When People Fall: Prevention for Those at Risk by Marie Boltz, MSN, CRNP, NHA Gerontological Nursing Consultant

1. When People Fall: Prevention for Those at Risk by Marie Boltz, MSN, CRNP, NHAGerontological Nursing Consultant

2. Why Talk About Falls? • Falls happen often • 1 in 3 elderly fall each year; 1 in 2 in the nursing home setting fall each year • Falls are dangerous • 25% of falls do cause minor injury • 11% of falls do cause major injury • such as hip fractures • Many falls can be prevented

3. Seriousness of Falls • After an older adult falls • 40% become less active • 40- 70% report fear of falling • Falls may be a warning sign of new or worsening illness.

4. Objectives At the end of this program you will be able to: 1. Identify risks factors and common causes for falls. • Describe proper assessment after a fall. • Discuss intervention and prevention strategies.

5. Who Falls? • Older personswho are acutely ill. • Elders admitted to a new setting. • Those with functional loss. • Elders with problems with walking, hearing and sight.

6. Age-Related Risk Factors Consider age-related changes: • Gait • Posture • Response to medication • Response to stress • Urinary frequency/incontinence

7. Cognitive Loss As a Risk Factor • Anxiety from not recognizing environment • Lack of insight and judgement about safety

8. Health Problems As RiskFactors 1. Circulation to the brain and heart 2. Blood sugar level 3. Polypharmacy 4. Gait disorders

9. Environmental Risk Factors • Lighting • Flooring • Furniture • Equipment • Improperly fitted shoes or clothing • Physical obstructions

10. Assessment After a Fall: What Should Staff Do? • Assess all skin and joints for injuries • Check vital signs • Move to a safe location off floor • Notify nurse supervisor • Notify family member

11. Impairment Sensory loss Muscle weakness Approach Eyeglasses and hearing aids Exercise Restorative mobility program Assistive devices Strategies to Compensate for Physical Impairment:

12. Strategies for Cognitive Loss • Communication/re-direction • Biographical profiles • Structured daily routine • A security system

13. Strategies for Incontinence • Medical evaluation • A consistent toileting program • Proper bathroom equipment

14. Prevention and Management Program • Assess each person in your care • Provide a safe and enabling environment • Plan balance and fitness programs • Educate families and staff about falls and a restraint-free environment • Institute performance improvement

15. Prevention and Management:Fitness & Activity Programs • Individual programs: Exercise, self-care, walking • Group programs: Exercise, yoga, walkercise, games/sports, dance/movement, tai chi • Other activity: Art, cooking, gardening, “mental gymnastics”

16. Education Program • Staff education for each caregiver role • Safety education and fall/injury prevention for all: Staff, older adults, and family

17. Education Program • Education of the person at risk for falls • Nurses are responsible for education programs for consumers. Aides should remind consumers of safe techniques as they complete assigned tasks.

18. Objectives Review Can you now • Identify risks factors and common causes for falls? • Describe proper assessment after a fall? • Discuss intervention and prevention strategies?

19. Thank you for your attention! The End