Falls are not limited to a specific age group, but are prevalent in elderly patients and can lead to severe injuries. In fact, in the United States, over 800,000 patients are hospitalized every year because of a fall injury. More often than not, they are admitted to the hospital because of a broken hip or head injury. Although most cases are benign and don’t involve injuries, 10% to 25% result in broken bones and hospital admission.
Falls in hospital premise are no news. Preventing falls among older people is one of the bigger challenges faced by the medical care team. Such incidents make it vital for the administration team to conduct comprehensive analysis of the accidents, and look beyond the obvious reasons for falls.
It is essential for nursing homes to conduct a thorough falls risk assessment of the premise and the physical condition of the patient, right on the first day of his/her admission to the center. This will help the assigned medical team prepare a plan that mitigates all identified risks. Despite these efforts, however, some falls will continue to occur. The team should, therefore, be vigilant throughout the patient’s stay and be prepared to handle emergencies.
Common Risk Factors of Falls:
Falls can result in minor and major injuries in the elderly population. Minor injuries include bruises, abrasions, and lacerations. At the same time, hip fractures, broken bones, and head injuries are often caused by falls. Some of the common fall risk factors include:
- Gait and balance disorder: With age, most people face problems in movement coordination, flexibility, and body balance. This is commonly referred to as gait and balance disorder, and may result from inactivity or other medical condition, making people more vulnerable to falling.
- Visual impairment: Aging eyes often experience the lack of visual clarity due to less light reaching the retina. Even if it is corrected by wearing a pair of spectacles, the poor vision remains prevalent, and so does the risk of tripping and walking into obstacles as they are harder to see.
- Chronic medical conditions: The majority of the older generation have at least one chronic condition like diabetes, stroke, or arthritis. These ailments often increase the risk of falling because they result in inactivity, depression, pain, multiple medications, and loss of agility.
- High-dose medications: Because of one or more ailments, older patients need to follow prescriptions and medications that can cause dizziness, dehydration or side effects that can lead to a fall.
Even though fall injuries carry grave consequences, most of them can be prevented. The key is to know where to look. Read on to know about the measures that can reduce the risk of falling in a medical care center:
1. Implement a Fall Prevention Program
Hospitals and nursing homes should devise a fall prevention program depending on the risks of falling in the premise. An effective fall prevention program should first focus on a patient’s need to understand what may put him/her at risk for falling. Further, medical providers should be inducted into the prevention program. They must help patients identify risks and develop a customized plan for every patient. Specific physical activities should be scheduled for the patient to reduce fall risk by increasing balance and mobility skills.
As suggested by the U.S. National Library of Medicine, key components of a fall prevention program include: environmental assessment, assistive device evaluation and modification, gait assessment and training, staff education, exercise programs, use of hip protector, and regular blood pressure evaluation for the patient.
2. Regular Risk Assessment and Follow-Up
When an older patient is admitted to the hospital, the medical care team should conduct regular risk assessment of patients’ rooms to check for risks of falling. Even during routine doctor visits, the assigned doctor should constantly monitor the environment.
Osteoporosis is one health factor that can contribute to falls among people over the age of 80 years. This medical condition changes the body’s balance and walking patterns, vision and sensation, and patients need to take multiple medications. Some of these medications can cause dizziness among older patients. This makes regular risk assessment crucial to avoid cases of falling. Patients who are aware of some of the risks that may affect them should inform the doctor and other health professionals to determine what factors can be modified in the treatment plan to reduce their risk of falling.
3. Reduce Discomfort and Desire to Move
In several cases of elder patients falling, the medical teams have found the patients sliding into a sacral sitting position or attempting to transfer from a wheelchair unsupervised. This highlights that they wanted to stand up or move to avoid discomfort.
In long-term care setting, patients often experience distress because of restricted mobility. Medical teams should keep checking on the comfort level. When they are bored or in pain, they tend to become restless and attempt to change positions more frequently. This movement can be dangerous and the medical care team should regularly evaluate patients for pain or discomfort, even if they are unable to express it properly. Engaging the patient inappropriate social activities to prevent boredom, adding appropriate cushioning and assistive devices, and ensuring proper nutrition can help control the patient’s urge to move too much.
Medical care providers at nursing homes must be extra cautious when treating elder patients, as they are more prone to falling and hurting themselves than younger patients. Their aim should be to reduce both, the fall rate and the injuries sustained by patients admitted in a long-term care setting. Implementing flexible and efficient fall prevention programs within the medical care center can reduce the risk of falling and make the center safer for patients.