environmental safety improvements. It also provides guidance on responding to falls, post-fall care, documenting falls, and analyzing fall data trends to continually improve the program.
This document outlines an evidence-based fall prevention project conducted by nursing students at Alvernia University. It includes background information on the problem of falls in hospitals, learning objectives, a PICO question, and a literature review. The literature review found that multicomponent fall prevention programs utilizing multiple nursing interventions tailored to individual patient needs are most effective at reducing inpatient falls compared to single interventions alone. Continuous re-evaluation of interventions is important to assess effectiveness and improve outcomes. Current practices at Good Samaritan Hospital for fall prevention are also described.
Falls are a major issue and collecting information about falls in the IIMS system allows for targeted prevention strategies. It is important to identify patient risk factors for falls through screening and put appropriate prevention measures in place, such as mobility aids, supplements for osteoporosis, and reviewing medications that could increase fall risk. Staff should communicate fall risks and prevention plans to ensure consistent care that keeps patients safe from falls.
This document discusses falls that occur in hospitals. It defines a fall as an unplanned descent to the floor. Falls are a leading cause of non-fatal injuries and can prolong hospitalization and create legal liability. Individual factors like comorbidities, confusion, and muscle weakness as well as environmental factors contribute to why patients fall. The document outlines high-risk groups, types of falls, fall risk assessment tools, levels of injury, and post-fall protocols. It includes an audit tool to assess nursing interventions to reduce falls like raising side rails, ensuring call bells are within reach, and providing education to patients and staff. Data on fall rates is collected monthly and reported to hospital leadership.
Event @ AICare Hub (15 Feb) - Falls Prevention and Home Safety for the ElderlySingapore Silver Pages
This document discusses falls among the elderly and fall prevention. It defines falls, notes their consequences like fractures and fear of falling, and identifies common risk factors such as age, medical conditions, and home hazards. It outlines the roles of various health professionals in fall prevention through activities like assessment, education, exercises, and home safety modifications. Modifications to high-risk areas of the home like bathrooms and stairways are recommended to help prevent accidental falls among the elderly.
The comprehensive geriatric assessment pcp slidesMarc Evans Abat
This document discusses the comprehensive geriatric assessment (CGA). It begins by defining the CGA as a multidimensional, interdisciplinary diagnostic process that develops a coordinated treatment plan emphasizing quality of life, functional status, and prognosis.
It then identifies the key components of a CGA as including medical history, physical and functional status, behavioral and emotional status, environmental and social support, and spiritual well-being. Common tools used include assessments of activities of daily living, cognition, nutrition, and fall risk.
The document explains that a CGA is recommended for older adults who are frail or have geriatric syndromes like falls or polypharmacy. Evidence shows that CGA can reduce mortality, institutionalization
Role of physiotherapy in fall prevention in geriatricRanjeet Singha
Falls are common in the elderly population and can lead to injuries, loss of mobility, and increased healthcare costs. Physiotherapy plays an important role in fall prevention for older adults. A multifactorial approach is most effective, including exercises targeting balance, strength, and risk factors like medications and behaviors. Suitable balance exercises for older adults include reaching, stepping, walking, sit-to-stand, and squats, with progression over time. Physiotherapists should implement well-designed exercise programs individually and in groups to help prevent falls in geriatric patients.
This document summarizes a presentation on fall prevention given by SN Merlyn Soliven Eslao. It defines a fall, discusses risk factors for falling such as previous falls, medications, vision problems, and mobility issues. It outlines actions people can take to reduce fall risk, including exercising to improve balance and strength, having medication reviewed, getting vision checked, and making homes safer. Nursing homes are advised to identify and eliminate fall hazards, and to closely monitor high-risk residents.
This document discusses osteoporosis and provides information on evaluating individuals for the disease. It defines osteoporosis as a skeletal disorder characterized by compromised bone strength and increased fracture risk. Key points include:
- Osteoporosis is most prevalent in postmenopausal women and those over age 70. It can also occur secondary to certain diseases, medications, and risk factors.
- Evaluation for osteoporosis involves assessing bone mineral density via DXA scan and considering risk factors like prior fractures, family history, smoking status, and certain medical conditions.
- Identifying those at risk helps prevent fragility fractures through lifestyle changes, medication, and fall prevention strategies.
Preventing Patient Falls in Acute Care HospitalsJoe Tomsic
This document provides guidance for healthcare professionals developing falls and fall injury prevention programs. It outlines key factors that contribute to patient falls such as medications, mobility issues, and environmental hazards. The author recommends a multifactorial approach including fall risk screening, customized interventions, staff education, and monitoring programs. As a psychiatric nurse practitioner, the author is well-positioned to lead initiatives that address behavioral and cognitive risks for falls. Standardized communication tools like SBAR can help ensure fall risks are well-communicated between care teams.
This document provides an overview of an ad hoc workgroup meeting held by the Patient-Centered Outcomes Research Institute (PCORI) to discuss preventing injuries from falls in the elderly. The meeting included introductions from researchers, patients, and stakeholders. Background information was then presented on interventions that have been shown to prevent falls such as exercise programs, home safety improvements, and medication management. However, the document notes that while many interventions can prevent falls, further research is still needed to determine which interventions are most effective at preventing injurious falls specifically. The workgroup aims to identify high priority research questions on this topic to inform future PCORI funding opportunities.
