Health Promotion:Safety and The Elderly PopulationChelsea KimbelKim Larson-HuntSandra KolkNathan Griswold

Vulnerable Population: Elderly

Persons 65 or older Why? Fall Risks Physical/Mental Impairments

GeneralizedRisk factors amongst the elderly Injury Nutrition Deficit Social isolation/Depression Dementia, Alzheimer Muscle atrophy/weakness Compromised Immune system

Literature Review 1

Research/Findings Falls increase morbidity and mortality among elderly Burden on caregivers Increased hospital visits

Increase Physical Activity and reduce or modify risks Implement exercises classes for older people Increasing the knowledge, skills, and attitudes about fall prevention in the

community

Literature Review 2-Elderly 10x more likely to be hurt from a fall-Fall prevention exercise programs appear to

be effective-Cognitive functioning is an important factor

Literature Review 3

Most common unexpected death among the elderly

Vitamin D correlates with improved balance and walking

Vitamin D deficiency related to muscle weakness

Statistics “Elderly individuals were reported to be 10 times more likely to be

injured by falling on the floor (Kim, Moonyoung & Duk-Hyun, 2013, p.651).

“The prevalence of falls in the elderly is high and strongly correlated with age, increasing from 30% in subjects over the age of 65 to 50% in subjects over the age of 80 . Falls represent the commonest accident of daily living (Annweiler, Montero-Odasso, Schott, Berrut, Fantino, Beauchet, 2010, pg.1)”.

“It is estimated that a fall accompanied by injuries in community-residents aged 72 and over resulted in increased total costs of $19,440 ($5323 nursing home, $11,042 hospital). The mean hospital costs were estimated at $16,030, close to that for acute care by Teresi, et al. (2013, p. 450).

Poulos et al. Australia and New Zealand Health Policy 2007 4:6   doi:10.1186/1743-8462-4-6

Fall Risks and the Elderly: Current CDC- “Stopping elderly accidents, deaths, and

injuries” created for Physicians Risk Assessment by physician Treatment of risk factors Referral to fall prevention programs in the

community Australian “Stay on your feet” program.

Raising awareness, policy development, education, home hazard reduction

Fall risks among the elderly is an urgent public health challenge (Klein, 2014).

Fall Risk in hospitals 65+ are automatically a fall risk Fall risk assessment Yellow rubber soled socks Fall Risk bands, gait belt

Fall Risks: Trending “A 2008 meta-analysis showed the greatest effects on fall rates

were from programs that included a combination of a higher total dose of exercise (> 50 hours during the trial period) and challenging balance exercises”. (Al-Aama, 2011, para, 24)

According to the CDC article “ Be mindful of medications. Some medicines—or combinations of medicines—can have side effects such as dizziness or drowsiness. This can make falling more likely. Having a doctor or pharmacist review all medications can help reduce the chance of risky side effects and drug interactions”.

An article by the American Academy of Orthopedic Surgeons- A poor diet and not getting enough water will deplete strength and energy, and can make it hard to move and do everyday activities”.

Life Alert: Since 1987-Used for many different medical emergencies including falls-Very beneficial to elderly with high fall risk, who live alone, or who have a history of repeated falls

Health Promotion: Plan of action

Education of elderly and caregivers Where and when?

At discharge from hospital stays When starting medications that affect balance or dizziness In long term care facilities

About what? Exercise Willingness to learn and implement Environmental factors Effects of medication

Additional safety tips Mobility aids (canes, walkers) Grab bars in bathrooms Rubber Soled shoes De-clutter the home

Remove rugs and other hazards Consider alternatives for indoor pets

Dorothea Orems Theory “Self-care is a human need, self-care deficits

require nursing action” (Taylor et al., 2011, pg. 74) Falls place a burden on family members “Needs Theory describes people as whole, with

many complex needs that motivate behavior” (Maville & Huerta, 2013, pg.30).

Generalized weakness limits the ability to perform many self care needs Shower Cook exercise

Healthy People 2020“Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death.”

Strength and balance training will help to build muscles, decreasing generalized weakness, and increase prevention of falls, allowing for a higher quality of life.

Group exercises with functional balance exercises will allow the elderly to participate in a group setting, improving social interaction and improving physical mobility, and exercise also helps to prevent diseases and increase heart health.

Comprehensive geriatric assessments in nursing homes can help address areas that can focused on to help improve fall risk issues such as balance and generalized weakness.

Targeted hospital interventions will help prevent further injury when the elderly return home which could potentially result in death.

References Al-Aama, T. (2011). Falls in the Elderly: Spectrum and Prevention. Canadian Family Physician,

57(7), 771-776.

Annweiler, Cedric, Manuel Montero-Odasso, Anne Schott, Gilles Berrut, and Bruno Fantino. "Fall prevention and vitamin D in the elderly; an overview of the key role of the non-bone effects." Journal of Neuroengineering and Rehabilitation 7.50 (2010): pp 1-13.

Klein, Diana, Kilian Rapp, Michaela Kupper, Clemens Becker, and Torbin Fischer. "A Population-Based Intervention for the Prevention of Falls and Fractures in Home Dwelling People 65 Years and Older in South Germany." JMIR Publications 3.1 (2014).

Lynn, P.A., LeMone, P., Lillis, C., & Taylor, C. (2010). Fundamentals of Nursing: The Art and Science of Nursing (7th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.

Maville, J.A., & Huerta, C.G. (2013). Health Promotion in Nursing (3rd ed.). Clifton Park, NY: Delmar, Cengage Learning.

RealAge Test (2010). In Sharecare. Retrieved July 20, 2014, from http://www.sharecare.com/static/realage-test-marketing-landing?cbr=GGLE10037X

Won-Jin, Kim, Chang Moonyoung, and An Duk-Hyun. "Effects of a community-based Fall Prevention Exercise program on Activity Participation." Journal of Physical Therapy Science 26.5 (2013): pp 651-53.