Download Education & Compliance: Hospice Partners of America

Falls Risk Assessment
and Planning
Dr. BC Farnham & Elizabeth Pugh, LBSW, CM
This program is made possible through a collaborative community-education partnership between The Consortium for Advancements
in Health & Human Services, Inc. and Kindred at Home. The primary goal of this effort is to increase public awareness and access to
hospice and home health through the provision of community-based education. Contact Hours are awarded to professionals who
complete this program by The Consortium for Advancements in Health & Human Services, Inc. (www.cahhs-partners.org)
The Consortium for Advancements in Health and Human Services, Inc. © 2014
Important Information

This education program for healthcare professionals was developed by The Consortium for Advancements in
Health and Human Services, Inc. (CAHHS) and is facilitated by Kindred at Home via a community education
partnership agreement. CAHHS is a private corporation and is solely responsible for the development,
implementation and evaluation of its educational programs. There is no fee associated with receiving contact
hours for participating in this program titled, Falls Risk Assessment and Planning. However, participants
wishing to receive contact hours must offer a signature on the sign-in sheet, attend the entire program and
complete a program evaluation form.

The Consortium for Advancements in Health and Human Services, Inc. is an approved provider of continuing
nursing education by the Alabama State Nurses Association, an accredited approver by the American Nurses
Credentialing Center's Commission on Accreditation.

The Consortium for Advancements in Health & Human Services, Inc., is approved as a provider of continuing
education in Social Work by the Alabama Board of Social Work Examiners, #0356, Expiration
Date: 10/31/2016.

This program is Approved by the National Association of Social Workers (Approval #886684291-5173) for 1Social Work continuing education contact hour.

In most states, boards providing oversight for nursing and social work recognize contact hours awarded by
organizations who are approved by another state's board as a provider of continuing education. If you have
questions about acceptance of contact hours awarded by our organization, please contact your specific state
board to determine its requirements. Provider status will be listed on your certificate.

