Preventing Falls Fall Prevention Preventing

Preventing Falls Fall prevention Preventing falls amongst elderly patients at subacute facilities Preventing falls amongst elderly patients at subacute facilities While falling can be dangerous for any individual, regardless of their state of health, due to elderly patient's greater fragility falls are particularly dangerous for seniors. Having a serious fall is one of the greatest predictors of future degeneration and fragility for older patients.

Although the common image of an elderly fall victim is someone who has 'fallen and can't get up,' and is lying alone at home, in subacute hospitals falls are reported to occur between 13% and 32% of admitted patients and in stroke rehabilitation units, falls have been reported in up to 47% of patients. Up to 70% of falls result in injuries and 1-10% of falls result in fractures as well as long-standing psychological effects for the elderly person (Haines et al. 2004).

Falls are costly for the patient's and the patient's family in terms of psychological distress and also for the subacute facility in terms of additional healthcare costs, when treating the patient. One recent study, as reported in the British Medical Journal found that a specific fall prevention program was extremely helpful in dramatically reducing fall rates. "Participants in the intervention group received a targeted falls prevention programme in addition to usual care.

This programme consisted of a falls risk alert card with information brochure, an exercise programme, an education programme, and hip protectors" (Haines et al. 2004). The type of intervention depended upon the patient's specific complaint, level of cognitive impairment, and age. Regardless, all 310 patients who received intervention and care showed a significantly lower rate of falls than the 316 in the control group: 30% less. Current research conducted by Dr.

Andrea Trombetti of the University Hospitals and Faculty of Medicine of Geneva suggests that many types of educational programs can be helpful for the elderly in preventing falls -- the important thing is that an interventional fall-prevention program is indeed undertaken. A trial of 134 people, average age 75, with notable unsteadiness and identified as being at high risk for falls received weekly hour-long eurhythmics sessions.

Eurhythmics focuses on teaching movement in time to music, having patients "walk and turn around, stay in step with changing tempos, learn to shift their weight and balance, handle objects while walking, and make exaggerated upper-body movements while walking" (Rabin 2010). Only 24 of the elderly patients in the experimental group experienced falls, versus 54 in the control group, suggesting that intervention of various kinds can have a demonstrable positive effect for the elderly.

Despite the small number of participants in the study, the difference between the two groups is significant Balance is a skill that can quickly deteriorate with age, if not reinforced. In another recent study comparing the balance of healthy elderly volunteers (average age 75), with undergraduates, despite the fact that the older individuals were in good health and exercised an hour a day: "They thought they were in good shape and had good balance.

It scared them a bit, frankly, to see how awful their balance really was" compared with younger test subjects (Reynolds 2010). After several sessions using a Wii Fit, the popular video exercise system, the older subjects showed significant improvement in their ability to engage in simple balance exercises, such as standing on one foot. After the intervention the subjects tested eight years 'younger' than they had previously.

Additionally, in another "representative case study published last year found that an 89-year-old woman with a balance disorder and a history of falls significantly improved her scores on a series of balance tests after six sessions of Wii Bowling" (Reynolds 2010). Education in balance-awareness for older adults can be empowering as, regardless of the subjects' initial state of fitness, being able to demonstrably improve their balance gives the elderly a greater sense of control over their bodies and state of health.

According to the Centers for Disease Control, muscle-related problems and a lack of exercise account for about 24% of the falls in subacute facilities. Other causes, which can also be easily addressed within subacute facilities, "include wet floors, poor lighting, incorrect bed height, and improperly fitted or maintained wheelchairs" (Falls in nursing homes, 2010, CDC). These types of environmental hazards are estimated to cause 16% to 27% of falls for patients.

Even seemingly unavoidable problems such as medications that interfere with coordination can be mitigated by flagging the individual as taking such a drug, and notifying staff that additional care of the patient is required. In the instances of patients with dementia, or those who cannot care for themselves enough to learn to improve their balance skills to mitigate the risk of falls, measures other than educational endeavors should be undertaken.

"Grab bars, adding raised toilet seats, lowering bed heights, and installing handrails in the hallways," as well as "providing patients with hip pads that may prevent a hip fracture if a fall occurs" and "using devices such as alarms that go off when patients try to get out of bed or move without help" are helpful in these instances (Falls in nursing homes, 2010, CDC). The Haines (et al.

2010) study merely identified a general fall mitigation program, including both exercise and environmental changes, but to most effectively treat patient needs, engaging in some 'triage' efforts will enable the staff to more appropriately structure a fall prevention program. A 2003 multifactor review of contributing factors to falls amongst the elderly yielded the surprising finding that, along with such expected fall-mitigation efforts as a pharmacist's review of medications, "Vitamin D supplementation may help reduce falls in elderly nursing home residents" (Barclay 2003).

While Vitamin D has been linked to a lower risk of osteoporosis, because of its bone-building attributes (along with calcium, zinc, and magnesium), falls in general were reduced amongst patients that received Vitamin D supplementation, according to the results of a systematic review reported online January 20 in the Cochrane Database of Systematic Reviews (Barclay 2003). In my own experience on a subacute unit, I have experienced the frustrations of dealing with patients who are often not cooperative with measures taken to prevent falls, such as when.