Chapter 22 Risk Reduction

1. Chapter 22Risk Reduction

2. Older Adults and Safety Risks • Older adults face similar risks to adults of any age. • Age-related factors can: • Reduce capacity for self-protection. • Increase vulnerability to safety hazards. • Assessment should include a review of safety risks. • Preventive and corrective interventions should be planned.

3. Factors Contributing to High Elderly Susceptibility to Infections • Age-related changes • Altered antigen–antibody response • High prevalence of chronic disease • Atypical symptomatology • Often results in delayed diagnosis of infection.

4. Factors Leading to Safety Risks Involving Use of Drugs in Elderly • Altered pharmacokinetics • Self-administration problems • The high volume of drugs consumed by older individuals

5. Environment • Microenvironment: immediate surroundings with which we closely interact. • Furnishings, wall coverings, lighting, temperature • Macroenvironment: the elements in the larger world that affect groups of people. • Weather, pollution, traffic, natural resources

6. Factors Affecting Environment • Lighting • Temperature • Colors • Scents • Floor coverings • Furniture • Sensory stimulation

7. Factors Affecting Environment (cont.) • Noise control • Bathroom hazards • Psychosocial considerations

8. Factors Affected by Lighting • Function • Orientation • Mood • Behavior

9. Using Lighting to Promote Safety • Use several diffuse lighting sources. • Do not use fluorescent lighting. • Control bright lights and direct sunlight. • Use nightlights to provide visibility and orientation. • Use natural light to maintain body rhythms.

10. Effect of Temperature on Older Adults • Body temperature affects performance. • The elderly are especially sensitive to lower temperatures. • Environmental temperatures should not be lower than 75°F.

11. Effects of Color on Older Adults • Red, yellow, and white • Can be stimulating and increase pulse, blood pressure, and appetite. • Blue, brown, and earth tones • Can be relaxing. • Orange • Can stimulate appetite.

12. Effects of Color on Older Adults (cont.) • Violet • Can decrease appetite. • Green • Can give a sense of well-being. • Black and gray • Can be depressing.

13. Precautions for Use of Essential Oils • Do not ingest orally. • Keep out of the eyes. • Store away from sunlight, heat, and fire. • Assess for allergies before using.

14. Precautions for Use of Essential Oils (cont.) • Seek advice of aromatherapist before using with chemotherapy. • Be aware of sedative effect on certain medications. • Use pure essential oils, not artificial scents.

15. Risks Associated with Carpeting • Static electricity and cling • Difficult wheelchair mobility • Cleaning • Odors • Pests • Falls

16. Use of Furniture • Furnishings should be: • Appealing • Functional • Comfortable

17. Components of a Pleasing Environment • Textured wall surfaces • Soft blankets • Differently shaped and textured objects to hold • Murals; pictures; sculptures • Plants and flowers • Coffee brewing; food cooking; perfumes • Birds and animals • Soft music

18. Bathroom Safety • Lighting • Keep a small light on at all times. • Floor • Do not leave items on the bathroom floor, • Do not use throw rugs. • Faucets • Use color-coded, lever-shaped faucet handles.

19. Bathroom Safety (cont.) • Tubs and shower stalls • Use nonslip surfaces, grab bars, safety rails, and tub seats. • Toilets • Use grab bars or support frames; raised seats. • Electrical appliances • Monitor the use of electrical devices.

20. Respecting Personal Space • Define an area that is specifically the individual’s. • Ask permission before entering personal space. • Allow maximum control over personal space.

21. Enhancing Institutional Environments • Provide an attractive décor. • Include the individual’s personal possessions. • Respect privacy and personal territory. • Recognize the individuality of the resident. • Allow maximum control over activities and decision making. • Make environmental modifications to compensate for deficits.

22. Considerations for Reducing Safety Risks • Sufficient fluid intake • Adequate nutrition • Vision aids • Hearing aids • Stable body temperature • Infection prevention

23. Considerations for Reducing Safety Risks (cont.) • Sensible clothing • Cautious use of drugs • Crime avoidance • Safe driving

24. Early Detection of Illness • Older adults can: • Take their own temperature and pulse. • Listen to their own lungs with a stethoscope. • Observe changes in their own body fluids. • Identify effects of their medications. • Recognize symptoms that warrant evaluation.

25. Factors Contributing to High Risk of Falls • Age-related changes • Improper use of mobility aids • Medications • Unsafe clothing • Disease-related symptoms • Environmental hazards • Caregiver-related factors

26. Interventions to Address Safety Problems • Refer the individual to specialists. • Provide assistive devices and mobility aids. • Help the person to prepare and label drugs. • Arrange for community resources. • Instructing and support family caregivers • Modify the environment to reduce hazards.

27. Using Alternatives to Restraints • Place patient in room near nursing station. • Use supervision and companionship. • Use electronic alert devices. • Use comfort measures. • Use frequent reality orientation and diversional activities.

28. Source • Eliopoulos, C. (2005).  Gerontological Nursing, (6th ed.).  Philadelphia: Lippincott, Williams & Wilkins (ISBN 0-7817-4428-8).