Health care professionals work to maintain safety in every facet of their jobs. Fall prevention requires an interdisciplinary team approach focused on coordinated care planning which includes continuing education, monitoring and assessment of safety concerns and medications, and proper use of assistive devices. As a clinician, it is important to advocate for clients' safety and health while developing effective fall prevention strategies.
The Importance of Preventing Falls
Falls are a major health risk for elderly populations. In fact, every year, 1 out of every 4 seniors in America will fall, making it the leading cause of injury and injury-related death for people over the age of 65.[i] Personal risk factors associated with falls include age, activity levels contributing to strength and balance, habits, and diet. When assessing the risk level of a client, it is important to consider their history of falls including oxygenation, level of awareness, impaired judgement, footwear, blood pressure, elimination needs, and any medications that may impact fall risk or outcomes. Most of these falls happen at home, and in 20 percent of cases, the senior who fell will come away with a head injury or broken bone.[ii]
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Risk Factors to Consider:
- Lack of supervision or assistance is the leading cause of falls for seniors. Individuals determined to age-in-place—either in their family home, an apartment, or a senior living community—often need to be convinced that accepting the help of a home health aide supports their independent living and goes a long way toward keeping them out of a hospital or nursing facility.
- Fear of falling actually can cause falls. It may seem counterintuitive, but especially when a client has a history of fall-related injury, fear may cause them to become dangerously inactive or to unconsciously modify their positions and movements in unsafe ways. Watch for changes in activity, posture, balance, and gait that may be overcautious and impeding their quality of life.
- Rest points sometimes appear organically and may create a trip hazard. Have you ever entered the home of someone with a disability or health issue and wondered, ‘What is that random chair doing there in the hallway?’ The resident may be using it as a rest point. Help eliminate potential stumbling blocks in the home by referring the client to physical therapy to explore alternatives.
- Financial concerns often make seniors reluctant to make home safety improvements or to ask for professional assistive care. As a sensitive subject, such concerns may not be expressed. Take the initiative to head-off any money worries by helping seniors take advantage of insurance benefits for personal care assistance and other help from community programs, nonprofits, or church groups.
There are many precautions home health care professionals should take to minimize their clients’ fall risk, some more obvious than others. They include:
- Scan every living space, every interior and exterior entrance for trip hazards and proper lighting. Remove clutter and throw rugs. Repair or secure carpet and flooring. Rearrange furniture and power cords for wide passageways and unobstructed movement throughout the house and yard. Assess nighttime visibility and add night lights where needed, especially in the hallway and bathroom.
- The three S’s: stabilize, support, non-slip. Scan every living space, every interior and exterior entrance for ways you can prevent slips and provide stability. Handrails on both sides of a staircase, toilet, or bed—anywhere transfers are common. Grab bars, a shower seat, or non-slip appliqués in the shower or tub.
- Teach your client, family, and care team effective fall prevention strategies, such as keeping frequently used items (phone, tv remote, medications) within easy reach, paying attention to when the client feels dizzy or weak, and changing positions slowly—sit on the edge of the bed, sofa, or chair for a few minutes before turning or standing to walk.
- Talk to the client’s doctor to assess what can be done to prevent falling, and inform the doctor of any previous falls or near-misses. The doctor can check their vision, hearing, and bloodwork, discuss any potential side effects of their medication regimen, recommend a walker or cane, or refer them to physical therapy or an exercise program to improve their strength, balance, gait, and flexibility.