This document discusses orthogeriatrics and focuses on elderly patients who sustain injuries. Some key points:
- Elderly trauma patients, defined as over 70 years old, are more likely to die from their injuries regardless of severity due to decreased physiological reserves.
- Common causes of falls in the elderly include osteoporosis, cardiovascular disease, dementia, and polypharmacy. Early surgery (within 48 hours) leads to better outcomes compared to delayed surgery.
- Mortality rates after hip fractures are high, around 35% for men and 22% for women after 1 year. However, most hip fracture-associated deaths are due to preexisting medical conditions rather than the fracture itself.
- Special
Physiotherapy involves evaluating, diagnosing, and treating a range of diseases, disorders, and disabilities using physical means. Physiotherapy management is provided for conditions such as musculoskeletal disability, cardiorespiratory dysfunction, central nervous system trauma/disease, and more. Physiotherapy includes both inpatient and outpatient services for treatments like orthopedics, trauma, and spinal injuries/surgeries.
The document discusses a physical therapy program called Better Balance that aims to reduce falls in older adults. It notes that falls are common and dangerous for older adults, resulting in injuries, hospitalizations, and increased healthcare costs. The Better Balance program identifies individuals at risk of falling and helps them address impairments in balance, sensation, movement, and cognition through individualized physical therapy. Treatment may include exercises to improve strength, coordination, gait, and vestibular function, as well as education on home safety and proper assistive devices. Computerized testing can monitor patients' balance progression during the program.
Falls are the leading cause of injury for older adults over 65 and cause 70% of accidental deaths for those over 75. Risk factors include age, living alone, previous falls, chronic conditions, and use of multiple medications. Interventions like home safety checks, physical therapy, and balance training can help prevent falls. However, falls often reoccur if the underlying cause is not properly evaluated and treated, and if patients do not follow intervention recommendations. Educating patients, families, and healthcare providers is important to address falls and reduce injuries and deaths in the geriatric population.
2016: Falls in Older Adults Risk Assessment and Interventions-ShumakerSDGWEP
This document discusses falls in older adults, including risk factors, causes, assessments, and interventions. It notes that falls are a common threat to older adult independence associated with functional decline, nursing home placement, and increased medical costs. Causes of falls are usually multifactorial, involving intrinsic factors like chronic diseases as well as extrinsic hazards. Assessments include evaluating gait, balance, medications, home environment, and cognitive/neurological function. Effective interventions include home modifications, exercise programs, vision correction, and vitamin D supplementation. Gait disorders are predictive of further functional impairment and institutionalization.
Falls are the leading cause of injury for those over 65 years old, with over a third falling each year and two-thirds of those falling again within six months. The main causes of falls are osteoporosis, lack of physical activity, impaired vision, medications, and environmental hazards in the home like clutter, poor lighting, and a lack of handrails. Making changes such as exercise, home modifications, and medical reviews can help prevent falls.
The document discusses falls in the elderly from a physical therapy perspective. It provides statistics showing that 28-50% of elderly people fall each year, with rates increasing with age. Falls are the leading cause of injury and death for those over 55. Risk factors include both intrinsic factors like physical/functional limitations and extrinsic environmental hazards. A comprehensive falls risk assessment incorporates questionnaires, single-task tests like sit-to-stand and gait, and multi-task tests like Berg Balance Scale. Physical therapy can help prevention through multi-component exercise, whole-body vibration training, home hazard modification, and hip protectors for high-risk individuals. Urgent international action is needed for risk assessment and reduction.
Falls are a common and serious problem for older adults. They can cause physical injuries like hip fractures as well as psychological issues like a fear of falling. A multifactorial assessment and intervention is recommended to prevent falls, including reviewing medications, addressing vision problems, checking for home hazards, and encouraging exercise programs that improve balance and strength. Healthcare providers should routinely ask older patients about falls and refer them to prevention programs as needed.
This document outlines a fall prevention program for a hospital. It defines what constitutes a fall, notes that falls are common among elderly and confused patients and can result in serious injury. It stresses the importance of identifying patients at risk of falls through assessment tools like the Morse Fall Scale and implementing prevention strategies like hourly rounding, ensuring call lights and other items are within reach, and using devices to prevent falls for high-risk patients. The overall goal is to prevent falls and injuries to increase patient safety and reduce healthcare costs from fall-related injuries.
The Prevention of Falls Network for Dissemination (ProFouND) is an EC funded initiative dedicated to the dissemination and implementation of best practice in falls prevention across Europe. ProFouND aims to influence policy and to increase awareness of falls and innovative prevention programmes, amongst health and social care authorities, the commercial sector, NGOs and the general public. Through this work ProFouND will facilitate communities of interest and disseminate the work of the network to target groups across the EU.
This document outlines a fall prevention program with the goals of decreasing falls and fall-related injuries. It defines a fall and identifies intrinsic and extrinsic risk factors. The program involves comprehensive patient assessments to determine individualized fall risk levels, monitoring, care plans, staff education, and environmental safety improvements. It also provides guidance on responding to falls, post-fall care, documenting falls, and analyzing fall data trends to continually improve the program.
