Risks Of Falls In The Elderly – Use this nursing diagnostic guide to help develop nursing plans and interventions for patients at risk for falls.
A fall is an event in which a person accidentally rests on the ground, floor or other lower surface (WHO, 2021). Falls put people at risk of serious injury and reduce their ability to live independently.
Risks Of Falls In The Elderly
According to the Centers for Disease Control and Prevention (CDC), falls are the leading cause of death among adults age 65 and older, accounting for more than 34,000 deaths in this age group. Falls are the second leading cause of death from accidental injuries worldwide. The decline in mortality among the elderly is a serious and persistent problem. It is estimated that the U.S. Between 2007 and 2016, the death rate increased by 30%. If this rate continues, the CDC expects seven deaths per hour by 2030. Injuries from falls are costly and result in prolonged hospitalization for the elderly. In 2015, the total medical costs of falls exceeded $50 billion and accounted for more than 3 million emergency room visits. In addition, the quality of life changes significantly after a fall. Falls are the most common cause of traumatic brain injury (TBI), and most hip fractures are caused by falls. More than 800,000 patients are hospitalized each year due to falls.
Overcoming The Fear Of Falling — More Life Health
Nurses play a major role in preventing falls by educating their patients, assessing fall risk, creating a safe environment, and providing interventions to prevent fall injuries.
Falls can have many causes and a holistic approach to the individual and the environment is important. Suppose a person is at high risk of falling after screening. In such cases, a health professional should perform a fall risk assessment to obtain a more detailed analysis of an individual’s risk of falling. Fall risk assessment requires the use of a validated tool that researchers have tested to be useful in identifying the causes of individual falls. As a person’s health and circumstances change, it should be reassessed.
1. Assess conditions associated with increased fall risk after any change in the patient’s physical or cognitive status, systematically during the hospital stay or at specific times in the long-term care setting:
The degree of risk of falling can be determined by assessing internal and external factors. Standard assessment tools can also be used (see below). Nurses should consider these factors when planning care for patients at risk of falling.
Common Causes Of Falls In People With Dementia
A person is likely to relapse if they have had one or more relapses in the past six months. The elderly population is at increased risk for fall-related readmissions based on studies identifying factors that predict fall-related outcomes (Prabhakaran et al., 2020).
Individuals with reduced awareness and disorientation may not understand where they are or what to do to help themselves. They may migrate from one place to another, which may endanger their safety. In addition, confusion and impaired judgment increase the likelihood of a patient falling.
People’s ability to protect themselves from falls is influenced by factors such as age and development. Elderly people with weak muscles are more likely to fall than those who maintain muscle strength, flexibility and endurance. These changes include reduced visual function, impaired color perception, changes in the center of gravity, unsteady gait, reduced muscle strength, reduced endurance, altered depth perception, and delayed response and reaction time.
In older adults with age-related macular degeneration, increased vision loss is particularly associated with a higher incidence of falls and other injuries. Low contrast sensitivity was associated with increased rates of falls and other injuries, while reduced visual acuity was only associated with increased rates of falls (Wood et al., 2011).
Advancing Evidence Based Approaches To Falls Prevention Among Older Adults
Sensory perception of environmental stimuli is extremely important from the point of view of safety. Impaired vision and hearing limit the patient’s ability to perceive the dangers around them. Older adults living in homes with dimly lit kitchens and crowded entryways or yards are at increased risk of falling (Huang, 2004).
Older adults who have poor balance or difficulty walking are more likely to fall. These problems may be related to lack of exercise or neurological causes, arthritis or other medical conditions and treatments. An important risk factor highlighted in the study is that adults with arthritis have a higher risk of falls, which is characterized by lower limb swelling and tenderness. joints, fatigue and use of psychotropic drugs (Stanmore et al., 2013).
