Chapter 22 Risk Reduction

Older Adults and Safety Risks Older adults face similar risks to adults of any age. –Age-related factors can: Reduce capacity for self-protection. Increase vulnerability to safety hazards. Assessment should include a review of safety risks. –Preventive and corrective interventions should be planned.

Factors Contributing to High Elderly Susceptibility to Infections Age-related changes Altered antigen–antibody response High prevalence of chronic disease –Atypical symptomatology Often results in delayed diagnosis of infection.

Factors Leading to Safety Risks Involving Use of Drugs in Elderly Altered pharmacokinetics Self-administration problems The high volume of drugs consumed by older individuals

Environment Microenvironment: immediate surroundings with which we closely interact. Furnishings, wall coverings, lighting, temperature Macroenvironment: the elements in the larger world that affect groups of people. Weather, pollution, traffic, natural resources

Factors Affecting Environment Lighting Temperature Colors Scents Floor coverings Furniture Sensory stimulation

Factors Affecting Environment (cont.) Noise control Bathroom hazards Psychosocial considerations

Factors Affected by Lighting Function Orientation Mood Behavior

Using Lighting to Promote Safety Use several diffuse lighting sources. Do not use fluorescent lighting. Control bright lights and direct sunlight. Use nightlights to provide visibility and orientation. Use natural light to maintain body rhythms.

Effect of Temperature on Older Adults Body temperature affects performance. The elderly are especially sensitive to lower temperatures. –Environmental temperatures should not be lower than 75°F.

Effects of Color on Older Adults Red, yellow, and white –Can be stimulating and increase pulse, blood pressure, and appetite. Blue, brown, and earth tones –Can be relaxing. Orange –Can stimulate appetite.

Effects of Color on Older Adults (cont.) Violet –Can decrease appetite. Green –Can give a sense of well-being. Black and gray –Can be depressing.

Precautions for Use of Essential Oils Do not ingest orally. Keep out of the eyes. Store away from sunlight, heat, and fire. Assess for allergies before using.

Precautions for Use of Essential Oils (cont.) Seek advice of aromatherapist before using with chemotherapy. Be aware of sedative effect on certain medications. Use pure essential oils, not artificial scents.

Risks Associated with Carpeting Static electricity and cling Difficult wheelchair mobility Cleaning Odors Pests Falls

Use of Furniture Furnishings should be: –Appealing –Functional –Comfortable

Components of a Pleasing Environment Textured wall surfaces Soft blankets Differently shaped and textured objects to hold Murals; pictures; sculptures Plants and flowers Coffee brewing; food cooking; perfumes Birds and animals Soft music

Bathroom Safety Lighting –Keep a small light on at all times. Floor –Do not leave items on the bathroom floor, –Do not use throw rugs. Faucets –Use color-coded, lever-shaped faucet handles.

Bathroom Safety (cont.) Tubs and shower stalls –Use nonslip surfaces, grab bars, safety rails, and tub seats. Toilets –Use grab bars or support frames; raised seats. Electrical appliances –Monitor the use of electrical devices.

Respecting Personal Space Define an area that is specifically the individual’s. Ask permission before entering personal space. Allow maximum control over personal space.

Enhancing Institutional Environments Provide an attractive décor. Include the individual’s personal possessions. Respect privacy and personal territory. Recognize the individuality of the resident. Allow maximum control over activities and decision making. Make environmental modifications to compensate for deficits.

Considerations for Reducing Safety Risks Sufficient fluid intake Adequate nutrition Vision aids Hearing aids Stable body temperature Infection prevention

Considerations for Reducing Safety Risks (cont.) Sensible clothing Cautious use of drugs Crime avoidance Safe driving

Early Detection of Illness Older adults can: –Take their own temperature and pulse. –Listen to their own lungs with a stethoscope. –Observe changes in their own body fluids. –Identify effects of their medications. –Recognize symptoms that warrant evaluation.

Factors Contributing to High Risk of Falls Age-related changes Improper use of mobility aids Medications Unsafe clothing Disease-related symptoms Environmental hazards Caregiver-related factors

Interventions to Address Safety Problems Refer the individual to specialists. Provide assistive devices and mobility aids. Help the person to prepare and label drugs. Arrange for community resources. Instructing and support family caregivers Modify the environment to reduce hazards.

Using Alternatives to Restraints Place patient in room near nursing station. Use supervision and companionship. Use electronic alert devices. Use comfort measures. Use frequent reality orientation and diversional activities.

Source Eliopoulos, C. (2005). Gerontological Nursing, (6 th ed.). Philadelphia: Lippincott, Williams & Wilkins (ISBN ).