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When People Fall: Prevention for Those at Risk by In grid Sidorov, MSN, RN Brian H. Kim, MD and Carol A. Maritz, PT,

When People Fall: Prevention for Those at Risk by In grid Sidorov, MSN, RN Brian H. Kim, MD and Carol A. Maritz, PT, EdD , GCS . Why Talk About Falls?. Falls happen often 1 in 3 older adults fall each year; 1 in 2 in long term care fall each year Falls are dangerous

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When People Fall: Prevention for Those at Risk by In grid Sidorov, MSN, RN Brian H. Kim, MD and Carol A. Maritz, PT,

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  1. When People Fall: Prevention for Those at Risk by Ingrid Sidorov, MSN, RNBrian H. Kim, MDand Carol A. Maritz, PT, EdD, GCS

  2. Why Talk About Falls? • Falls happen often • 1 in 3 older adults fall each year; 1 in 2 in long term care fall each year • Falls are dangerous • 25% of falls cause minor injury • 11% of falls cause major injury such as hip fracture • 88% of falls are related to medical and or physical conditions • Many (about 2/3) fall associated injuries and deaths can be prevented

  3. Seriousness of Falls • After older adults fall • 40% become less active • 40- 70% report fear of falling • Almost 10% go to the ER for treatment after 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 risk factors and common causes for falls. • Describe proper assessment after a fall. • Discuss intervention and prevention strategies.

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

  6. Where do Falls Happen? • 10% in long term care • 30% in public places • 60% at home

  7. Age-Related Risk Factors Consider age-related changes: • Gait • Posture • Muscle Strength • Balance issues • Response to medication • Response to stress • Reduced vision or hearing • Urinary frequency/incontinence

  8. Fear of Falling • About 30% of older adults have a fear of falling. • This includes people who have NOT fallen. • Fear of falling affects how people react to their environment and actually increases the risk of falling.

  9. Should a Single Fall be of Concern? • ABSOLUTELY! • Every fall has the potential for being serious. • Consider changes in health, risk factors.

  10. Health Problems As RiskFactors 1. Heart disease and stroke 2. Diabetes 3. Osteoporosis 4. Gait disorders 5. Depression 6. Polypharmacy 7. Dementia

  11. Cognitive Loss As a Risk Factor • Anxiety from not recognizing environment • Lack of insight and judgment about safety • Sundowning • Behavior issues

  12. Environmental Risk Factors • Lighting • Flooring/Pavement • Stairs • Furniture • Equipment/Physical Obstruction • Improperly fitted clothing

  13. 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

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

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

  16. Strategies for Incontinence • Medical evaluation • A consistent toileting program • Proper bathroom equipment • Constipation may be the cause

  17. Prevention and Management Program • Assess each person in your care • Provide a safe and enabling environment • Implementbalance and fitness programs designed by PT • Educate families and staff about falls and a restraint-free environment

  18. SAFE ENVIRONMENT • Lighting • Handrails • Chair height • Equipment and items in reach • Shoes that fit • Carpeting

  19. THE BATHROOM • Grab bars by shower and toilet • Rubber mats in bathtub/shower • Raised toilet seat • Drawers kept closed

  20. 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”

  21. Prevention and Management:Fitness & Activity Programs • Exercise programs • Incorporate both balance and strength training • Balance training should include both static and dynamic activities performed at moderate to high challenge • Ideal program duration – 3-12 months

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

  23. Education Program • Education of the person at risk for falls • Nurses are responsible for education programs of older adults. CNAs should remind older adults of safe techniques as they complete assigned tasks.

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

  25. Thank you for your attention! The End

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