Five Key Areas for Phone Interviewing with a Fall Prevention Focus

1
Five Key Areas for Phone Interviewingwith a Fall
Prevention Focus

• Holly Lookabaugh-Deur
• President Generation Care

2
For Case Managers

• We need to consider what research tells us about
  adult attention spans
• First 90 seconds our peak attention time
• Using client names, dates, proper nouns (like
  city, name of hospital, etc.), all help stimulate
  attention
• We should be able to get most of the information
  we need in three to five minutes

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Five Key Information Areas for Phone Interviewing
about Fall Prevention

• 1. Recent loss of critical ADLs
• 2. Gait and balance changes
• 3. New weakness and/or pain
• 4. Fatigue/sleep/hydration/nutrition changes
• 5. Home barriers

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Critical ADL Losses Indicative of Possible
Functional Change

• Bathing unable to get in/out tub no longer
  sponge bathing daily showering less often
• Cooking/meal preparation more meals being
  brought into the home more frozen foods less
  fresh food more canned products more cold food
  (like cereal)
• Donning and doffing shoes/socks no longer
  wearing shoes in the house slippers worn all
  day wearing same socks night and day

5
More ADL Changes to Check

• Getting the mail not checking it every day have
  not reviewed/disposed of mail waiting for
  someone to bring it in for them
• Making it to the bathroom in time changes in
  urine leaks and number of pad/clothes changes per
  day
• Difficulty getting out of bed prolonged lying in
  bed in the a.m. struggling reported by client

6
Gait and Balance Changes

• Knowing the baseline of current gait and mobility
  is important How far or how long do they walk
  every day? Do they use an assistive device? Are
  they able to go up and down a few steps?
• Ask about changes Are they using an assistive
  device more often? Still walking to the end of
  the driveway? Feeling steady with their walker?
  Do they feel controlled when they move from
  standing to sitting?

7
New Weakness and C/O Pain

• Do they feel like they are maintaining their
  strength?
• (If no) Is there a certain time of day that they
  feel weak?
• Do they feel weak all over or just in certain
  muscles?

• Anything new hurting?
• (If yes) Why do THEY think they are having more
  pain?
• Are they able to control their pain so they can
  do what they normally do every day?

8
Fatigue, Sleep, Nutrition, and Hydration

• Any changes in the amount they are sleeping at
  night?
• Are they sleeping more/less during the day?
• More difficult to fall asleep?
• Weight gain or loss?
• Changes in appetite?
• Describe other questions for nutrition/hydration

9
Home Barriers

• The home rarely changes, so if there is a new
  perceived barrier, it is likely to be due to an
  acquired functional loss
• New home barriers are usually related to getting
  in/out tub, up/down stairs in/out garage
  sleeping on couch instead of bed
• Examples of questions
• Are they still able to go downstairs to do the
  laundry?
• In what room do they usually eat dinner?
• When they sleep, do they usually fall asleep in
  the chair or do they go lie on the bed?

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Asking a few Questions can give Case Managers
many Client Status Clues

• Self reported wellness score Start by asking for
  a I feel like a (0-10) today.
• Yesterday was a (0-10) day.
• Any new problems in the bathroom? Getting meals?
  Still getting out of the house? New aches or
  pains? Any near falls? Keeping themselves busy?
• Describe significance of key questions