This document outlines an evidence-based fall prevention project conducted by nursing students at Alvernia University. It includes background information on the problem of falls in hospitals, learning objectives, a PICO question, and a literature review. The literature review found that multicomponent fall prevention programs utilizing multiple nursing interventions tailored to individual patient needs are most effective at reducing inpatient falls compared to single interventions alone. Continuous re-evaluation of interventions is important to assess effectiveness and improve outcomes. Current practices at Good Samaritan Hospital for fall prevention are also described.
Falls are a major issue and collecting information about falls in the IIMS system allows for targeted prevention strategies. It is important to identify patient risk factors for falls through screening and put appropriate prevention measures in place, such as mobility aids, supplements for osteoporosis, and reviewing medications that could increase fall risk. Staff should communicate fall risks and prevention plans to ensure consistent care that keeps patients safe from falls.
This document discusses falls that occur in hospitals. It defines a fall as an unplanned descent to the floor. Falls are a leading cause of non-fatal injuries and can prolong hospitalization and create legal liability. Individual factors like comorbidities, confusion, and muscle weakness as well as environmental factors contribute to why patients fall. The document outlines high-risk groups, types of falls, fall risk assessment tools, levels of injury, and post-fall protocols. It includes an audit tool to assess nursing interventions to reduce falls like raising side rails, ensuring call bells are within reach, and providing education to patients and staff. Data on fall rates is collected monthly and reported to hospital leadership.
Event @ AICare Hub (15 Feb) - Falls Prevention and Home Safety for the ElderlySingapore Silver Pages
This document discusses falls among the elderly and fall prevention. It defines falls, notes their consequences like fractures and fear of falling, and identifies common risk factors such as age, medical conditions, and home hazards. It outlines the roles of various health professionals in fall prevention through activities like assessment, education, exercises, and home safety modifications. Modifications to high-risk areas of the home like bathrooms and stairways are recommended to help prevent accidental falls among the elderly.
The comprehensive geriatric assessment pcp slidesMarc Evans Abat
This document discusses the comprehensive geriatric assessment (CGA). It begins by defining the CGA as a multidimensional, interdisciplinary diagnostic process that develops a coordinated treatment plan emphasizing quality of life, functional status, and prognosis.
It then identifies the key components of a CGA as including medical history, physical and functional status, behavioral and emotional status, environmental and social support, and spiritual well-being. Common tools used include assessments of activities of daily living, cognition, nutrition, and fall risk.
The document explains that a CGA is recommended for older adults who are frail or have geriatric syndromes like falls or polypharmacy. Evidence shows that CGA can reduce mortality, institutionalization
Role of physiotherapy in fall prevention in geriatricRanjeet Singha
Falls are common in the elderly population and can lead to injuries, loss of mobility, and increased healthcare costs. Physiotherapy plays an important role in fall prevention for older adults. A multifactorial approach is most effective, including exercises targeting balance, strength, and risk factors like medications and behaviors. Suitable balance exercises for older adults include reaching, stepping, walking, sit-to-stand, and squats, with progression over time. Physiotherapists should implement well-designed exercise programs individually and in groups to help prevent falls in geriatric patients.
This document summarizes a presentation on fall prevention given by SN Merlyn Soliven Eslao. It defines a fall, discusses risk factors for falling such as previous falls, medications, vision problems, and mobility issues. It outlines actions people can take to reduce fall risk, including exercising to improve balance and strength, having medication reviewed, getting vision checked, and making homes safer. Nursing homes are advised to identify and eliminate fall hazards, and to closely monitor high-risk residents.
This document discusses osteoporosis and provides information on evaluating individuals for the disease. It defines osteoporosis as a skeletal disorder characterized by compromised bone strength and increased fracture risk. Key points include:
- Osteoporosis is most prevalent in postmenopausal women and those over age 70. It can also occur secondary to certain diseases, medications, and risk factors.
- Evaluation for osteoporosis involves assessing bone mineral density via DXA scan and considering risk factors like prior fractures, family history, smoking status, and certain medical conditions.
- Identifying those at risk helps prevent fragility fractures through lifestyle changes, medication, and fall prevention strategies.
Preventing Patient Falls in Acute Care HospitalsJoe Tomsic
This document provides guidance for healthcare professionals developing falls and fall injury prevention programs. It outlines key factors that contribute to patient falls such as medications, mobility issues, and environmental hazards. The author recommends a multifactorial approach including fall risk screening, customized interventions, staff education, and monitoring programs. As a psychiatric nurse practitioner, the author is well-positioned to lead initiatives that address behavioral and cognitive risks for falls. Standardized communication tools like SBAR can help ensure fall risks are well-communicated between care teams.
This document provides an overview of an ad hoc workgroup meeting held by the Patient-Centered Outcomes Research Institute (PCORI) to discuss preventing injuries from falls in the elderly. The meeting included introductions from researchers, patients, and stakeholders. Background information was then presented on interventions that have been shown to prevent falls such as exercise programs, home safety improvements, and medication management. However, the document notes that while many interventions can prevent falls, further research is still needed to determine which interventions are most effective at preventing injurious falls specifically. The workgroup aims to identify high priority research questions on this topic to inform future PCORI funding opportunities.
This document discusses orthogeriatrics and focuses on elderly patients who sustain injuries. Some key points:
- Elderly trauma patients, defined as over 70 years old, are more likely to die from their injuries regardless of severity due to decreased physiological reserves.
- Common causes of falls in the elderly include osteoporosis, cardiovascular disease, dementia, and polypharmacy. Early surgery (within 48 hours) leads to better outcomes compared to delayed surgery.
