Download 1 Falls Awareness Falls are often viewed as accidents

Falls Awareness
Falls are often viewed as accidents, however, there are many ways we can reduce the risk of falls.
What is the role and responsibilities of an agency worker to prevent falls?
Agency workers should always be vigilant and assess a service user/patient and their home or
hospital for risks to falls. Any concerns must be reported and addressed as quickly as possible to
minimise the risk of falling.
What are the legal requirements of an agency worker to prevent falls?
Always follow your Health and Safety Policy and the risk assessments. You must report any concerns,
incidents or near misses as soon as possible to avoid future accidents. You have a duty of care to
your service user/patients, if you think they need a specialist to assess them or give advice you must
highlight this to your manager.
What are the main aims of an agency worker to prevent falls?
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To constantly check for risks within the environment in which you work
Monitor the service user/patient and report any identified risks
Follow any risk assessments already completed
Eye sight
Poor eye sight is a huge factor in falls. Service user/patients may not see items or spillages on the
floor and could easily trip, slip or fall. It is important that if you see a hazard you remove it and warn
the service user/patient. If this is in their own home remember you need consent to remove items.
Also consider if their eye sight is poor, they will need to know where the item is, they may be happy
with it where it is.
Check the service user/patients glasses. Are they clean? If not, prompt them to clean them or offer
to clean them if they are unable. Ask when they last had an eye test and had new glasses, they may
need new ones. It is recommended we have an eye test every two years, and once you reach 70 this
should be every year. Always encourage a service user/patient who has fallen to see an optician.
Remember opticians also do home visits for those who cannot go in.
Make sure areas that the service user/patient is in or will walk through are well lit. Poor lighting as
well as eye sight problems could be disastrous.
Medication
Medication can also have an effect on our mobility. If a service user/patient is on four different types
of medication or more they should have their medication reviewed every 6 months. Older people
who are at risk, or have recently fallen should have their medication reviewed.
Continence
Urge continence – A service user/patient may suddenly need the toilet and rush to get there, putting
them at a higher risk of falling. They could be especially at risk if they take medication such as
diuretics as they may cause this.
Nocturia – getting up in the night, may put a service user/patient at higher risk due to the lack of
adequate lighting, effects of any medication e.g. sedatives, and not being fully conscious.
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Neurological Conditions
Conditions such as stroke, Parkinson’s, cognitive impairment (Dementia) may also be a risk factor for
falling. Often service user/patients with Dementia will have perceptual problems, the inability to see
objects of a similar colour and spatial awareness, memory loss, or they may think they are living in a
different place and expect it to be flat or have steps. Additionally medication for the specific
condition may affect movement and walking. Diabetes can cause peripheral impairment which is a
lessened sensation of the hands and feet, causing an increased risk of falling.
Balance and Mobility
Mobility disorders are a significant indicator of future falls. Muscle deteriorates with age so exercise
is important. To combat falls the service user/patient would need to do specific exercises. Physical
activity will help the Service user/patient with not only their balance, but will help their self esteem
and well being, confidence, fitness, cardiovascular fitness and function, weight control, muscle
strength and joint mobility.
Walking aids should be assessed and fitted correctly and checked regularly for damage and that they
still meet the needs of your service user/patient. Wheels and brakes should be checked regularly.
The service user/patient should also use it properly.
Footwear and Foot care
Always check your service user/patient’s footwear, and encourage them to wear appropriate
footwear. Make sure they are done up properly and not loose and slack.
Toe nails should be cut regularly and any hard skin or corns removed. If your service user/patient
can no longer cut their own toe nails this is another indicator of risk of falling.
Home environment
Rugs, trailing wires, slippery floors, poor lighting, clutter, pets, raised door sills, low/high chairs,
unstable furniture, lack of grab rails, toilet too low, steep stairs, lack of handrail on stairs,
loose/worn carpets are all hazards within someone’s own home. Be aware though it is the service
user/patients own home and they may not welcome your comments on the hazards. If you have any
concerns report them.
Alcohol
Alcohol affects our mobility and judgment, so increases our risk of falling.
Government guidelines recommend that to stay healthy:
 Men do not consume more than 1-2 units of alcohol per day which is equivalent to half to
one pint of beer per day.
 Women do not consume more than 1-2 units of alcohol per day which is equivalent to half
to one pint of beer per day.
One measure of spirit – one unit
One pint of beer – two units
Wine depends on the size glass you have, starts at 2.3 units for a 175ml glass at 13%
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Smoking
Reduces absorption of calcium in the body and reduces osteoblast – bone building activity.
Smoking has a negative effect on bone thus increasing the risk of fractures.
Reporting & Recording
Always follow your Thornbury Nursing Services policy and report any fall, near miss or trip hazard
immediately.
Osteoporosis
Osteoporosis is a condition that weakens the bones which heightens the likelihood of fractures
occurring. The fractures/breaks are most common in the wrist, hips and spine, however, other areas
can be affected too.
Losing bone density as you get older is normal, and this starts from around the age of 35, for some
this will lead to osteoporosis. The risk is increased if there is a family history, you have an overactive
thyroid gland, you are a heavy smoker or drinker and some medications will put you at a higher risk.
