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Fall Prevention

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by

Meg Carroll

on 7 February 2014

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Transcript of Fall Prevention

Fall Prevention
Evaluation
Evidence-Based Research
A fall prevention program for elderly individuals: Exercise in long-term care settings

Setting: Participants were selected from 2 long-term care facilities located in the Midwest US
Participants: 16 participants, ages range from 65-95.
Study Design: A pretest-posttest design was used to evaluate changes. Baseline was assessed and then reassed again at 3 months and 6 months after initiation of the intervention.
Intervention: Intervention included supervised exercising was completed three times weekly for 3 months, lasting approximately 20 minutes each time.
Outcomes: Standing balance, walking endurance, and ankle strength increased in the intervention group at both 3 and 6 month post-tests. The only area that did not show improvement was the participant’s fear of falling across every participant.
Best evidence:
Fall Prevention in the Elderly
Facts
The risk of falling increases with age and is greater for women than for men.

Two-thirds of those who experience a fall will fall again within six months.

About 50 percent of the elderly who sustain a fall-related injury will be discharged to a nursing home rather than returning to home.

Falls account for 25% of all hospital admissions and 40% of all nursing home admissions.

The costs for treatment & rehabilitation of the injuries related to falls average over 70 billion dollars a year.
A fall is defined as failure to maintain an appropriate lying, sitting, or standing position resulting in an individuals abrupt, undesired, relocation to a lower level.
Education
Educate caregivers in physical activities the resident can do
Train caregivers in appropriate exercise/activity program
Modify environment to promote best ability to function
Identify activities appropriate for cognitive and physical abilities
References
Bonder, B.R., & Bello-Haas, V.D. (2008).
Functional performance in older adults
(3rd Ed.). Philadelphia: FA Davis

Chase, C. A., Mann, K., Wasek, S., & Arbesman, M. (2012).
Systematic review of the effect of home modification and fall prevention programs on falls and the performance of community-dwelling older adults
. The American Journal of Occupational Therapy, 66(3), 284-291. Retrieved from http://ajot.aotapress.net/content/66/3/284.full.pdf+html?sid=ec0a5754-e1e7-48f3-a74a-f7ef57882305

Functional Pathways (2012). Pathways to safety: Pathway to fall prevention and balance

Hendrich, A. (2013). Fall risk assessment for older adults: The hendrich II fall risk model.

Schoenfelder, D., P. (2000).
A fall prevention program for elderly individuals: Exercise in long-term care settings
. Journal of Gerontological Nursing,
26(3)
, 43-51.


Risk Factors

Muscle weakness & fatigue
Balance & coordination deficits
Impaired vision
Auditory changes
Somatosensory-sensory input recognition
Neurological changes & cognitive deficits
Medications
Environmental Hazards
Fear of Falling
Etiology
Physiologic changes of normal aging may increase the risk of falls. For example, with normal aging there is diminished input from the visual, proprioceptive, and vestibular systems, which may result in alterations of balance.
Age-related physiological changes
Disease/Medical conditions
Medications
Environmental Hazards

Evaluation -- Has the older person experienced a fall?

Yes- Fall assessment
Muscle Function & Strength
ROM
Balance
Postural Stability
Gait & Functional Mobility
Coordination & Motor Planning
Sensory Motor
Visual Discrimination & Processing
Pain
Cognition


Therapeutic interventions should address all of the impairments noted during the evaluation process and be a stepping stone to the achievement of therapy goals
Cognitive level
physical abilities
assess the environment/need for modifications

Falls Efficacy Scale
Helps identify if the individual has a fear of falling

Fall Prevention Home Assessment Chart
Environmental Strategies
Increase lighting
arrange furniture & remove obstacles
install railings, grab bars, transfer poles
Treatment & Intervention
No- Fall risk assessment
The Hendrich II Fall Risk Model

Acute care setting
Identify adults risk for falls based on:
Gender
emotional status
symptoms of dizziness
medications
Evaluation Continued

Systematic review of the effect of home modification and fall prevention programs on falls and the performance of community-dwelling older adults

Setting: Homes of Participants
Participants: community-dwelling older adults
Study Design: Systematic Review
Intervention: The strongest results were found for multifactorial programs that included home evaluations and home modifications, physical activity or exercise, education, vision and medication checks, or assistive technology to prevent falls.
Outcomes: Positive outcomes include a decreased rate of functional decline, a decrease in fear of falling, and an increase in physical factors such as balance and strength.
Evidence-Based Research
BY: Ashley Babilya, Meg Carroll, Jill DiCola, Jerrika Hooven, Alyssia Marshall
Full transcript