- Mortality rates after hip fractures are high, around 35% for men and 22% for women after 1 year. However, most hip fracture-associated deaths are due to preexisting medical conditions rather than the fracture itself.
- Special
Physiotherapy involves evaluating, diagnosing, and treating a range of diseases, disorders, and disabilities using physical means. Physiotherapy management is provided for conditions such as musculoskeletal disability, cardiorespiratory dysfunction, central nervous system trauma/disease, and more. Physiotherapy includes both inpatient and outpatient services for treatments like orthopedics, trauma, and spinal injuries/surgeries.
The document discusses a physical therapy program called Better Balance that aims to reduce falls in older adults. It notes that falls are common and dangerous for older adults, resulting in injuries, hospitalizations, and increased healthcare costs. The Better Balance program identifies individuals at risk of falling and helps them address impairments in balance, sensation, movement, and cognition through individualized physical therapy. Treatment may include exercises to improve strength, coordination, gait, and vestibular function, as well as education on home safety and proper assistive devices. Computerized testing can monitor patients' balance progression during the program.
Falls are the leading cause of injury for older adults over 65 and cause 70% of accidental deaths for those over 75. Risk factors include age, living alone, previous falls, chronic conditions, and use of multiple medications. Interventions like home safety checks, physical therapy, and balance training can help prevent falls. However, falls often reoccur if the underlying cause is not properly evaluated and treated, and if patients do not follow intervention recommendations. Educating patients, families, and healthcare providers is important to address falls and reduce injuries and deaths in the geriatric population.
This document discusses falls in the elderly and provides guidance on assessing risk and preventing falls. It outlines a case of a 78-year-old female presenting for care and notes her reported falls and balance issues. The document reviews intrinsic and extrinsic risk factors for falls and recommends screening all patients aged 65+ annually. It provides details on components of the history, physical exam, functional assessment, and interventions including exercise, home modifications, and medication management to reduce fall risk.
Nursing and Rehabilitation of Residents of Old Age HomesEnoch Snowden
Nursing Elderly, Elderly Care, Old Age Homes, Nursing and Rehabilitation of elderly, Nursing Services related to old age, Nursing Interventions for elderly
This document discusses common problems in the elderly population and principles of geriatric care. It outlines several key issues:
1. Common geriatric syndromes include impaired cognition, urinary incontinence, falls, depression, and polypharmacy. Chronic diseases such as hypertension, diabetes, and osteoarthritis are also prevalent.
2. Effective geriatric care requires a comprehensive approach that considers multimorbidity, screening for underdiagnosed conditions, and goals of maintaining function rather than cure.
3. Key principles of care include considering aging itself is not a disease, screening for cognitive and affective disorders, preventing iatrogenic illnesses, and providing interprofessional and person-centered care.
Falls management in acute care settings requires a multidisciplinary approach. A successful falls prevention program has leadership support, frontline staff engagement, a multidisciplinary committee, pilot testing of interventions, use of data to monitor falls, staff education and training, and convincing staff that falls can be prevented. When a fall occurs, the policy should include risk identification, care planning, preventative strategies, procedures to follow, and action plans. Risk assessment tools, policies, education, signage, and patient information can help reduce falls and their costs on the healthcare system and patients.
Heather Smith, NYULMC Inservice - FINALHeather Smith
The document provides an overview of postural instability and falls in the aging population. It defines key terms, discusses prevalence and risk factors for falls, and describes the relationship between postural instability and falls. Maintaining postural stability requires the integration of multiple sensory, motor, and cognitive systems. Evidence-based interventions that have been shown to improve postural stability and reduce falls in older adults include yoga, Tai Chi, and exercises challenging balance.
The document discusses geriatric health maintenance and comprehensive geriatric assessments. It outlines the components of primary, secondary, and tertiary prevention for older adults, including screening tests, immunizations, and identifying/managing common conditions like falls, incontinence, and medication management. Comprehensive geriatric assessments evaluate multiple domains like function, cognition, mood, social support and goals of care to develop care plans for older patients.
This document discusses key aspects of nursing care for older adults in the community. It covers assessing common health problems, promoting functional independence, health promotion and illness prevention guidelines, and safety concerns for older adults. Nurses should be trained to provide comprehensive geriatric assessments, manage chronic conditions, address functional and mental health needs, implement screening and immunization protocols, and identify risks like falls, medication non-compliance, and elder abuse for this vulnerable population.
This document discusses geriatric rehabilitation and provides information on:
- The components of geriatric rehabilitation including accommodation, prevention of disability/restoration of function, and medical treatment of impairments.
- Physiological changes that occur with normal aging like changes in body composition, posture, gait, neurological and skin functions, and cardiopulmonary and urological systems.
- Principles of geriatric rehabilitation including ascertaining the level of function, differentiating between delirium, dementia and depression, determining patient goals and motivation, and emphasizing function over diagnosis.
- Common impairments seen in geriatrics like fractures, arthritis, Parkinson's disease, and peripheral nerve impairments.
The document discusses children with special health care needs. It defines these children as those who require health services beyond what is typical due to chronic conditions, disabilities, or developmental issues. These children face greater medical and financial burdens. The document advocates for a "medical home" approach that provides comprehensive, coordinated care centered around the needs of the child and family. It also explores the impact of illness on children and families, and the important role of family physicians in supporting these patients.
