Falls is a concern in the frail elderly residing in long term care homes (LTCHs). Safer Health Care Now, a Canadian initiative to provide safe health care in all health sectors reports that 40% of all admissions to LTCHS are a direct result of a fall. Additionally almost half of all elderly residents residing in LTCHs fall every year; 1/3 of those who fall develop serious injury. Furthermore, those who do fall are at higher risk for future falls and injury (http://saferhealthcarenow.ca)
There are many factors to consider for the prevention of falls in the frail elderly. An elderly person who has fallen may become tense, fearful, embarrassed and discouraged. These emotions increase the risk of falling and it is important to discuss these feelings with your family member and the LTCH team.
The common risks of falling in the elderly include:
• Previous history of falling
• Decreased muscle tone
• Loss of hearing
• Diminished sensation in feet
• Vision problems (glaucoma, macular degeneration and/or cataracts)
• Disorders that affect balance, i.e. osteoporosis, arthritis, diabetes and Parkinson’s disease
• Dementia including wandering and agitation
• Bladder and bowel problems
• Certain medications
• Improper footwear
• Clutter and obstructed walkways
• Poor lighting
• Trip hazards and slippery floors
Family members can help with prevention of falls in the frail elderly. At time of admission to a LTCH it is important to advise LTCH staff of history of falls. History of a fall places a person at high risk to fall again. If your family member is at risk for falls, please inquire with the LTCH staff about “hip protectors”. These are special devices worn under clothing that can be effective in reducing injury if a fall occurs. Ensure your family member is wearing proper footwear. Avoid slippers and athletic shoes with deep treads. Thin, non-slip soles, proper fitting, low heels are preferred. Limit amount of clutter your family member has in the room. Personal items from home are meaningful, however furnishings, knick-knacks may create mobility hazards.
Prevention of falls in the frail elderly is a team effort. Clear, concise communication between dieticians, housekeeping, nurses, pharmacists, physicians, physiotherapists, recreation therapists and family members will provide opportunities to develop strategies to prevent a fall from occurring. We welcome your input and involvement.
~Nora VanDalen RN(EC)
We serve the frail elderly by providing clinical assessments and offering treatment options which may assist in the avoidance of a hospital transfer. We understand that transferring to hospital is a traumatic experience for both resident and family members. We are available to nursing staff of the homes to offer an in-depth assessment which might prevent the transfer. We offer flexibility to respond to urgent calls throughout the day, Monday to Friday.
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