Identify local, state, and national resources which facilitate safe and effective transitions of care for older adults. Your supervisor at Home Health Services is sati

Increased Risk of Falls

Everyone strives to feel safe and comfortable in their living surroundings. With age comes the necessity to keep one's mind at ease while going about one's everyday tasks. In older individuals, falls are the primary cause of fatal and nonfatal injuries. Because of the increasing incidence of frailty and a limited physiologic reserve among the aging population, fatal falls occur in persons of all ages, but those over 75 experience higher rates of morbidity and mortality. Falls are the primary cause of injury-related emergency room visits, especially among the elderly. Falls can cause injuries such as hip fractures, brain injuries, and rib fractures. Depression, social isolation, and limitations in their other activities are some of the additional drawbacks. Falls, whether they cause harm, have a significant influence on one's quality of life, especially for the elderly. As a result of their fear of falling, an increasing number of older adults are limiting their activities and social engagements. Therefore, as nurses, ensure assess fall risks and prevent falls in older adults.

I. Falls are a frequent clinical condition that affects approximately half of all Americans over the age of 65.

A. An older adult is treated in the emergency room after a fall every 11 seconds.

1. Because of the higher incidence of frailty and a limited physiologic reserve among the elderly, falling causes higher rates of morbidity and mortality among individuals over 75.

a. It is typical for elderly adults to have multiple chronic health conditions, as well as a loss of physical strength and bone density. Those are the ones who induce them to fall and easily fracture their bones.

b. Muscle strength, balance, and reaction time all decline as we age which put older adults at a significant risk of falling.

II. There are many risk factors of fall in elderly.

A. Polypharmacy, antipsychotic drugs, visual deficit, and cognitive impairment can cause falls in older adults.

1. Many older adults take multiple drugs daily and receive treatment from different physicians. As well as they tend to take antipsychotic drugs for depression or other mental illnesses.

a. For instance, many elderlies have hypertension, and sometimes they take both diuretics and antihypertensive medication for it. These combined medications may cause severe hypotension and risk for falls.

b. Many older adults must depend on other people with ADLs, lost their loved ones, lonely, and depressed, so they take antipsychotic drugs to minimize these conditions. Antipsychotic medications might cause drowsiness and risk for falls.

III. Nursing management of falls

A. Management of fall is challenge for nurses, but there are several ways to reduce falls.

1. Encourage fall risk clients to wear slip resistant socks or shoes, reinforce to use call light before getting up, rise and reposition slowly, use walker, stay within arm’s reach, use bed alarm or chair alarm, and answer call lights promptly. These interventions produced a 30% reduction in falls in an Australian subacute hospital.

a. Some facilities use video monitor or one to one sitter to prevent falls in high-risk older adults.

b. Wear a high-risk fall bracelet to alert all staffs that the patient requires assistance with ambulation.

c. Keep high fall-risk patients closer to nursing stations so that staffs can get to them faster.

In conclusion, falling is becoming more common among older adults, and it is not a natural part of the aging process. Fall prevention is particularly important in older adults because falls are the leading cause of fatal and nonfatal injuries in this age group. Because falls in the elderly have such serious effects, it's vital to watch for signs and symptoms, as well as risk factors. Patients over 65 who have fallen should be thoroughly assessed. By detecting and treating the underlying cause of a fall, patients can regain baseline function and reduce the risk of recurrent falls. These methods help to reduce the morbidity and mortality associated with falls.  If left untreated, it can result in serious harm and even death. As competent nurses, we strive to protect our patients from falling and provide them with the highest quality of life possible.

References:

Hoffmann, V. S., Neumann, L., Golgert, S., & von Renteln-Kruse, W. (2015). Pro-active fall-risk

management is mandatory to sustain in hospital-fall prevention in older patients-

validation of the Lucas fall-risk screening in 2,337 patients. The Journal of Nutrition,

Health & Aging, 19(10),1012-1018. http://dx.doi.org/10.1007/s12603-015-0662-1

Meiner, S. E. ([Insert Year of Publication]). Gerontologic Nursing (6th Edition). Elsevier Health

Sciences (US). https://ambassadored.vitalsource.com/books/9780323498111

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