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Chapter 13: Falls Prevention
Overview:
- Lists the causes and outcomes of falls and includes a falls incident report form
- Provides a comprehensive risk-assessment tool
- Contains a general environmental hazard checklist
- Summarises several medical conditions associated with falls
- Reviews toileting issues and falls in an easy-to-read table
- Addresses the use of walking aids; their effectiveness, potential problems and maintenance
Description:
Falls among older people in aged-care settings are common, with up to 60% of residents experiencing one or more falls during a 12-month period (Tinetti 1987). This chapter provides a review of the range of activities that can be implemented to reduce falls among older people with dementia. It allows nurses to identify an individual resident’s risk, to determine appropriate management and referral strategies and to implement a tailored program.
Topics:
- Circumstances and consequences of falls
- Documenting falls incidents
- Risk factors
- Falls
- Fractures
- Risk assessment and care-planning
- Dementia and increased risk of falling
- Specific features of dementia
- Other health conditions
- Medications
- Toileting
- Restraint
- Feet and footwear
- Mobility and walking aids
- Physical activity
- Injury minimisation
- Organisational environment
Speakers / Authors:
Keith Hill
Keith is a physiotherapist with more than 20 years of experience in rehabilitation and aged care. Keith’s PhD thesis was entitled ‘Balance studies in older people’, and he has published numerous papers in this area. Keith is a senior research fellow at the National Ageing Research Institute and co-director of the falls and balance clinic at the Melbourne Extended Care and Rehabilitation Service (Victoria, Australia). He was recently project manager for a falls-prevention project in seven residential aged-care facilities, as a result of which falls were reduced by half.
Robyn Smith
Robyn is an occupational therapist specialising in aged care and rehabilitation, and is a researcher with an interest in health services and health promotion. She is director of the public health division of the National Ageing Research Institute (Melbourne, Australia) and has had a lead role in many research projects, with a focus on fostering sustainable change in community and residential aged-care environments. Robyn has a particular interest in falls prevention, and in strengthening staff capacity to apply current research evidence in everyday practice.
Dr Dina LoGiudice
Dina is a consultant physician in geriatric medicine, a senior associate at the National Ageing Research Institute (Melbourne, Australia) and coordinator of the Cognitive Dementia and Memory Service at the Melbourne Extended Care and Rehabilitation Service. Her PhD thesis was entitled ‘The Assessment of Services for Elderly People with Dementia’. Dina’s main interests lie in assessment and management of older people with dementia and their carers, in particular those of non English speaking background.
Margaret Winbolt
Margaret is a nurse with 20 years of experience in the care of older people and is currently a clinical nurse consultant in gerontic nursing at Bundoora Extended Care Centre (Melbourne, Australia). In this role, Margaret has been involved in the development and implementation of a falls-prevention and injury minimization program at the centre. Margaret has a keen interest and expertise in the care of older people with dementia and was previously a nurse unit manager of a dementia unit specialising in the management of challenging behaviors.
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