Facts About Falls

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2 Νοε 2013 (πριν από 4 χρόνια και 6 μήνες)

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Facts About Falls

Jo A. Taylor, RN, MPH

Older Adult Population

34.9 million people 65 years and older in the
US (13% of the population)

By 2030, 71 million or 20% of US population

Over 1/3 of all older adults fall each year

30% have moderate to severe injures

Fall risk increases with age

Falls in Older Adults

Most common cause of nonfatal injuries and
hospital admissions for trauma

72% of fall related deaths occur in 13% of
older adult population

Most common cause of nonfatal injuries and
hospital admissions for trauma

Falls Have Serious Consequences

Serious injury like hip fracture & brain injury

Increased risk of death

Loss of independence

Decreased ability to function

Increased need for care

Loss of self confidence and fear

Even without injury, falls lead to fear of falling
with self imposed restriction of activity and
reduced social interaction.

decreased quality of life

Healthcare Costs

Direct medical costs in 2000 were $19 billion
for nonfatal fall injuries

By 2020, the annual direct and indirect costs
of fall injuries is expected to reach $43.8

Older Adults in Nursing Homes

Over 50% fall each year

Of those, 30
40% will fall again

Why Do Residents Fall?

verage age at admission is 82.6 years

Over 50% have 3 or more admitting diagnoses

48% receive full
time skilled nursing care
under a physician’s supervision, 98% require
help with bathing and 45% with eating

Intrinsic Fall Risk Factors

Effects of aging


decreased acuity, decreased contrast
sensitivity, increased sensitivity to glare, decreased
peripheral vision, decreased night vision


decreased sensitivity

Changes in gait and balance

reduced arm
swing, decreased step length, slower reaction time,
slower movements, weakness


feelings of urgency and frequency

Intrinsic Fall Risk Factors

Acute disease such as pneumonia and urinary
tract infection and chronic disease such as

stroke, diabetes & Alzheimer’s disease

Examples of symptoms:

Confusion, impaired judgment, agitation

Weakness, dizziness, fainting

Paralysis, tremors

Lower extremity weakness


Intrinsic Fall Risk Factors

Side effects of medications

Drowsiness, over sedation

Agitation, confusion, pacing

Weakness, unsteadiness,

Gait disturbances

Dizziness, low blood pressure

Extrinsic Fall Risk Factors





Unstable furniture

Hard to reach personal items

Unsafe footwear

New admissions


Missing wheelchair parts

Incorrect wheelchair fit

Inadequate wheelchair seating

Broken wheelchair parts

Research Evidence

Fall reduction programs are effective when
they have

interventions that target
individual risk factors

Physical restraints do not reduce falls and are
associated with soft tissue damage, injuries,
fractures, delirium and death

It is impossible to prevent all falls in frail, older
nursing home residents but it is possible to
reduce risk.

Staff Strategies to Reduce Fall Risk

Falls assessment to determine high risk
medications, unsafe behavior, vision loss,
impaired gait and mobility and postural

Medical evaluation

Medication review

Gait and balance training

Staff Strategies to Reduce Fall Risk

Protective equipment (e.g., hip protectors,
helmets, wrist protectors)

Individualized wheelchair seating

Low beds, mats

½ or ¼ side rails

Alarms, sensors

Specialized chairs

Staff Strategies to Reduce Fall Risk

Toileting assistance


Muscle strengthening and balance training

Behavioral strategies

How Families Can Help

Remove clutter and keep pathways clear

Provide safe footwear

Promote safety during transfer and mobility

Use low blood pressure precautions when

Remove Clutter

Keep pathways around the bed and to the
bathroom clear

Provide only stable furniture from home

Remove items that are no longer needed

Help to keep personal items within easy reach

Provide Safe Footwear

Shoes and slippers with tread or non
soles, with firm shape and low, even heels


tennis shoes with Velcro fasteners,
oxford style shoes, canvas or leather slip
and fitted slippers with some form of tread

skid socks can be useful to wear at night

Promote Safety During Transfer

Call for help from staff when unsure about

Provide easy to manage clothing with elastic
waist and Velcro fasteners

Lock wheelchair brakes before transfer

Keep all seating items in the wheelchair

Use Low Blood Pressure Precautions

For residents with low blood pressure:

Sit on edge of bed and dangle feet before

Flex feet backwards several times before

Do not tilt head backwards

Get up slowly with assistance

Report dizziness

Reducing the fall risk of our residents
is a challenge. With your help, we
can do a better job.

Thank you for your time and support.