Elderly people are a vulnerable population for many reasons. Characteristics of a vulnerable population include being susceptible to or at risk for health problems (de Chesnay & Anderson, 2012, p. 4). One thing that elders are susceptible to is being prone to a fall. Falls can result in a variety of injuries from fractures to chronic pain to reduced quality of life and increased morbidity (Karlsson, Magnusson, von Schewelov, & Rosengren, 2013). Many risk factors contribute increased likelihood of falls. Change in routine or environment, inappropriate footwear, and other chronic health conditions contribute to a higher risk of suffering a fall (Karlsson, Magnusson, von Schewelov, & Rosengren, 2013). Nurses can work to reduce falls in the long term care setting. I will review the hazards of falls and what the nurse can do to recognize risks and prevent falls in residents in order to avoid injuries. The attached PowerPoint will help illustrate the dangers of falls and teach the main points of prevention. I have also created a brochure for nurses to keep with them as a reminder of how they can help prevent falls.
Hazards of Falls in the Elderly
Falls are dangerous for anyone at any age. They lead to injuries from bruises to broken bones. However, in the elderly, the risks for injury and morbidity associated with falls are increased. Falls are the leading cause of death by unintentional injury in older adults (“Healthy People 2020, n.d.). Falls contributed to 23% of injury-related deaths in those over 65, 34% in those over 85 years of age (Karlsson, Magnusson, von Schewelov, & Rosengren, 2013). In an effort to raise awareness of these issues, Healthy People 2020 included the goals of improving the health, function, and quality of life of older adults and reducing the rate of visits to emergency departments that stem from falls (“Healthy People 2020, n.d.). In order to meet these goals and promote quality of life, nurses must understand the hazards of falls and work to educate their patients and colleagues in prevention and reduction of injury.
Recognizing Risk Factors
Once nurses understand how detrimental falls are to an older adult’s quality of life; they can better understand their roles in prevention and meeting the needs of our long-term care population. Prevention begins with knowing the risks. Elderly residents have reduced safety awareness and gait instability (“Mayo Clinic”, 1998-2014). They are typically unaware of these safety reductions and need those around them to fill this gap. Nurses also must be alert for signs of cognitive impairment. When a resident or elderly person is forgetful, they may not recall how to assist themselves. They can forget their walkers or other assistive devices further making them prone to falls.
They may also have sensory impairments such as poor eyesight and diminished hearing (“Mayo Clinic”, 1998-2014). Nurses must assist the elderly resident by keeping walkways clear and maintaining a safe and consistent environment. Monitoring medication regimen for certain drugs that increase falls risk is another way nurses can meet these goals. Antihypertensive drugs, diuretics, stool softeners, and benzodiazepines all increase the chances of a fall and are common medications for elderly in long term care settings (Karlsson, Magnusson, von Schewelov, & Rosengren, 2013). Recognizing these concerns promote the importance of the nurse’s role in the meeting needs and improving quality of life for the elderly.
Assisting in Prevention
Knowing the risk factors associated with falls is a large factor in prevention. However, there are other actions that nurses can take to protect the safety of their elderly residents. Monitoring a resident’s fall history and requesting a referral to physical therapy is one important action nurses can take. Staff communication is another vital aspect of prevention (Murphy, 2013). It may sound simple, but subtle changes in a resident’s routine or regimen can occur from shift to shift. Therefore, it is crucial to discuss this between shifts and between disciplines to aid in prevention. Another vital component of prevention is that nurses assess and consider additional triggers for falls. Assessing when falls commonly occur and determining the continent status of high risk residents, can lead to methods of intervention. Falls are frequently associated with the need to void (Hitcho, et al., 2004). Therefore, instituting a toileting regimen is another nursing intervention that may decrease a resident’s chance for a fall.
Older adults are a vulnerable portion of our population. One factor that contributes to their vulnerability is high fall risk. However, this is a factor that can be affected by intervention. Nurses have a unique opportunity to intervene in the lives of the elderly for whom they provide care. They can recognize factors that increase the likelihood of falls and implement actions to prevent them. In doing so, they decrease vulnerability and improve the quality of life of their elderly residents.
Courtney from Study Moose
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