This document discusses falls in long-term care and multi-pronged approaches to prevention. It notes that 30-50% of elderly individuals fall each year and 5-10% sustain serious injuries. At one nursing home, 27.22% of residents fell in 2018, with 3 cases resulting in serious injury. Falls can cause injuries, loss of independence, and decreased quality of life. A multi-factorial approach is recommended, including understanding each resident, applying evidence-based practices, responding to individual needs through function promotion and autonomy support, empowering staff, and modifying the physical and social environment. The results showed a 32.88% decrease in falls at the nursing home from 2017 to 2018.

1. Presented by:
Cabales, Marc Kevin
Lacambra, Brent Jeremy

2.  Better understanding about the Challenge of falls in long-term care
 Multi Prong Approaches in prevention of falls
Analyse & Make Sense of Fall Data
Reflect the knowledge to incorporate with care plan & clinical practice

4.  30% of Elderly in community ages > 65 y/old , and 50% of Nursing Home resident
fall each year (Tinetti, 2015)
 5-10% of Elderly in community sustains serious injury after a fall, whilst 10-25% of
Nursing home fall results in fracture, laceration or will need hospital care.
(Tinetti, 2015)

5.  In 2018 27.22% of our resident had incidents of fall over average occupancy of 180
residents.
 It means 1 of 3 resident had incidence of fall for the year 2018
 Out of 49 incidence of fall in 2018 there were 3 or (6 %) incidence of serious injury
(laceration, fracture, contusion) that needed further medical attention.

7.  are more likely to experience problems with mobility, balance and muscle
weakness
 can have difficulties with their memory and finding their way around
 can have difficulties processing what they see and reacting to situations
 may take medicines that make them drowsy, dizzy or lower their blood pressure
 are at greater risk of feeling depressed
 may find it difficult to communicate their worries, needs or feelings

8.  Serious injury such as hip fracture and traumatic brain injury(TBI)
 Increased risk of death
 Loss of independence
 Decreased ability to function
 Increased need for care
 Depression
 Increased fear of fall & risk of fall

9.  Even without injury, falls lead to fear of falling with self imposed restriction of
activity and reduced social interaction.
DECREASED QUALITY OF LIFE

13. Knowledge of resident
• Culture, personality, spirituality
• Social context, preferences
• Mental and physical status
Knowledge of EBP
• Clinical pathways for acute and
chronic disease management
• Prevention of geriatric
syndromes
Response to Individual Needs
• Treatment of acute conditions
• Symptom management of chronic disease
and age related changes
• Promotion of highest level of physical
function and personal autonomy
Person
(Resident)

14. INDIVIDUALIZED
 Knowing the person
 Viewing the world through their eyes
 Careful assessment of person and environment
“To individualize care requires learning about the
individual’s life history, assessing the individual’s
current strengths and needs, developing plans with
resident and/or family input, and designing care
around the resident’s wishes and needs-not facility,
staff, or family needs”
(Rader, J. (1995). Individualized Dementia Care: Creative,Compassionate
Approaches. New York: Springer Publishing Company, Inc., p. 8)

15. Person
(Staff)
• Multidisciplinary Approach
• Staff’s culture of safety awareness
• Continuous communication
• Staff Empowerment as Fall Champions
• Competency enhancement
• Staff Deployment Model
• Lean Management

16. Person
(Relatives/ NOK)
• Close Partnership with NOKs
• Staff providing professional inputs in advocating for residents cataract operations to
prevent falls thus increase their quality of life.

17. Environment
(Physical & Social)
• Proper use and maintenance of Assistive Devices
• Daily checking of residents assistive devices
• Managing visual concerns
• Use of visual cues to reorient residents
• Environmental Risk Assessment & Modification/ Enhancement
• Furniture suitability & safety measures
• Harnessing Technology
• Use Early Warning & Alert System to assist staff in monitoring residents

18. Occupation
• Reorientation of their daily life routine to reduce confusion.
• Reducing their risk through:
Engagement
Reduced use of psychotropic medication
Reduced reliance in the use of physical restraints

19. RESULTS

20. RESULTS
Overall for 2018 there is a decrease of 32.88% in the incidence of
fall for the whole lodge, from 73 incidence of fall last 2017 to 49
incidence of fall last 2018.