The document discusses falls and fall prevention for older adults. It notes that falls are a leading cause of injury for those over 65 and outlines several key risk factors for falls, including medical conditions, medications, poor vision or balance, and hazards in the home. The document provides tips for caregivers to help prevent falls, such as ensuring safe footwear, modifying the home as needed, addressing medical issues, and limiting alcohol intake.
This document discusses care of the elderly population. It covers health concerns that are common in elderly patients like diabetes, hypertension, infections and malignancies. It also discusses geriatric syndromes like pressure ulcers, incontinence, falls and functional decline. The goals of geriatric assessment are outlined. Specific conditions seen in elderly patients are described in more detail, including risk factors, screening tools, treatment and management considerations. The importance of preventative care and immunizations in elderly patients is also highlighted.
The possible adverse effects of long-term prednisolone use are:
- Susceptibility to infection
- Fluid retention
- Osteoporosis
- Muscle weakness and atrophy
- Delayed wound healing
Promoting Patient Safety and Preventing Medical ErrorsAnjali Malpani
Errors are common in hospitals due to various factors like lack of time, complexity of work, and excessive workload. While errors should be reported to improve patient safety, most errors go unreported due to fears of blame and punishment. A systems-based approach is needed to reduce errors by standardizing processes, improving communication and teamwork, automating tasks, and implementing safety checks. Reducing medical errors requires changing systems, not blaming individuals, as errors are an inevitable property of complex systems.
Preventing patient errors and promoting medical safety - a guide for medical...Dr Aniruddha Malpani
This document discusses medical errors and ways to reduce them. It notes that errors are common in hospitals due to factors like lack of time, complexity, workload and lack of training. It advocates adopting a systems approach to errors rather than blaming individuals, and promoting a culture of reporting and learning from errors. Some strategies discussed to reduce errors include automation, standardization, simplification, safety nets, and improving teamwork and communication. The use of health IT, like electronic medical records, barcoding and drug alerts, is also presented as a way to help reduce errors.
This document provides an overview of geriatrics and common issues in caring for elderly patients. It discusses how biological age is more important than chronological age in clinical decision making. Frailty and disability are also addressed. Common geriatric problems like falls, delirium, incontinence and adverse drug reactions are examined in terms of presentation, evaluation, and management strategies. The importance of a comprehensive assessment, considering multiple comorbidities and functional status, is emphasized in developing treatment plans for elderly patients.
Similar to 2018: Falls evidence based prevention gwep (20)
We live in an era of medication, but what else can we do to improve mental health? Are we excessively prescribing, can we approach medicine in a more holistic way?
With vision loss comes increased chance of trauma and falls. How can one prevent such injuries from occurring and are their preventative measures one can take?
What is the correlation between CNS active medication and fall risk for the geriatric community and how should one best prevent fall injuries from occurring for those taking such medication?
Approach to oral health for geriatricians apr 2019SDGWEP
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Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
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1. I WONT FALL FOR THAT AGAIN!
EVIDENCE BASED FALL PREVENTION IN THE ELDERLY
Neila Shumaker M.D.
Associate Professor
Internal Medicine/Geriatrics/Palliative Medicine
Program Director, Geriatric Medicine Fellowship
2. LEARNING OBJECTIVES
1. Explain the significance of falls to elders and society
2. Identify fall risk factors
3. Assess elderly fallers
4. Apply evidence based fall interventions
3. DEFINITION OF A FALL
• A fall is an event which results in a person coming to rest inadvertently on the
ground
• Not a consequence of loss of consciousness, seizure or sudden paralysis
• ICD-10 codes
• E880-E888.9 Accidental fall
• R29.6 Repeated falls
4. ETIOLOGY OF FALLS IN OLDER
ADULTS
• Result from the cumulative effects of
• Impaired gait and balance
• Aging changes
• Polypharmacy
• Cognitive impairment
• Acute illness
• Environmental factors
5. FREQUENCY OF FALLS IN ADULTS
OVER 65
• Community dwelling elders – 30 to 40% per year
• Nursing home residents – over 50% fall during stay
• Hospitalized elders – 3 times outpatient rate
6. MORBIDITY AND MORTALITY FROM FALLS
• Falls are the leading cause of fatal injuries over age 65
• Over 800,000 hospital admissions per year for falls
• 70% of accidental deaths over age 75 are due to a fall
• Mortality from a fall is highest among older white men
• “1/3 of older adults fall per year, 1/3 of falls cause injury, 1/3 of injuries are
serious”
• Serious injuries – fractures, head injuries, lacerations
• Falls are a common cause of immobility, ADL dependence, downward spiral and
institutionalization
7. ECONOMIC COSTS OF FALLS
• About 10% of ED visits among the elderly
• 1/3 of these were admitted to the hospital
• Mean length of stay 5.5 days
• Total cost of older adult fall injuries was $31 billion in 2014
8. FALL RISK FACTORS IN ELDERS
• Intrinsic
• Acute illness
• Vestibular (balance) dysfunction
• Cardiovascular (arrhythmias, orthostatic hypotension, cardiac syncope)
• Neurologic (Parkinson’s disease, neuropathies, myelopathies, stroke, cognitive
impairment, “senile” gait)
• Musculoskeletal (foot, knee and leg disorders affecting strength, mobility and gait)
• MEDICATIONS!
