Fall Prevention in Long-term Care: Practical Advice to Improve Care

Mara Ferris, MS, RN, GCNS-BC, CPHQ, FASCP

Disclosures

Topics in Advanced Practice Nursing eJournal. 2008;8(3) 

In This Article

Interventions to Prevent Falls

Because falls are due to many causes and often more than 1 cause, no single intervention will prevent all elders from falling. A comprehensive assessment to determine the fall risk factors for each individual resident is essential. Only with such an assessment can a care plan be developed that addresses the individual's unique risk factors, needs, and preferences.

In Ms. P's case, the nurse practitioner found that she needed to lower the doses of the antihypertensive and hypoglycemic medications. The nursing staff recognized that Ms. P was especially stiff and uncomfortable first thing in the morning and late in the day, making it difficult for her to get to the toilet "in time." With some suggestions from the pharmacist, the schedule of her arthritis medications was changed to provide more consistent relief. The pharmacist also suggested adding vitamin D and calcium to Ms. P's drug regimen to strengthen her bones, and because vitamin D has been shown to reduce falls.

The nursing assistants cued Ms. P to use the toilet more frequently during the day, which reduced both her episodes of incontinence and the number of times that she had to "run" to the toilet. The occupational therapist posted signs in Ms. P's room to provide visual cues to help independent mobility in her room (eg, picture of a toilet on the bathroom door). Ms. P accepted physical therapy and learned to use a rolling walker, but, to the staff's dismay, she was unwilling to give up her stylish high heels for something more practical and to her mind "ugly."

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