Upload
juliet-bridges
View
219
Download
2
Tags:
Embed Size (px)
Citation preview
Health Care Professional Educational Module
Module GoalsModule Goals
To increase: Health care professional knowledge about
falls-related issues and prevention interventions among older adults
The number of health care professionals who attend the Stand Strong for Life: Health Care Professional Educational module
The number of health care professionals who educate older adults about fall prevention using the Stand Strong for Life intervention
To Increase: The number of health care professionals
who attend the Stand Strong for Life: Health Care Professional Educational module
The number of emergency departments, hospitals, and senior living facilities that implement falls prevention initiatives
Community partnerships among health agencies to increase falls prevention among community-dwelling older adults
Module GoalsModule Goals
Intervention ContentIntervention Content
Stand Strong for Life: Health Care Professional Educational Module
Stand Strong for Life: Community-dwelling older adults PowerPoint presentation
Four brochures that accompany the community-dwelling older adult presentation
Resources and Tools
Definition of FallDefinition of Fall
A fall is “any event in which a person unintentionally comes to rest on the ground or another lower level such as a chair, toilet, or bed.”12
Scope of the ProblemScope of the Problem
For adults 65+, falls are the leading cause of injury-related death3,4
Each year, more than one-third of older adults fall5-9
In 2004, 2.9 M older adults were treated for non-fatal injuries in U.S. emergency departments; of those, 1.9 M were the result of falls10
Nearly one-half of all falls among older adults occur in or around their homes10
Scope of the ProblemScope of the Problem
Of those who fall, 20% to 30% suffer moderate to severe injuries13
Nearly 50% of those hospitalized after a fall die within one year9
In 2003, nearly 13,820 older adults died from fall-related injuries: of those, approximately 50% were age 85 and older.10
Cost of Falls Among Cost of Falls Among Older AdultsOlder Adults
Fall-related injury costs $20 billion per year21
By 2020, total annual direct cost is expected to reach $32,4 million21
Direct costs do not account for the long-term consequences of these injuries22
Challenges to Be MetChallenges to Be Met
Between 2000 and 2030, the older adult population (65+) is projected to grow from 35 million (12.4% of the population) to over 70 million (20% of the population)1,2
The U.S. public health service estimates that 66 percent (2/3) of deaths related to fall are preventable14
How do we go about facing the challenge of reducing falls and fall-related injuries among older adults?
Risk FactorsRisk Factors
Internal – integral to patient’s system Medical conditions Aging process
External – physical environment Living environment Emergency Department/Hospital/
Senior Living Facility Outdoors
Falls among older adults are usually not the result of a single risk factor, but of a combination of internal and external factors24
Internal Risk FactorsInternal Risk Factors
History of Falls (Previous Falls) Medication use (Polypharmacy) Balance, gait, and muscle strength
(Lack of Physical exercises) Vision impairment Podiatric problems
Older adults who have previously fallen or who stumble frequently are 2 to 3 times more likely to fall within the next year9,25,33
Previous falls often leads to fear of falling, which may lead to decreased activity and loss of self-confidence27
History of Falls History of Falls (Previous falls)(Previous falls)
FALL
DECREASED ACTIVITY
FEAR OF FALLING
REDUCED ▪ MUSCLE
STRENGTH▪ BALANCE
AND GAIT▪ FLEXIBILITY
DECREASED FUNCTIONAL
ABILITY
History of Falls History of Falls (Previous falls)(Previous falls)
Visual ImpairmentVisual Impairment
Poor visual acuity27
Older adults experience decreased night vision, altered depth perception, decline in peripheral vision, and glare intolerance25,37
Also be aware of old or new prescription glasses27
Medication Use Medication Use (Pol(Polypharmacy)ypharmacy)
Types of medications25,32
Psychoactive medicines
Number of administered or prescribed medications (polypharmacy)25,27
Rule of thumb: 4 or more medications
Number and types of over-the-counter medication (NSAIDs, vitamins, supplements, homeopathy, etc.)
