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

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

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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.

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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.

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Who Falls?

• Older persons who are acutely ill.
• Elders admitted to a new setting.
• Those with functional loss.
• Elders with problems with walking, hearing and
  sight.

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Age-Related Risk Factors

• Consider age-related changes
• Gait
• Posture
• Response to medication
• Response to stress
• Urinary frequency/incontinence

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Cognitive Loss As a Risk Factor

• Anxiety from not recognizing environment
• Lack of insight and judgement about safety

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Health Problems As Risk Factors

• 1. Circulation to the brain and heart
• 2. Blood sugar level
• 3. Polypharmacy
• 4. Gait disorders

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Environmental Risk Factors

• Lighting
• Flooring
• Furniture
• Equipment
• Improperly fitted shoes or clothing
• Physical obstructions

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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

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Strategies to Compensate for Physical
Impairment

• Impairment
• Sensory loss
• Muscle weakness

• Approach
• Eyeglasses and hearing aids
• Exercise
• Restorative mobility program
• Assistive devices

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Strategies for Cognitive Loss

• Communication/re-direction
• Biographical profiles
• Structured daily routine
• A security system

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Strategies for Incontinence

• Medical evaluation
• A consistent toileting program
• Proper bathroom equipment

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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

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Prevention and ManagementFitness 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

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Education Program

• Staff education for each caregiver role
• Safety education and fall/injury prevention for
  all Staff, older adults, and family

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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.

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Objectives Review

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

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Thank you for your attention!

• The End