9. MEDICATIONS AND FALL RISK
• Use of more than 4 medications may increase fall risk.
• Many drug classes are linked to falls
• Antihypertensives
• Diabetes meds
• Anxiety/mood/sleep medications
• Antipsychotics
• ETC! Any medication that alters alertness, concentration, judgment, gait/balance
10. EXTRINSIC FALL RISK FACTORS
• Environmental hazards
• Contribute to 50% of falls in elders
• 70% of these falls happen at home
• Kitchen, bathroom, stairs are most common sites
• Slippery surfaces, loose rugs, uneven/unmarked steps, clutter etc.
11. SCREENING FOR FALL RISK
• Ask all adults over 65 if they have
• Fallen 2 or more times in the past year
• Sought medical attention after a fall, or
• Feel unsteady when walking
• Refer for further assessment for any positive response
• Gait/balance evaluation if elder had one fall without injury – refer if abnormal
• Fall risk assessment is part of Welcome to Medicare and Medicare Annual
Wellness visits
12. FALL RISK ASSESSMENT
• Falls history
• Number, circumstances, warning symptoms, location, time of day, activity, footwear,
assistive device, glasses
• Injuries, any treatment
• Is the elder able to get up after a fall?
• Medications
• Psychoactive drugs, diuretics, blood pressure and diabetes meds
• Any drug causing sedation, confusion, altered gait, balance, alertness and judgment.
13. FALLS RISK ASSESSMENT –
PHYSICAL, LAB
• Physical Exam
• Orthostatics, cardiovascular, neurologic, legs/feet/shoes
• Gait/balance tests – on STEADI site – can be done by team member
• Timed Up and Go (TUG)
• 30 second chair stand test
• 4 stage balance test
• Functional assessment – ADLs, IADLs
• Cognitive screen – Mini-Cog
• Lab, imaging – not always indicated
• Consider acute illness as a cause of a fall
• CBC, Chem panel, TSH, B12 level, vitamin D level
• Xrays, head CT if indicated by presentation, injuries
• Bone density study when stable
14. APPROACH TO MANAGING FALL RISK
• Ask what elder thinks causes their falls
• Ask about fear of falling
• Educate – many falls can be prevented
• Beware overprotective caregivers!
• Nursing home placement is not the answer to falls!
• Focus on quality of life, independence, values, goals of care
• STEADI toolkit has many patient/caregiver resources
• http://www.cdc.gov/injury/STEADI
15. EVIDENCE BASED FALL PREVENTION
INTERVENTIONS
• Strength and balance exercise interventions are the most effective
• Both individual and group exercises
• Walking alone has not been shown to prevent falls
• Home environmental assessment by OT or other trained clinician
• Effective alone or as part of multifactorial intervention by a team
• Covered by Medicare if elder qualifies as homebound
• Assesses ADLs, cognition, vision, footwear, lighting, clutter , outside hazards
• Teaches adaptive safety behaviors in the home
• Physical therapy
• Gait/balance assessments
• Exercise programs
• Mobility aids
• Anti-slip shoe devices for ice
16. MORE INTERVENTIONS
• Community fall prevention programs
• Otago home exercise program
• Group tai chi classes
• What do you have in your community? AOA endorsed programs
• Reduce doses and numbers of prescription medicines
• Calcium and vitamin D supplementation
• 1200 mg calcium from diet and supplements
• 1000 to 2000 iu vitamin D
• First eye cataract surgery shown to decrease falls
• Carry cell phone or wear medical alert device
17. HOSPITAL FALL PREVENTION BEST
PRACTICES
• Universal fall precautions
• Standardized assessment of fall risk factors
• Similar risks PLUS acute illness, tethers (eg IV poles), delirium, new medications, sleep deprivation,
etc.
• Beware Alarm and Risk Score fatigue! targeted to risk factors
• Care planning and interventions – mobility algorithm
• ACE unit and HELP studies – ambulation does not increase falls
• Postfall procedures
• AHRQ: Preventing Falls in Hospitals - A Toolkit for Improving Quality of Care
• HELP website – includes mobility program information
18. BARRIERS TO AMBULATION OF OLDER
HOSPITALIZED PATIENTS
• Pain, fatigue, weakness
• Lines, catheters
• Nurse staffing, training
• Medical focus
• Environmental obstacles
• Patient, family reluctance
• Bedrest orders!
19. FALL INJURY PREVENTION IN
NURSING FACILITIES
• Alarms don’t prevent falls
• Restraints increase falls and cause many other harms
• Evidence based interventions
• Comfort rounds, fall prevention rounds
• Bed height appropriate to resident, functional status
• Fall pads when in bed
• Hip protectors
• Restorative nursing
• Activities, exercise
20. SUMMARY
• Balance, medications and home safety should be addressed in all high risk fallers
• Leg strength, vision, footwear, calcium, vitamin D and carrying a cell phone are
other evidence based interventions
• Refer to effective fall prevention programs endorsed by public health departments
and Area Agencies on Aging
• Monitor repeat fallers
• Clinical Modification (ICD-10-CM) code R29.6 for repeated falls
21. KEY POINTS
• Ask about falls at least annually
• Falls are multifactorial
• Use evidence based assessments and interventions, targeted to risk factors and
setting
• Many falls can be prevented!
