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Health Care Professional Educational Module. Module Goals. To increase: Health care professional knowledge about falls-related issues and prevention interventions among older adults

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Presentation Transcript
module goals
Module 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
module goals3
Module Goals

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
intervention content
Intervention 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 fall
Definition 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 problem
Scope 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 problem7
Scope 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 older adults
Cost of Falls Among Older 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 met
Challenges 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 factors
Risk Factors
  • Internal – integral to patient’s system
    • Medical conditions
    • Aging process
  • External – physical environment
    • Living environment
    • Emergency Department/Hospital/ Senior Living Facility
    • Outdoors
slide11
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 factors
Internal Risk Factors
  • History of Falls (Previous Falls)
  • Medication use (Polypharmacy)
  • Balance, gait, and muscle strength (Lack of Physical exercises)
  • Vision impairment
  • Podiatric problems
history of falls previous falls
History of Falls (Previous falls)
  • 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
visual impairment
Visual 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 polypharmacy
Medication Use (Polypharmacy)
  • 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 strength lack of physical activity
Balance, Gait, and Muscle Strength (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 conditions
Podiatric 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 factors
External Risk Factors
  • Unsafe home environment
  • Inadequate footwear
  • Unsafe outdoor environment
  • Unsafe emergency department/ hospital/facility environment
unsafe home environment 22 25
Unsafe Home Environment22,25
  • 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 footwear
Inadequate 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 outdoor environment
Unsafe Outdoor Environment
  • Uneven sidewalk, terrain, curbs, sidewalks
  • Lack of or structurally unsecured handrail
  • Hazardous materials (ice, snow, gravel, etc.)
  • Poor lighting
unsafe ed hospital facility environment
Unsafe ED/Hospital/Facility Environment
  • 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
how can you prevent falls from occurring
How Can You Prevent Falls From Occurring?

The goal of a falls prevention program is to reduce the number of risk factors

intervention model
Intervention Model
  • Community Setting Presentation/Intervention
  • Emergency department, hospital, senior living community Intervention
falls risk assessment previous falls
Falls-Risk Assessment(Previous falls)
  • Falls-Risk Assessment Tools
    • Morse Fall Scale (MFS)
    • Hendrich II Fall Risk Scale
    • Falls – Assessment/Screening/ Diagnosis Scale
falls risk assessment previous falls27
Falls-Risk Assessment(Previous falls)
  • Community Presentation
    • Conducted before presentation
  • Emergency Department, Hospital, or Senior Living Community
    • Conduct screening when fitting (triage, admission, move-in)
vision examination visual impairment
Vision Examination(Visual impairment)
  • In all settings
    • Educate older adults
    • Refer to primary care provider for regular eye examinations
medication review polypharmacy
Medication Review(Polypharmacy)
  • Community Presentation
    • Educate older adult
    • Refer to primary care provider or pharmacist
    • Distribute SafeMedication 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 SafeMedication Card
physical activity reduced balance gait and muscle strength
Physical Activity(Reduced balance, gait, and muscle strength)
  • Community Presentation
    • Educate older adult
    • Distribute and PracticeHealthy 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 activities
Examples of Physical Activities
  • Walking
  • Gardening
  • Dancing
  • Strength, resistance, and flexibility exercises
  • Yoga
  • Tai Chi
in home safety unsafe home environment
In-Home safety(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 assistive devices
In-Home Modifications and 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 check podiatric problems and inadequate footwear
Feet and Footwear Check(Podiatric problems and inadequate 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 footwear
Adequate/Inadequate Footwear
  • Adequate
    • Proper fit
    • Non slippery soles
    • Low heels
  • Inadequate
    • Floppy slippers
    • Loose fitting
    • Wearing socks only
assistive devices
Assistive Devices
  • Cane
  • Walker
  • Hip protectors
  • Grip bars
  • Shower chair
  • Raised toilet seat
community services and referrals
Community Services and Referrals
  • Home care service agencies
  • Personal trainer or exercise program dedicated to older adults
  • Social services
  • Day care
  • Meals on Wheels
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