High Risk Falls

[crnhusker 0]

EVERYTIME THERE IS A HIGHER THAN NORMAL RATE OF FALLS, THE NURSING STAFF THINKS IT IS BECAUSE THE ACTIVITY DEPT. ISN'T DOING ENOUGH ACTIVITIES. I GET FRUSTRATED BECAUSE THERE IS ME AND ONE OTHER ASSISTANT THAT MUST LOOK AFTER 110 RESIDENT. PLEASE TELL ME IF THE TWO OF IS DOING SOMETHING WRONG OR IF WE ARE KIND OF A SCAPE GOAT FOR AN ONGOING PROBLEM WITH FALLS. I AM A VERY TEAM ORIENTED DIRECTOR AND TRY MY BEST TO WORK WELL WITH ALL DEPT. HEADS AND STAFF, BUT I GET FRUSTRATED WHEN SOMEONE TELLS ME TO DO SOMETHING TO CORRECT A PROBLEM THAT I THINK HAS TO BE LOOKED AT AS A WHOLE WITH ALL DEPARTMENTS. DOES ANYONE ELSE EVER ENCOUNTERED THIS PROBLEM WITH FALLS AND THE BLAME MYSTERIOUSLY GETS PUT ON ACTIVITIES? :-x

[Guest Guest]

Hi, my department use to get the blame about a year ago. However, it is not the activity departments fault you are only one person, and very busy. When the DON did an investigation she found that residents who were falling were ones who should of had some sort of bed or chair alarm on them, and nursing wasn't doing that. Which in turn would prevent some falls. So maybe someone should look into bed and/ or chair alarms @ your facility. It is not your departments fault that residents are falling, I am sure you are doing the best you can and no matter how hard everyone trys not all falls can be prevented.

[Margi 0]

Hey, I just got blamed because a resident complained to State about the food. Not about the food activities serve, but about the food served from the kitchen. Nursing said it was Activities fault. That if this resident had more activities she wouldn't be complaining about the food. Try to figure that one out.

[StacieO 0]

My point of view, is, that no one department is soley responsible for the well-being of the residents. That's a pretty tall order if Nursing is going to lay the blame of falls on basically 2 people. Find out when falls are happening. Is there a high number during change of shift, break times, early a.m.'s, etc? Finding why they are falling (bathroom, behavior, wanting to walk, etc.) will help in fall prevention. I'm on the "Falls Committee" at our facility & it is an all-facility program (Nursing Home & Hospital working together to prevent falls). Best of luck.

[wonytineres 0]

I've been in your shoes more than once in my career- it alway seems so easy to say "Where's Activities?" As others have mentioned you and the other members of the interdisciplinary team need to look at all the contributing factors for the falls- time of day, alarm use, clinical issues such as UTIs, the list is endless. If your facility does not have a Falls Committee suggest this as an idea. It has been my experience that most residents who have had a fall would not have been engaged in an activity at the time of the fall even if the activity was available. Typically residents fall because they need to have a need met (bathroom!!). If your coworkers continue to turn up the heat offer this as a suggestions- you and your one assistant are not able to be everywhere so provide nursing (yes nursing) with a supply of 'busy' type activities which they can easily grab and use. Good luck!

[crnhusker 0]

:-D THANKS FOR THE INSIGHT, AND GLAD TO KNOW THAT MY DEPT. IS NOT ALONE AND OTHERS HAVE HAD THIS SITUATION. I AM GOING TO ASK FOR ALL FALL TIMES AND REQUEST THAT I ALSO BE ON THE FALL COMMITTEE AT MY FACILITY. THAKKS.....................

[Guest Tinki]

Here is an article I found on Falls

 

Safety and Falls in Long-term Care Settings

By Helen Lach, MSN, RN, CS

Division of Geriatrics and Gerontology, Washington University

 

 

 

 

 

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One of the most common safety problems in a long-term care setting are falls. Residents with Alzheimer's disease (AD) are at an increased risk. If caregivers, both professional and family, are aware of the issue of fall prevention, some accidents can be avoided.

 

Falls can have many causes. One example might be a 75-year-old woman with AD sitting in a chair outside her room when she realizes she needs to use the bathroom. She forgets her cane and to turn the light on in her room. As she hurries toward the bathroom, she catches her foot on a chair and falls. Did she fall because it was dark or because she was moving too quickly? Could she have prevented the fall if she had her cane?

 

Good detective work will identify the events that lead up to a fall and try to prevent them from happening again. Some of the main causes of falls by older people include:

 

Age. While age itself does not cause falls, it does result in a slower reaction time and less efficient balanace systems. Often, older adults in nursing homes get little physical activity and become weakened and out-of-shape.

 

Health Problems. Arthritis, Parkinson's disease, foot problems, dizziness when getting up or any health condition affecting walking or balance can be problematic.

 

Visual impairments can also increase the risk of falling.

 

Environment. Proper lighting, nonslippery floors, the presence of grab rails, the use of supportive footwear, lowered beds and clear walking paths are good preventive measures for decreasing falls in long-term settings.

 

Medications. Blood pressure medications, water pills, tranquilizers or sedatives, and some antidepressants and antihistamines can increase the risk of a fall.

I

ndividuals with AD and other dementias may have some additional problems that place them at an even higher risk of falling. The brain cell loss association with AD often causes a slower reaction time. Poor depth perception or trouble with visual-spatial relations can result in misinterpreting the environment such as missing a step. Some people with dementia have apraxia, or trouble coordinating movements and walking. Memory loss can result in getting lost, forgetting walking aids or difficulty remembering how to use them correctly.

 

Health-care facilities want to prevent all falls, but this goal is not realistic. We have to remember that one-third of older adults who live at home also fall each year. However, there are several things we can expect from a facility to keep our loved ones as safe as possible, such as:

 

Walking paths and rooms should be safe and free of obstacles.

 

Residents wear supportive shoes, receive regular exercise and walking to maintain strength.

 

Physicians and occupational therapists are available, as needed, to address mobility issues.

 

Falls are thoroughly investigated, and steps taken to decrease risks.

Restraints are rarely used; the restrictions they cause only increase weakness. For instance, drugs or chemical restraints can cause harmful interactions with existing medications. Other restraints can cause health problems such as incontinence, pressure sores or depression. Research suggests they may not prevent falls.

If you have any concerns about falls by a loved one in a nursing home, discuss them with the staff. They should be willing to discuss your concerns and help find ways to decrease your loved one's risk of having a fall.