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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, (6th
ed.). Philadelphia: Lippincott, Williams & Wilkins (ISBN
0-7817-4428-8).