23. BEFORE YOU GO…..LET’S PRACTICE!
• LINKS TO CDC STEADI FUNCTIONAL
ASSESSMENTS:
• 30 second chair test:
https://www.cdc.gov/steadi/pdf/30_Second_Chair_S
tand_Test-a.pdf
• 4 Stage balance test:
https://www.cdc.gov/steadi/pdf/4-
Stage_Balance_Test-a.pdf
• Timed Up and Go test:
https://www.cdc.gov/steadi/pdf/TUG_Test-a.pdf
24. REFERENCES
General fall and fall injury prevention
• http://www.cdc.gov/injury/STEADI
Preventing Falls in Hospitals A Toolkit for Improving Quality of Care
• https://www.ahrq.gov/sites/default/files/publications/files/fallpxtoolkit.pdf
Editor's Notes
Thank you for your interest in a very important topic, falls and fall prevention in the elderly. I hope you will each take away something you can use in your setting.
Here are my objectives for todays presentation.
Here is the official definition of a fall. Research studies usually exclude those falls that are due to sudden loss of consciousness from a cardiac event, seizure or massive stroke.
Falls in older adults are usually due to multiple contributing factors, shown on this slide.
Prevalence: 1 in 4 Americans over 65 falls each year
Every 11 seconds an older adult is treated in the ED for a fall – over 2.8 million injuries are treated in ED annually.
Every 19 minutes an older adult dies from a fall in the U.S. – over 27000 deaths per year, the leading cause of fatal injuries amongst older adults. There are over 800,000 hospital admissions for falls – the leading cause of admissions for trauma over 65.
Why do you suppose mortality is highest amongst older white males?
Rule of thumb “1/3 1/3 1/3”
Falls lead to loss of independence, even placement. There are many hidden impacts from falls, such as fear of falling, social isolation and depression.
Cost of falls are direct and indirect, including medical, emergency and trauma care, acute hospital and post acute facility costs, lost productivity of caregivers etc. Anticipated to reach as much as $67.7 billion by 2020.
We can look at the risk factors for falls as being either specific or “intrinsic” to the individual elder, or environmental (extrinsic). While different people age differently, these are some of the common categories of aging and disease that are associated with increased risk of falling. Most of these are easily diagnosed, but I want to mention a few specifically. Parkinson’s disease should be differentiated from Parkinsonism, which can be medication induced (antipsychotics, metoclopramide). Senile gait refers to a short stepped, hesitant gait which is easily confused with Parkinson’s disease but is due to factors such as weakness, gait instability, fear of falling and vision impairment.
In my setting I don’t see any patients on fewer than four medications! The total number of drugs, the numbers of doses, and the drug categories can all contribute to falls.
“Contribute to” is the key point here. Although fall events are usually attributed to a trip or a slip such as on a wet surface or over the family dog, it is important to recognize that falls are rarely due to a single cause. Ask yourself if a younger adult could have avoided falling under the same circumstances. “I’ll be more careful” is not an effective fall prevention strategy!
Older adults don’t always tell their health care team that they have fallen. You should ask about falls at least annually in the OP setting. Screening consists of asking patients whether they have fallen 2 or more times in the past year or sought medical attention for a fall, or, if they have not fallen, whether they feel unsteady when walking. Patients who answer positively to any of these questions are at increased risk for falls and should receive further assessment, which we will review. Those who have fallen once without injury should have their balance and gait evaluated; those with gait or balance abnormalities should receive additional assessment.
A history of 1 fall without injury and without gait or balance problems does not warrant further assessment beyond continued annual fall risk screening.
Assessment of risk: A history of falls is the single strongest risk factor for future falls. The proportion of older people who fell in one year increased from 19% for those with one risk factor to 78% for 4 or more risk factors.
In 2010 The AGS/BGS published a clinical practice guideline to promote fall risk assessment and management. It recommends that health care providers ask all older adults if they have fallen in the past year. People who have fallen two or more times or who are experiencing difficulties with walking or balance should receive a multifactorial fall risk assessment. The history is as listed on the slide; be sure to ask about fear of falling, ADL function, mobility aids and medications. Higher ADL function correlates with falls on stairs, away from home, bending over, reaching. Lower ADL function correlates with falls at home during routine activities.
Many drugs increase the risk of falls. Deprescribing, or eliminating inappropriate medications, is a key tenet of Geriatric Medicine. Cognitive Behavioral Therapy for Insomnia (CBT-I), proven to be effective for chronic insomnia, is one example of options for deprescribing.
Psychoactive drugs and the inability to get up after a fall, or “fall with long lie” are both independent risk factors for further falls.
Physical Exam and Lab: The physical exam should be targeted but should include orthostatic blood pressure check, gait, balance, neurological function, lower extremity muscle strength, cardiovascular status, visual acuity, cognitive screen and evaluation of the feet and usual footwear. Gait, balance and LE strength can be assessed with several commonly used tests. In the Timed Up and Go (TUG) test you ask the elder to stand up, walk about 10 feet using usual assistive device if any, turn, walk back at usual pace, then sit down. Greater than 12 seconds suggests high fall risk. The 30 second chair stand uses a knee height chair, don’t use the arms. There is an age and gender specific normal range. You can also use this to teach simple quadriceps strengthening.
The 4 stage balance tests parallel, semi-tandem, tandem (heel toe – 10 seconds) and one-leg stances (5 seconds).