It is important that you understand someone with osteoporosis is more likely to fracture/break a
bone. Therefore you need to be more aware of any potential hazards they could slip, trip, fall or
knock into.
Fear of Falling
Some of your service user/patients may be scared of falling, they may then reduce their activity
levels believing this will reduce the risk of falling. This is untrue; it will in fact increase their risk of
falling. Encourage your service user/patient to be as active as possible. If you have concerns that one
of your service user/patients is worried and anxious about falling it is important that you report this,
so they can get the support they need to regain their confidence and then reduce the risk of falling.
Healthy Eating
Calcium and vitamin D are essential for good healthy bones – healthy bones mean less risk of
fractures. Often service user/patients do not get enough vitamin D as they do not go outside, the
body needs vitamin D from the sun to help with the absorption of calcium.
Cataract
Cataracts cause blurred or misty vision, they are cloudy patches on the eye, they develop over a
period of years and are often not noticed at first. Cataracts generally develop in both eyes, not
always at the same rate. Cataracts become worse over time, they can be removed by surgery that
removes and replaces the affected lens. Cataracts are not painful and don't make your eyes red or
irritated.
Glaucoma
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Glaucoma affects both eyes in varying degrees and is a group of conditions that affect vision. Fluid
cannot drain away from the eye due to blocked drainage tubes, which causes pressure to build up in
the eye. It can be painful and cause nausea, blurred vision and redness of the eye.
Macular Degeneration
Macular degeneration affects the central line of vision, it usually affects both eyes, how it progresses
in each though can be different. It does not affect your outer vision only the central vision directly in
front of you.
Bi-focals
Be aware that bi-focals can cause problems on uneven surfaces especially stairs as they impair depth
perception.
VIDEOS
Reablement: maintaining independence: http://www.scie.org.uk/socialcaretv/videoplayer.asp?guid=7f99fdd1-0e82-47c9-adb9-b939284397fc
Avoiding unnecessary hospital admissions among older people: residential care homes:
http://www.scie.org.uk/socialcaretv/video-player.asp?v=avoidunhospadmiresidential
Reablement: maintaining independence: http://www.scie.org.uk/socialcaretv/videoplayer.asp?guid=7f99fdd1-0e82-47c9-adb9-b939284397fc
Osteoporosis: http://www.nhs.uk/conditions/Osteoporosis/Pages/Introduction.aspx
What is one unit of alcohol? https://www.drinkaware.co.uk/check-the-facts/what-isalcohol/alcohol-unit-guidelines/
Glaucoma: http://www.nhs.uk/conditions/glaucoma/pages/introduction.aspx
NHS Choices falls awareness: http://www.nhs.uk/Conditions/Falls/Pages/Prevention.aspx
USEFUL WEBSITES
Osteoporosis: http://www.nhs.uk/conditions/Osteoporosis/Pages/Introduction.aspx
Glaucoma: http://www.nhs.uk/conditions/glaucoma/pages/introduction.aspx
Age related cataracts: http://www.nhs.uk/conditions/Cataracts-age-related/Pages/Introduction.aspx
Macular Degeneration: http://www.nhs.uk/conditions/maculardegeneration/pages/introduction.aspx
NHS Choices falls awareness: http://www.nhs.uk/Conditions/Falls/Pages/Prevention.aspx
Falls NICE guidelines: http://guidance.nice.org.uk/CG161
REFERENCES
Aware, D. (n.d.). How much alcohol is too much? Retrieved June 19, 2014, from Drink Aware:
https://www.drinkaware.co.uk/check-the-facts/what-is-alcohol/how-much-is-toomuch?gclid=CKbPnfmwhr8CFQXnwgod4ZIAKA
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Choices, N. (n.d.). Age related cataract. Retrieved June 19, 2014, from NHS Choices:
http://www.nhs.uk/conditions/Cataracts-age-related/Pages/Introduction.aspx
Choices, N. (n.d.). Falls Awareness. Retrieved June 19, 2014, from NHS Choices:
http://www.nhs.uk/Conditions/Falls/Pages/Prevention.aspx
Choices, N. (n.d.). Glaucoma. Retrieved June 19, 2014, from NHS Choices: Glaucoma:
http://www.nhs.uk/conditions/glaucoma/pages/introduction.aspx
Choices, N. (n.d.). How often can I have a free eye test? Retrieved June 19, 2014, from NHS Choices:
http://www.nhs.uk/chq/Pages/1093.aspx?CategoryID=68&SubCategoryID=157
Choices, N. (n.d.). Macular degeneration. Retrieved June 19, 2014, from NHS Choices:
http://www.nhs.uk/conditions/macular-degeneration/pages/introduction.aspx
Choices, N. (n.d.). Osteoporosis. Retrieved June 19, 2014, from NHS Choices: Osteoporosis:
http://www.nhs.uk/conditions/Osteoporosis/Pages/Introduction.aspx
NICE. (n.d.). Falls NICE guidelines. Retrieved June 19, 2014, from NICE:
http://guidance.nice.org.uk/CG161
patient.co.uk. (n.d.). Prevention of falls in the elderly. Retrieved June 19, 2014, from patient.co,uk:
http://www.patient.co.uk/doctor/prevention-of-falls-in-the-elderly-pro
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