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Preventing Falls in the Elderly Long Term Care FacilitiesRebecca McCarthy, MSN, RN-BC, CDONA Catherine W. Adedokun, MSN, RN Roseanne Moody Fairchild, PhD, RN Abstract The elderly long-term care population is at increase risk for falls and fall related injuries. The implementation of a fall prevention program is important for ensuring resident safety. Systematically assessing residents’ risk for falls and implementing appropriate fall prevention interventions can reduce the number of falls in the elderly long-term care residents. The article reviews a clinical practice guideline recommendation for implementation of a fall prevention program. Risk factors affecting falls in the elderly residing in long-term care are examined. Strategies for implementing a fall prevention program are discussed, including barriers to implementation. Preventing Falls in the Elderly Long Term Care Facilities Falls pose a serious risk for the elderly living in long-term care facilities. An average nursing home with 100 beds reports 100 to 200 falls annually (George, 2000). Falls can cause serious injuries and accidental death, and in older people. Prevention of falls in the elderly living in long-term care facilities is very important, and requires several different approaches to deal with the unique factors which may predispose the elderly to this type of injury. This paper reviews the major risk factors of falls and current clinical guidelines in fall prevention for elderly populations living in long-term care facilities. The authors also propose key features and critical aspects of successful fall prevention programs based upon a synthesis of the literature from 1996-2009. Significance of the Problem A fall is defined as a sudden, unintentional change in position, which results in an individual either hitting the ground or another object below his or starting point (George, 2000). The American Medical Directors Association (AMDA) (2005) reports that falls are a significant cause of injury and death in the elderly living in long-term care facilities, and according to the Agency for Healthcare Research and Quality (AHRQ) (2009), falls are the leading cause of fatal and nonfatal injuries among Americans aged 65 and older, resulting in more than two million emergency room visits. The AHRQ (2009) also found that one in ten of these emergency room visits were related to injuries from falls, with a rise in visits as patients become older. Moreover, approximately 1,800 older adults living in long term care facilities die each year from fall-related injuries and many of these falls go unreported (Center for Disease Control [CDC] 2009). What Influences this Issue? The elderly in long-term care facilities are predisposed to falling and may fall for a variety of reasons. Predisposing factors include, unsteady gait and balance, weak muscles, poor vision, medications, and dementia. In addition, other factors such as poor lighting, loose rugs, poorly fitting shoes, floor clutter, and beds or toilets without handrails, also may cause falls (Jenson, Lundin-Olsson, Nyberg & Gustafson, 2002). Furthermore, medical conditions such as low blood pressure, stroke, Parkinson’s disease, arthritis, Meniere's disease (affects the middle ear - causes vertigo), poorly controlled diabetes, poorly controlled epilepsy, brain disorders and thyroid problem increase the elderly client’s risk for falls (Osteoporosis-Info.com, 2009).
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