Lab and imaging depends on the presentation. It is important to note that a fall may be a marker for an acute illness; pneumonia, heart failure, dehydration, stroke and fracture can all present with a fall.
Approach to managing fall risk:
The goals of fall risk management are to reduce the chance of falling, reduce the risk of injury, maintain the highest possible mobility, and ensure follow-up.
Elders and caregivers often have inaccurate perceptions of what causes falls and will decrease activities after a fall, leading to deconditioning. You need to explore this and also fear of falling, since that can lead to self-limitation of mobility and socialization.
Evidence Based Fall Prevention and Interventions:
Here are some interventions that have been shown in high quality clinical trials to be effective. This information is all available on the CDC STEADI site (Stopping Elderly Deaths and Accidents).
A meta-analysis of randomized controlled trials of fall interventions concluded that assessing and addressing an older person’s fall risk factors, in addition to identifying and treating symptoms of chronic conditions, can reduce falls (Gillespie et al., 2012; American Geriatrics Society/British Geriatrics Society [AGS/BGS], 2010).
A Cochrane Systematic Review reported that clinical assessment by a health care provider combined with individualized treatment of identified risk factors, referral if needed, and follow-up, reduced the rate of falls by 24%.
Even individuals at low risk (no history of falls, no problems with gait or balance) can benefit from a primary prevention approach, namely education about fall risk factors, strength and balance exercises, and vitamin D supplementation.
To be effective, exercise must (1) focus on improving balance, (2) be of moderate to high challenge and progress in difficulty, and (3) be practiced a minimum of 50 hours, which equates to 2 hours weekly for 25 weeks.
The CDC STEADI tool kit based on this guideline and other sources has tools for patients, providers and community agencies and programs. The CDC site is a wealth of information on fall screening, assessment and prevention, including patient handouts and provider instructions.
More evidence based recommendations:
Tai chi has been shown to reduce fall risk by 29%.
Vitamin D was shown effective in elders with low levels. The recommended dose of vitamin D for fall prevention is 1000 IU of cholecalciferol daily.
Calcium from diet and supplements should be around 1200 mg daily.
First eye cataract surgery is effective but there may be a temporary increase in fall risk during adjustment.
Podiatrist can help with footwear recommendations, orthoses.
Support hose can sometimes help with orthostatic hypotension.
Dementia impairs gait, balance and safety awareness.
Recent evidence suggests that the mobility and balance deficits seen in dementia may be improved through exercise.
Hospital fall prevention best practices:
I want to briefly touch upon hospital and nursing home falls. How are falls in these settings different from home and community falls?
Studies have shown that 23 to 65% of older inpatients lose independent ambulation in the first 2 days of hospitalization and sadly only a third have regained lost function by 1 year post discharge.
Even healthy volunteers lose strength and lean body mass when kept in bed and sick patients also typically have anorexia and are in a catabolic state (negative energy balance).
Hospital care and environments result in additional risk factors as shown. Incentives to use IV and psychoactive medications are a problem. Many best practices have been studied, such as individualized care planning and mobility algorithms.
ACE units combine multidisciplinary geriatric assessments with acute hospital services and have shown decreased mortality vs usual care. Interventions include early mobilization and rehab, less sleep disruption, fewer meds etc. Walking patients does not increase falls!
The Agency for Healthcare Research and Quality (AHRQ) toolkit is a comprehensive document addressing hospital falls and fall prevention programs and interventions.
HELP – the Hospital Elder Life Program – is focused on delirium prevention but many of the interventions also help prevent falls.
Barriers to ambulation:
There are many barriers to mobilization of older hospitalized adults. Unit and hospital culture is key. Even intubated patients can be assisted to stand and transfer.
Bed rest orders are common but most do not have a clearly documented indication.
I recently watched a Webinar on a high resolution real time locating system (hr-RTLS) similar to a GPS system. It can be used for tracking when patients are out of bed and can generate a report showing a trail of a patients movements on the unit, time in bed etc.
Fall injury prevention in NFs: In the nursing home setting the focus is as much or more on injury prevention as on fall prevention. Cardiovascular causes are somewhat more common, but most falls are still mainly associated with ADL activities such as transferring and toileting. Virtually all residents are at moderate or high fall risk, so risk scales are not that helpful. Bed and chair alarms are disruptive and can lead to alarm fatigue. Other alarms such as programmed talking alarms are being trialed.
Restraints cause deconditioning so the residents are ultimately more likely to fall. Restraints also cause pressure sores, agitation, depression, delirium etc. and should not be used.
Evidence based interventions in the nursing home include anticipating resident needs, adjusting bed heights, correct use of fall pads, hip protectors, but MOST OF ALL trying to maintain and improve function.
Summary: So in summary we have reviewed fall risk assessment and evidence based interventions in home, hospital and nursing facility settings. Balance and strength, medications, vision, footwear and environmental hazards should be assessed and corrected if possible in all settings.
The CDC STEADI site is replete with tools for providers, patients, caregivers and community programs. Every elder and every setting is unique, but the resources in STEADI are rich and adaptable to your needs.
Key Points:
I hope I have been able to convince you that
Falls have multiple causes
There are evidence based interventions you can apply to decrease falls and fall injuries
Many falls can be prevented!
Questions?
Practice!!
Here are the STEADI and AHRQ .gov sites for your reading pleasure!