CAHHS does not offer free replacement certificates to participants. In the event that CAHHS elects to provide
a replacement certificate, there will be a $20.00 administrative fee charged to the individual who requests it.
Learning Objectives:
 To increase awareness of the risk of falls in both
the home and long-term care facilities.
 To provide preventative measures to decrease the
risk of falls in both the home and long-term care
facilities.
Participant Activity:
 List 5 common causes of falls in the home.
 List 5 common causes of falls in a long-term care
facility.
Did you know???
 Falls are the second leading cause of death in the
United States.
 One-third of the older adults who fall, fracture
their hip and are hospitalized, die within one year
from the fall.
 Fear of falling leads to inactivity and loss of self
confidence which decreases quality of life and
increases the risk of falls.
 The risk of falls increases with each decade of life.
Fall Statistics
 Among older adults, falls are the leading cause of
injury deaths. They are also the most common
cause of nonfatal injuries and hospital admissions
for trauma (CDC 2005).
 In 2005, 15,800 people 65 and older died from
injuries related to unintentional falls; about 1.8
million people 65 and older were treated in
emergency departments for nonfatal injuries from
falls, and more than 433,000 of these patients
were hospitalized (CDC 2005).
Fall Statistics
 The rates of fall-related deaths among older
adults rose significantly over the past decade
(Stevens 2006).
 30% of older adults fall each year
 60 % of fatal falls occur in the home
 50% of those admitted to the hospital following a
fall will not be alive one year later
Recurrent Falls
 Recurrent falls are defined as those occurring at
least three times in a year.
Nursing Home Facts:
 About 5% of adults 65 and older live in nursing homes
 NH residents account for about 20% of deaths from
falls
 Typical nursing homes with 100 beds report 100 to
200 falls per year
 As many as 3 out of 4 nursing home residents fall each
year.
 About 35% of fall injuries occur among residents who
cannot walk
Nursing Home Facts (cont.)
 About 1,800 people living in nursing homes die
each year from falls.
 About 10% to 20% of nursing home falls cause
serious injuries; 2% to 6% cause fractures.
 Falls result in disability, functional decline and
reduced quality of life. Fear of falling can cause
further loss of function, depression, feelings of
helplessness, and social isolation.
Why do falls occur more in
nursing homes?
 Falling can be a sign of other health problems.
People in nursing homes are generally more frail
than older adults living in the community. They
are generally older, have more chronic conditions,
and have difficulty walking. They also tend to have
problems with thinking or memory, have difficulty
with activities of daily living, and need help
getting around or taking care of themselves. All of
these factors are linked to falling.
Common causes for falls
 Muscle weakness and walking or gait problems
are the most common causes of falls
 Environmental hazards, such hazards include wet
floors, poor lighting, incorrect bed height, and
improperly fitted or maintained wheelchairs
 Medications can increase the risk of falls and fallrelated injuries. Sedatives and anti-anxiety drugs,
are of particular concern
How can falls be prevented?
 Fall prevention takes a combination of medical
treatment, rehabilitation, and environmental
changes.
Safety Measures
 As a caregiver it is part of your duty to ensure that
the patient is safe in their home.
 The following are tips to help your patients from
falling:
Stairs
 Extra lighting
 Able to see edges of steps
 Top and bottom step easily seen
 Non-skid treads on steps
 Handrails on both sides of stairs
Lighting
 Light switches easy to see
 Light switches easy to reach
 Can turn on light from bed
 Uses a night light
 Brighter lighting where medicines are kept
 Automatic lights
 Maximum watt light bulbs
Kitchen
 Items easy to reach
 Ventilation to reduce fogging of glasses
 Wipe up spills immediately
Living Area
 Carpet edges tacked down
 Remove throw rugs
 Avoid highly polished floor surfaces
 Remove extension and phone cords from pathways
 Adequate space between furnishings
 Sturdy furniture and at proper height
 Telephone easily accessible with emergency numbers
posted
Living Areas
 Shelving low to minimize use of step stool
 Home escape routes clear
 Be aware of other obstacles (pets, oxygen tubing,
foot stools)
Bedroom
 Bedspread without loops or fringe on edges
 Walking aides/eyeglasses within reach before
getting out of bed
 Use a monitor to hear sounds within home
 Bed at proper height
 Flashlight within reach
Bathroom
 Non-skid rubber mats in shower/bath
 Hot and cold water clearly marked
 Handrails for both bath and commode
 Seat in tub or shower
 Temperature on hot water tank lower to prevent
scalding
Clothing and Footwear
 Shoes with non-skid soles
 Shoes have round broad heels
 Clothing fits securely with no dangling cords,
belts or hems
 Night clothes short enough to prevent tripping
Sitting Balance
 Have chairs with higher seat and solid armrest
 Use pillows and chairs with back and side support
to prevent leaning
 Keep chairs in good condition and cushions firm
 Keep all supplies and frequently used items within
reach
 Use non-rolling chairs
Outside the home or facility
 Edges of steps clearly marked
 Non-skid strips or non-skid paint on steps and/or
ramp
 Sturdy handrails, steps and ramps
 Paths and sidewalks in good repair
 Entrances lit well
 Tools stored safely
 Pathways free from grease and oil
Hearing
 Use of hearing aids as directed
 Keep hearing aid batteries fresh
Vision

Keep eye glasses fitting appropriately

Maintain regular eye exams

Always allow time for eyes to adjust when entering and leaving from light and dark
areas

Have multiple sources of lights for rooms

Always use diffuse lighting

Correct all blinds, drapes and sheer curtains that cast bright light into a room

Adjust any mirrors in room to avoid blinding light from reflection

Adjust sitting arrangement so that any bright sources of light are to the side
Medical Alert Systems
 Patients who are at high risks for falls may benefit
from a medical alert system.
 There are a number of providers who offer this
service.
 It is always good practice for a caregiver to
support patient and family in accessing these
services.
FALL
Don’t panic!
Stay quiet for a moment, assess the situation
Make a decision whether or not to try to get
up.
I can’t get up
I will try to get up
Use stable
furniture to help
Try sliding or crawling to seek help
Front
Door
Telephone
Personal
Alarm
Take time to
recover
Tell someone you
have had a fall.
Seek medical
advice if
necessary.
Make yourself
comfortable and
warm. Lie quietly
until help arrives.
Loud
Noise
When a patient falls you should:
 Assess for injuries
 Provide follow up care (send to ER or MD)
 Notify physician of fall and injuries
 Institute interventions to prevent further falls
 Complete an incident report including (reason for
fall, follow up care, notification of MD and
interventions)
References
 Injury prevention and control: Home and recreational safety
(2009). Retrieved July 14, 2010 from Center for
Disease Control website: http://www.cdc.gov/
homeandrecreationalsafety/falls/adultfalls.html
 Prevention of falls in the elderly. (2010). Retrieved July 14,
2010 from Patient UK website: http://
www.patient.co.uk/doctor/Prevention-of-Falls-in- theElderly.htm
 Falls in nursing homes. (2009). Retrieved July 15, 2010 from
n
Center for Disease Control website:
http://www.cdc.gov/HomeandRecreationalSafety/Falls/
ursing.html