Download Fall Prevention - OlderAdultFocus.org

Towards
Fall Prevention
You need to know that…
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falling is not a normal
part of aging.
the risk of falling can
be minimized.
falling may be an
early sign of illness.
What causes falls?
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Person Factors
Poor balance
Postural hypotension
Weakness
Functional, cognitive,
and sensory, changes
Medication effects
Pain
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Environment Factors
Poor lighting
Slippery or uneven
flooring or sidewalks
Unexpected objects
(tubing, pets)
Restraints
Lack of structural
supports
Can you think of some other causes of falls?
Falls & Person-Environment Fit
We must always assess
both the individual person
and the environment.
However, at any given
time or in any given
setting, our focus may be greater on one
than on the other.
In the acute care setting…
Factors related to falls involve both the
person and the environment. For example:
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Person
Environment
Immobility
Factors Factors
Medication effects
Weakness and pain
Tubing ( e.g., IVs, catheters, oxygen)
Lack of familiar supports (e.g., eyeglasses,
ambulation devices)
Unfamiliar setting, people, and routines
What other factors have you observed?
In the home setting…
The focus of fall prevention tends to be
more on the environment. For example:
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Lack of grab bars in bathrooms
Lighting
Person Factors:
• Medication effects
Scatter rugs
• Decreased ability to
Pets
manage personal care
Cluttered walkways
• Functional, cognitive, and
sensory changes
Stairs
What other factors have you observed?
Take a walk
through your
living
environment.
What environmental
hazards could
cause a fall?
Prevention: In the Hospital
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Assess history of falls on admission.
Minimize restraint use.
Ensure use of glasses and hearing aids.
Frequently assess elimination, pain, and
cognitive status, making individualized
adaptations.
Keep patient area clutter-free.
Monitor effects of medications.
In the Hospital (continued)
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Lock wheels on wheeled tables and other
devices that may be used as supports.
Use alert system to notify staff about individual
fall risk.
Move patient closer to nursing station.
Restore and maintain functional status.
Use assistive devices.
Educate regarding safe transfers.
Obtain referrals for OT, PT,
Home Health.
Prevention: In the Home
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Secure or eliminate loose rugs
Remove clutter
Assess for adequate lighting (inside
and outside, especially on stairs)
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Assess bathroom for grab bars
Obtain referrals for OT and PT
(What can OT and PT do in the home
to prevent falls?)
Fall Prevention:
Occupational Therapy (OT)
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Evaluate need for:
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Assistive devices (especially those for
bathing, toileting, eating and dressing)
Home modifications
Fall Prevention:
Physical Therapy (PT)
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Transfer training
Balance training
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Gait training
Assistive device training
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Standing
Uneven surfaces
Curbs and steps
Canes, crutches, walkers
Strengthening exercises
Fall Prevention:
Additional Nursing Interventions
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Encourage to take classes in Tai Chi
Encourage the use of assistive devices
Monitor medications
Monitor elimination and
pain issues
Instruct to change positions
slowly
Instruct regarding non-slip
footwear
Fall Prevention: Interdisciplinary
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Nursing has a KEY role in
facilitating referrals for
evaluations in both the acute care
and home settings.
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Primary in fall prevention are the
interdisciplinary team and
coordination between settings.
Older adults benefit most from the collective
expertise of all related disciplines.
Towards Fall Prevention was created
by Catherine Van Son, Ph.D., R.N.
for the Older Adult Focus Project,
OHSU School of Nursing.