1. TLCTLC TLCTLC LTCLTC LTCLTC Delaware Valley Geriatric Education Center When People Fall: Prevention for Those at Risk When People Fall: Prevention for Those at Risk by Marie Boltz, MSN, CRNP, NHA Gerontological Nursing Consultant

2. TLCTLC TLCTLC LTCLTC LTCLTC Delaware Valley Geriatric Education Center 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

3. TLCTLC TLCTLC LTCLTC LTCLTC Delaware Valley Geriatric Education Center 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.

4. TLCTLC TLCTLC LTCLTC LTCLTC Delaware Valley Geriatric Education Center Objectives At the end of this program you will be able to: 1. Identify risks factors and common causes for falls. 2.Describe proper assessment after a fall. 3.Discuss intervention and prevention strategies.

5. TLCTLC TLCTLC LTCLTC LTCLTC Delaware Valley Geriatric Education Center 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.

6. TLCTLC TLCTLC LTCLTC LTCLTC Delaware Valley Geriatric Education Center Age-Related Risk Factors Consider age-related changes:  Gait  Posture  Response to medication  Response to stress  Urinary frequency/incontinence

7. TLCTLC TLCTLC LTCLTC LTCLTC Delaware Valley Geriatric Education Center Cognitive Loss As a Risk Factor  Anxiety from not recognizing environment  Lack of insight and judgement about safety

8. TLCTLC TLCTLC LTCLTC LTCLTC Delaware Valley Geriatric Education Center Health Problems As Risk Factors 1. Circulation to the brain and heart 2. Blood sugar level 3. Polypharmacy 4. Gait disorders

9. TLCTLC TLCTLC LTCLTC LTCLTC Delaware Valley Geriatric Education Center Environmental Risk Factors  Lighting  Flooring  Furniture  Equipment  Improperly fitted shoes or clothing  Physical obstructions

10. TLCTLC TLCTLC LTCLTC LTCLTC Delaware Valley Geriatric Education Center 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

11. TLCTLC TLCTLC LTCLTC LTCLTC Delaware Valley Geriatric Education Center Strategies to Compensate for Physical Impairment: Impairment Sensory loss Muscle weakness Approach Eyeglasses and hearing aids Exercise Restorative mobility program Assistive devices

12. TLCTLC TLCTLC LTCLTC LTCLTC Delaware Valley Geriatric Education Center Strategies for Cognitive Loss  Communication/re-direction  Biographical profiles  Structured daily routine  A security system

13. TLCTLC TLCTLC LTCLTC LTCLTC Delaware Valley Geriatric Education Center Strategies for Incontinence  Medical evaluation  A consistent toileting program  Proper bathroom equipment

14. TLCTLC TLCTLC LTCLTC LTCLTC Delaware Valley Geriatric Education Center 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

15. TLCTLC TLCTLC LTCLTC LTCLTC Delaware Valley Geriatric Education Center 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”

16. TLCTLC TLCTLC LTCLTC LTCLTC Delaware Valley Geriatric Education Center Education Program  Staff education for each caregiver role  Safety education and fall/injury prevention for all: Staff, older adults, and family

17. TLCTLC TLCTLC LTCLTC LTCLTC Delaware Valley Geriatric Education Center 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.

18. TLCTLC TLCTLC LTCLTC LTCLTC Delaware Valley Geriatric Education Center Objectives Review Can you now 1.Identify risks factors and common causes for falls? 2.Describe proper assessment after a fall? 3.Discuss intervention and prevention strategies?

19. TLCTLC TLCTLC LTCLTC LTCLTC Delaware Valley Geriatric Education Center Thank you for your attention! The End