| Falls suffered by the elderly pose one of the highest | | | | - evaluating whether medications are causing lethargy, |
| risk factors for mortality in the long term care | | | | disorientation or dizziness |
| population. Studies show that suffering from a hip | | | | - providing medications to help increase or prevent |
| fracture increases the likelihood of mortality by as | | | | the further loss of bone density |
| much as 83%[1]. Falls occurring in nursing homes and | | | | - providing assistance with ambulation, which can |
| assisted living facilities result in significant injury to | | | | range from personal assistance to a walker, |
| elders and corresponding legal liability for the facility. | | | | depending on an individual's ability to ambulate safely |
| Many falls are preventable in the long-term care | | | | - implementing routine toileting schedules so a patient |
| setting if the facility promptly identifies an individual's | | | | does not have to get up from bed to go to the |
| risk factors for falling, and puts in place an | | | | bathroom by himself or herself |
| appropriate care prevention plan to prevent the fall in | | | | - bed alarms to alert the staff when the resident is |
| the first instance. | | | | getting up without needed assistance |
| Generally risk factors for falling increase with age and | | | | - providing a low bed or bed with floor pads and |
| may be greater for women than with men. Typical | | | | safety cushions |
| risk factors for falling include the following: | | | | - bed rails on the beds for patients who, because of |
| Dementia, Alzheimer's disease, or other neurological | | | | dementia, insist on getting out of bed without using |
| conditiondecreased bone density or | | | | the call bell. Bed rails should have safety cushions to |
| osteoporosismuscle weaknesses or disturbances in | | | | prevent patient entanglement. |
| gaitrecent hospitalization causing physical limitations or | | | | - hip protectors or pads to cushion a patient during a |
| disorientationvision problemsmedications that can | | | | fall |
| cause confusion or disorientationunsafe environment, | | | | - wheelchair alarms to alert staff when a resident is |
| including slippery or wet floors, rises in carpets, or | | | | getting out of a wheelchair |
| other obstacles | | | | - wedge cushions to prevent a resident from sliding |
| Long-term care facilities are required to retain trained | | | | out of a wheelchair |
| professions who are knowledgeable in assessing risk | | | | Long-term care facilities also have access to various |
| factors for falling. They are obligated to put fall | | | | devices that allow residents to ambulate safely even |
| prevention protocols in place to prevent serious injury | | | | without assistance. Such devices include a |
| or death. At the time of admission, the standard of | | | | merri-walker, which actually surrounds the patient so |
| care requires that every resident of a long-term care | | | | that he or she can traverse through the nursing |
| facility get thoroughly evaluated for risk factors for | | | | home safely. Long-term facilities should be vigilant in |
| falling. If that risk factor analysis determines that the | | | | re-evaluating a patient's risk factors for falling as they |
| resident is at increased risk for falling, a fall | | | | may increase during a resident's prolonged stay at |
| prevention care plan should be put in place | | | | the nursing home. |
| immediately. | | | | If you have questions about whether a nursing home |
| A care plan is a multi-disciplinary tool where various | | | | is properly protecting your loved one from suffering |
| specialized disciplines (nursing, physical therapy, | | | | injury from a fall, ask the charge nurse what's |
| occupation therapy, treating physician, recreation aids, | | | | included in the care plan to prevent falls. Share your |
| etc) get together to come up with a multi-disciplinary | | | | views in a constructive way, and ask if you can |
| approach to the problem. A care plan for fall | | | | participate in the next care plan meeting. If your not |
| prevention may include the following: | | | | the power-of-attorney for the resident, you may |
| - keeping the floor free of debris or dangerous | | | | have to get permission to participate, or get |
| objections | | | | appointed as co-power of attorney, to assist in the |
| - providing strengthening of a patient's muscles | | | | health care decision making process. |
| through physical therapy | | | | [1] Fair Housing Amendments Act, 42 U.S.C. ยง 3601 |
| - providing gait orientation and training through | | | | et. seq. (2000). |
| physical therapy | | | | |