Incorrect use, selection, and maintenance of mobility aids such as canes, walkers, and wheelchairs can increase energy expenditure, unstable gait, overload, and joint damage, and ultimately increase the patient’s risk of falling. Older adults who are frail and do not use ambulatory aids are more common in their daily activities (Cruz et al., 2020). Educational programs should be developed to promote the appropriate use of ambulatory assistive devices among the frail elderly.
There was an increased incidence of falls in patients presenting with symptoms such as orthostatic hypotension, decreased cerebral blood flow, urinary disturbances, oedema, dizziness, weakness, fatigue and confusion. Patients with certain diagnoses experienced greater decline than others. For example, stroke patients are more likely to fall than other patients, which increases their length of stay and increases their medical costs during physical rehabilitation (Salmon et al., 2012). Patients with orthostatic hypotension, whose blood pressure often drops upon standing, may experience lightheadedness or dizziness, which may lead to falls.
Digital Assessment Of Falls Risk, Frailty, And Mobility Impairment Using Wearable Sensors
Risk factors for falls include the use of medications such as blood pressure medications, ACE inhibitors, diuretics, tricyclic antidepressants, alcohol consumption, anti-anxiety medications, opiates, and hypnotics or sedatives. Older adults often take a variety of medications to treat a variety of chronic conditions. Drug use and falls (Ralimi & Jecker, 2009). Medications that affect blood pressure and level of consciousness are associated with the greatest risk of falls.
If the score is greater than 6, the risk of falls is increased, a medication evaluation is needed for possible medications to reduce the risk of falls.
Ill-fitting or too-tight clothing and shoes can restrict a person’s movement and movement, increasing the risk of falling.
A person is more likely to fall if the environment is unfamiliar, such as placing furniture and equipment in an area. Increased exposure leads to greater exposure to environmental hazards in healthy older people than in healthy older people. The risk of such falls increases outdoors (Lord et al., 2006).
Medications And Falls — Do I Still Need This Medication? Is Deprescribing For You?
The nurse may need to assess the home, work, or community environment. Clutter in the house, thrown rugs, lack of lighting, broken or uneven steps can cause tripping. Poor lighting, being in an unfamiliar environment, wet floors or surfaces, clutter, slippery floors, and obstacles on the floor all increase the risk of a patient falling. Workplaces that require stairs can also cause occupational hazards in the workplace. In communities, inadequate street lights or unsafe streams and landfills can lead to accidents.
The Falls Risk Assessment Tool (FRAT) is a 4-item fall risk screening tool for subacute and residential care. FRAT consists of three parts: fall risk status, risk factor checklist and action plan.
The Hendrich II fall risk model determines fall risk based on gender, mental and emotional status, vertigo symptoms, and known drug categories. Risk points are assigned to each fall risk factor based on the test results. If a patient provides a score for a risk factor, the corresponding number of points is calculated in the field to the right of the patient’s fall risk score. If the patient’s total fall risk score is five or higher, then the risk of falling is high. If the patient scores only four or less, the patient is still at risk for falls, and the nurse should use best clinical judgment to address fall risk factors as part of the overall care plan.
4. Pediatricians assess clients for sensory or motor deficits, recent illness, unstable balance, running faster than capacity, and inadequate supervision.
Fall Prevention Program
1. Create a personal care plan to prevent falls. Creates a personalized care plan that is tailored to the patient’s unique needs.
Nursing in any health care environment requires the planning of a personalized fall prevention program and a multifaceted approach. Don’t rely too much on one fall prevention solution because different individuals have different needs. Universal fall precautions were implemented to reduce the risk of falls for all patients. These standard guidelines generally help create a safe environment that reduces the number of accidental falls and communicates the most important preventive measures to all patients.
2. Designate signs or safety armbands for patients at risk of falling to remind healthcare providers to implement fall precautions.
Signs are important for patients at risk of falling. Health care providers need to recognize whose condition they have because they are responsible for promoting patient safety and implementing measures to prevent falls. Use two patient identifiers when providing care, treatment and services. For example, the wristband should include the patient’s first and last name, date of birth and NHS number.