Falls, particularly in the elderly, are responsible for most fractured or broken bones, and in many cases, these falls are preventable. An insecure floor mat, not using a cane or walking aid, getting in and out of chairs or beds unsafely, and certain medications are all common contributors to falls.
Changing the way people move is often a major challenge and for that reason Niagara Health launched a Falls Prevention Program to ensure our patients are properly assessed for risk of falling, either in hospital or when they return home.
The main goals of the program are to focus on prevention, conduct risk assessments and to educate patients and family members about how to prevent falls. Achieving these goals means increasing patients’ safety, mobility and independence.
Risk Assessment
Patients and pre-admit (surgical) patients are assessed for their risk of falling using a comprehensive process. Patients are assessed based on the following risk
- Any age with pre-existing condition such as Parkinsons, MS, Cerebral Palsy, etc
- Altered mental status – unable to follow instruction, impaired short-term memory, impaired thought process or conditions which increase agitation and impulsive behaviour
- Attempts to get out of bed/chair unsafely – impaired mobility or weakness and demonstrates poor judgement or experiences acute delirium (climbs over bed rail)
- Previous fall in past six months – related to patient condition, cardiovascular, neurological, metabolic, orthopaedic, acute illness or depression
- Impaired mobility (balance and gait) – shuffling, small steps, slow pace, uses gait aides, uses wheelchair or gerichair, holds onto people or furniture for support, inappropriate footwear, and/or unsteady when standing or sitting
- Generalized weakness – complains of dizziness, feeling weak, shaking
- Alterations in urinary elimination – frequency, urgency, nocturia, incontinence, IV, evening diuretics, indwelling catheter, briefs
- Medications within 24 Hours – psychotropics (i.e. benzodiazepines, anti-psychotics), anti-hypertensives, narcotics, anaesthetics, diuretics, anti-convulsants, eye ointments, polypharmacy (multiple medications)
- Other patient characteristics with increase fall risk – auditory, visual, sensory, fear of falling, language barrier, aphasia, substance abuse
A wide range of interventions are in place to reduce the risk of falling, such as:
- Encouraging family involvement
- Non-skid socks and/or shoes
- Allied Health professional consults such as occupational or physiotherapists
- Provide assistive devices such as walker or cane
- Install raised toilet seat
- Remove trip hazards, such as cords and scatter mats
- Modify clothing to avoid tripping
- Review medication regime
- Add night lights
- Check hearing aids and glasses
- Contact Hamilton Niagara Haldimand Brant LHIN for homecare support upon hospital discharge
Extraordinary Caring. Every Person. Every Time.