Balance, Gait, and Muscle Balance, Gait, and Muscle Strength Strength (Lack of physical activity)(Lack of physical activity)
Less than 25% of older adults exercise regularly40
By age 65, a 20% decrease in strength and flexibility usually occurs41,42
After age 70, decrease in strength is even greater 41,42
Podiatric ConditionsPodiatric Conditions
Nearly 75% of older adults have some type of foot and ankle problems49
Decreased sensation in the feet21
Foot conditions can impair balance function50
External Risk FactorsExternal Risk Factors
Unsafe home environment Inadequate footwear Unsafe outdoor environment Unsafe emergency department/
hospital/facility environment
Unsafe Home Unsafe Home EnvironmentEnvironment22,2522,25
Slippery flooring and carpeting Use of throw rugs Inadequate furnishing design and
position Poor lighting Lack of equipment in bathroom and
bathtub Lack of or structurally unsecured
handrails Clutter Inadequate assistive devices
Inadequate FootwearInadequate Footwear
Improper shoes can:27 Lead to painful mobility Increase potential for feet problems Prevent older adults from staying active Increase the risk for falls
Unsafe Unsafe Outdoor Outdoor EnvironmentEnvironment
Uneven sidewalk, terrain, curbs, sidewalks
Lack of or structurally unsecured handrail
Hazardous materials (ice, snow, gravel, etc.)
Poor lighting
Unsafe Unsafe ED/ED/Hospital/Facility Hospital/Facility EnvironmentEnvironment
Transfer to or from a bed or chair17 Bed height16
Attachment to equipment (IV, oxygen)17
Slippery floors Lack of assistive devices Clutter, tripping hazard Unreachable bell, side table Improper lighting
Mechanical restraints19,20
The goal of a falls prevention program is to reduce the
number of risk factors
How Can You Prevent How Can You Prevent Falls From Occurring?Falls From Occurring?
Intervention ModelIntervention Model
Community Setting Presentation/Intervention
Emergency department, hospital, senior living community Intervention
Falls-Risk AssessmentFalls-Risk Assessment(Previous falls)(Previous falls)
Falls-Risk Assessment Tools Morse Fall Scale (MFS) Hendrich II Fall Risk Scale Falls – Assessment/Screening/
Diagnosis Scale
Falls-Risk AssessmentFalls-Risk Assessment(Previous falls)(Previous falls)
Community Presentation Conducted before presentation
Emergency Department, Hospital, or Senior Living Community Conduct screening when fitting
(triage, admission, move-in)
Vision ExaminationVision Examination(Visual impairment)(Visual impairment)
In all settings Educate older adults Refer to primary care provider for
regular eye examinations
Medication ReviewMedication Review(Polypharmacy)(Polypharmacy)
Community Presentation Educate older adult Refer to primary care provider or
pharmacist Distribute Safe Medication Card
Emergency Department, Hospital, or Senior Living Community Educate older adult Refer to primary care provider or
pharmacist Refer to Stand Strong for Life Distribute Safe Medication Card
Physical ActivityPhysical Activity(Reduced balance, gait, and (Reduced balance, gait, and muscle strength)muscle strength) Community Presentation
Educate older adult Distribute and Practice Healthy Movements Distribute Health Calendar Contract Refer to primary care provider or community
and home health services
Emergency Department, Hospital, or Senior Living Community Educate older adult Distribute Healthy Movements Refer to Stand Strong for Life (medium and
high risk)
Examples of Physical Examples of Physical ActivitiesActivities
Walking Gardening Dancing Strength, resistance, and flexibility
exercises Yoga Tai Chi
In-Home safetyIn-Home safety(Unsafe home environment)(Unsafe home environment)
Community Presentation Educate older adult Distribute Check for Safety: A Home Fall
Prevention Checklist for Older Adults brochure Refer to community and home health services
Emergency Department, Hospital, or Senior Living Community Educate older adult Distribute Check for Safety brochure Refer to Stand Strong for Life community
presentation (medium and high risk) Refer to community and home health services
In-Home Modifications and In-Home Modifications and Assistive Devices Assistive Devices
Widening doorways Remove any clutter (staircase, floor) Remove throw rugs Remove electric cords Install railings on stairways Install grab bars in bathtub, shower, and
by toilet Use shower chair Install raised toilet seat
Feet and Footwear CheckFeet and Footwear Check(Podiatric problems and inadequate (Podiatric problems and inadequate footwear)footwear) Community Presentation
Educate older adult Distribute Foot and Footwear Check brochure Refer to primary care physician and home
health services, if needed Emergency Department, Hospital, or Senior
Living Community Educate older adult Distribute Foot and Footwear Check brochure Refer to Stand Strong for Life community
presentation Refer to primary care physician and home
health services, if needed
Adequate/Inadequate Adequate/Inadequate FootwearFootwear Adequate
Proper fit Non slippery soles Low heels
Inadequate Floppy slippers Loose fitting Wearing socks only
Assistive DevicesAssistive Devices
Cane Walker Hip protectors Grip bars Shower chair Raised toilet seat
Community Services and Community Services and ReferralsReferrals
Home care service agencies Personal trainer or exercise
program dedicated to older adults Social services Day care Meals on Wheels