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When People Fall: Prevention for Those at Risk by Marie Boltz, MSN, CRNP, NHA Gerontological Nursing Consultant. 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
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When People Fall: Prevention for Those at Risk by Marie Boltz, MSN, CRNP, NHAGerontological Nursing Consultant
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
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.
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.
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.
Age-Related Risk Factors Consider age-related changes: • Gait • Posture • Response to medication • Response to stress • Urinary frequency/incontinence
Cognitive Loss As a Risk Factor • Anxiety from not recognizing environment • Lack of insight and judgement about safety
Health Problems As RiskFactors 1. Circulation to the brain and heart 2. Blood sugar level 3. Polypharmacy 4. Gait disorders
Environmental Risk Factors • Lighting • Flooring • Furniture • Equipment • Improperly fitted shoes or clothing • Physical obstructions
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
Impairment Sensory loss Muscle weakness Approach Eyeglasses and hearing aids Exercise Restorative mobility program Assistive devices Strategies to Compensate for Physical Impairment:
Strategies for Cognitive Loss • Communication/re-direction • Biographical profiles • Structured daily routine • A security system
Strategies for Incontinence • Medical evaluation • A consistent toileting program • Proper bathroom equipment
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
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”
Education Program • Staff education for each caregiver role • Safety education and fall/injury prevention for all: Staff, older adults, and family
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.
Objectives Review Can you now • Identify risks factors and common causes for falls? • Describe proper assessment after a fall? • Discuss intervention and prevention strategies?
Thank you for your attention! The End