by Aurora Cyganik-Barker, RN, BN

Falls are a huge concern, regardless of the setting. They account for almost half of patient safety incident reporting, and cost the health care system hundreds of thousands of dollars every year as result of hospital admissions, long term care admissions, and surgeries. Did you know that 1 in every 3 seniors will have a fall each year, and half of those will fall more than once? From this third of seniors that will fall, almost half will fracture a hip, and looking back at injury-related deaths among seniors, 20% began with a fall. Falls occur for various reasons, but common contributing factors include: impaired hearing, vision, mobility, reflexes, senses, arthritis, advanced age, disease process (think Parkinson’s, Huntington’s etc.), polypharmacy and many, many more.

There are some ways to help reduce the number of falls experienced by seniors, both in care and in the home. More falls occur within the home than any other setting. There are some simple strategies to prevent falls at home. Non-slip surfaces in bathrooms and kitchens are a good first step. My brother decided to help my mother clean her house when he last visited. Help is always appreciated, and he waxed the linoleum in the bathroom until it shone. It looked great, but in reality, it was an accident waiting to happen. Areas that have the potential to become wet with spilled liquid should be as non-slip as is possible. Mats in tubs and showers help, and there are non-slip floor waxes available.

Other tips for the home include the removal of scatter mats and general clutter. The less there is to trip on, the better. Good lighting on the stairs and solid handrails will make this potential hazard that much safer. Night lights can be helpful, especially for those middle of the night trips to the bathroom. Keeping kitchen items within easy reach can prevent any ladder or stepstool climbing, and keeping heavier items on the lower shelves is also a good idea.

In the UK, statistics show that residents of care facilities are 40% more likely to fall than those in the community. There are also many pearls and tips to prevent falls from happening in care facilities. Medications are huge contributors to falls. If a patient is on many medications, they should be flagged as higher fall risk, whether it is a paper or electronic system. Medication changes, especially concerning sedatives or antipsychotics should also be a red flag as far as falls are concerned. Some studies suggest that vitamin D supplements lower the incidence of falls, and exercise programs also help. Fall risk assessments should be performed regularly on each resident, and then acted upon. If a resident is identified as high risk, there should be a protocol in place to address their safety needs.

Most falls occur as residents travel to the bathroom, so teaching regarding ringing for assistance is crucial. A strategy that has proved successful in New Zealand is bedside handovers. Instead of hearing a report in a closed room, handover occurs literally at the bedside, and the patient is involved in the discussion. Hourly rounding and staggered staff breaks also made a huge difference in the number of falls at these facilities, as well as increasing resident satisfaction. Finally, there is a link between low staff to resident ratio and increased risk of falls. However, the evidence also supports the fact that clinical staff knowledge regarding falls is a stronger influence on fall reduction than staff to resident ratios. The bottom line is that we have to identify those at high risk and take the necessary precautions. Through educating staff about fall risk and prevention, we may be able to lower the number of falls we see in our workplaces. However, falls do happen, and my next blog addresses what to do if it happens to you.

If you are considering a new rewarding job in senior living or in senior care nursing, therapy or administration, be sure to search NSLPN.com for the latest senior care jobs available including Home Health Jobs, Hospice Jobs, Nursing Home Jobs, Independent Living Jobs, and Assisted Living Jobs.

By Eleanor Feldman Barbera, PhD

A little over a year ago, I decided to stop coloring my hair (Going Gray). I’d started to feel uncomfortable hiding my silver while I was spending my days helping folks deal with growing older. I kept a box of fire red in the closet, though, just in case it was a disaster.

I got through the difficult early phase (Going Gray Update) by hiding my hair under thick headbands that (mostly) covered the gray.

I kept going through the multi-colored stage (Going Gray Update #2), emotionally fortified by splurging on great cuts by Stacey Lyn Weinstein of Loft 26 in Manhattan.

And now I’m done!!! And I love it. I’m a silver sister. Thanks, to those who encouraged me along the way.

For more blogs by Eleanor Feldman Barbera please see her blog at http://mybetternursinghome.blogspot.com/.

If you are considering a new rewarding job in senior living or in senior care nursing, therapy or administration, be sure to search NSLPN.com for the latest senior care jobs available including Home Health Jobs, Hospice Jobs, Nursing Home Jobs, Independent Living Jobs, and Assisted Living Jobs.

I am sure that you will agree that people with Alzheimer’s disease and other dementias want to communicate with us even though they often can no longer do so directly. As their caregivers we must do the greater part in securing an understanding of their needs, their feelings and communications.

I often had chance to listen carefully to my mother in the early stages of her dementia. One night as we returned home, she was enchanted by the red moon sinking low in the western sky. We stood together in darkness watching for a long time at the back door.

She recalled that red moon the next day. “Did you see it? Must be burying something, or someone,” she said. Then looking at the calendar she became engaged in deep thought.

“The moon was burying a few days,” she said with certainty making sure that I was listening to her. “The moon is not always there. It hides sometimes.”

When I asked her if it was the new or old moon – she knew it was the new moon, although she could not answer the correct year or month. The native ways of counting and observing are still sharp, although the brain damage of dementia causes loss of socialized learning and language.

The moon is the biggest object in the sky next to the sun visible to the naked eye. The moon moves more quickly than any other planet. The moon never looks the same two nights in a row. Yet how many of us pause to observe and interpret like my aging mother the many moons luminous changing gestures? 

Understanding the simplicity with which persons who are memory impaired can look at things gives you a better understanding of how to approach sensitive and humane caregiving.