Archive for the ‘Falls’ Category
Posted on August 25, 2011 - by Nurse Virginia
NANCY REAGAN FALLS AT POLITICAL EVENT – FALLS IN THE ELDERLY ARE PREDICTABLE EVENTS RELATED TO RISK FACTORS – PERSONAL AND ENVIRONMENTAL
(PART I)
This blog was first posted in April of 2010 – in the light of Nancy Reagan(now 90) tripping on the evening news last night- I thought to re-post it. Was that trip predictable? Maybe if she can no longer see tripping hazards in her path and the person assisting her is not looking as well.
Environmental Factors
“Mom fractured her ankle in three places.”
“I didn’t know your mother was still living,” I replied to my friend. “You never mention her.”
“Well, we don’t go to see her very often,” she replied. “Why is that?” I asked.
“Because there is no place for us to sit” she said.
Now I understood, Mom was a hoarder and fell over her clutter and fractured her ankle. Yes, that’s what it was. Mom was in her early 70’s and this could have been a predicted fall because of the cluttered environment she lived in.
Personal Factors
Marge is 80 years young, lives alone and still drives. She has decreased ability to focus her eyes due to aging. It is a bright sunny day and Marge drives herself to the grocery where she walks into the store and immediately falls. With age it takes eyes longer to re-focus to different levels of light. Most falls in stores are at the entrance due in part to wet surfaces from wet feet and a , change in surfaces. (Environmental factors) But many times due to personal factors and the reduced ability for elderly eyes to adjust to different levels of light. (The elderly shopper can easily fix this by grabbing a shopping cart when they park and pushing it into the store with them. This way they have something to hold onto.)
History of Falls
In 1900 the average life expectancy was 49 years. At that time people were dying from infectious diseases; TB, pneumonia, influenza etc. Advances in public health, with improved sanitation, antibiotics, and vaccines increased the age expectancy to 68 yrs by the 1940’s.
Now that there was an older population, there also was an increase in falls. Over the years since then, the thinking regarding the cause of falls in the elderly has changed.
Previous thinking on the cause of falls in the elderly:
- The first thinking was “this is an act of God” a chance event with no explanation
- That turned into “Falls are purely accidental” it happened to you, so you had some bad luck.
- Then, its “normal” to fall,” look at your age, what can you expect?”
- Falls are a matter of personal negligence – “You should have been more careful.”
Falls Today
Now falls are no longer considered normal or just part of aging. They are considered to be predictable events related to environmental and personal factors.
Virginia Garberding, R.N.
Director of Education, The Wealshire, Lincolnshire, Illinois
Author: Please Get To Know Me – Aging with Dignity and Relevance
Posted on May 27, 2010 - by Nurse Virginia
WHAT TO DO WHEN THE CONFUSED ELDERLY FALL IN THE NURSING HOME
This is one of the most dreaded calls from the Nursing Home. “You’re Mom fell.” You’re first reaction is natural, whether you say it or just think it. “Why do I have her there, isn’t that what you people are supposed to be doing, keeping her safe and off the floor?”
Supporting the confused elderly’s right to walk includes, however strange it may sound, the right to fall.
What to do after the elder falls.
When a family member learns of a fall the first question should be:
“Did anyone see the fall?”
“Did she hit her head?”
“Does she sound like she is in pain?” (A groan for example)
“Are there any outward signs of pain?”
There are many benefits from walking if elders are able to do so. Yet too often families want elders forced into wheelchairs prematurely to keep them “safe” after a fall. Elders want to remain as independent as possible. Even those who are demented but still able to walk can experience opportunities for interaction while “ wandering” the community. When wandering, they have opportunities for social interaction, such as when staff personnel greet them by name.
The elder can remain strong. They may wander, but they also maintain the ability to walk. As an added benefit, it enables them to work up an appetite, breathe deeper, and it supports the process of elimination.
General guidelines for families
When you have identified a change in the elder’s usual condition:
Don’t hesitate to voice your concern to the nursing staff.
Identify and talk to staff that may be more pro-active in problem solving.
Establish yourself as part of the team caring for the elder.
Be willing to participate as part of the solution.
Realize that seeing an unaddressed change in condition can be stressful. Try to communicate your concern without becoming overly emotional.
Pray for your loved one.
Excerpt from: Please Get To Know Me – Aging with Dignity and Relevance
By: Virginia Garberding, R.N. and New York Times Best Selling author Cecil Murphey
Available at: www.pleasegettoknowme.com
Posted on April 20, 2010 - by Nurse Virginia
PAST HISTORY OF FALLS WILL PREDICT FUTURE FALLS WHEN ELDERLY REFUSE TO BE ACTIVE
(Part III)
When an elderly person falls it creates fear in the elder, resulting in a decrease in activity. Just the opposite should be the reaction. The elder should instead do more; get out more and joining exercise groups that focus on strength and balance.
Everyone wants a magic pill – the magic pill just might be exercise
It might not come in an easy to swallow capsule, and might require self-discipline and effort. But the benefits of exercise can seem like magic for the elderly. How does reduced risk of heart disease, lower blood pressure, reduce risk of osteoporosis, better sleep, and reduced risk of falls and injury sound? These are all documented benefits of exercise in the elderly. And it doesn’t seem to matter how old you are when you start. Every one, no matter what age can improve their strength and endurance through exercise.
There are so many opportunities for the elderly to join exercise classes at their Church, local Senior Center, Health and Fitness Centers even some Libraries offer programs. Balance programs combined with strengthening are the best. For the person that wants or needs to exercise at home, The National Institute on Aging offers some great exercises for balance and increased strength.
Go to: www.nia.nih.gov/healthinformation/publications/exerciseguide/chapter04.htm
A Prescription for exercise
For the elder who needs a little extra convincing that exercise would be good for them and help them reduce the incident of falls. It will help to have the physician write a “prescription” on a regular prescription pad. A prescription for walking could be – Take a walk every day for 20 minutes, seven days a week.
Trip to Nursing Home a blessing in disguise
When the elder has a fall that sends them to a Nursing Home to recover, this is an opportunity for the elder to have evaluations and assessments done.
See Blog: July 28, 2009 – Caregiver Tips: When Seniors come into the Nursing Home, get better and go Home
Virginia Garberding, R.N.
Director of Education, The Wealshire, Lincolnshire, Illinois
Author: Please Get To Know Me – Aging with Dignity and Relevance
www.pleasegettoknowme.com
Posted on April 16, 2010 - by Nurse Virginia
FALLS IN THE ELDERLY ARE PREDICTABLE EVENTS – RELATED TO FEAR OF FALLING
Fear is your enemy, not the floor
Fear of falling can keep you from thinking clearly. Fear of falling can cause you to over react to a slight difficulty, stiffen your body and lose your balance. Fear of falling can make you walk in an un-natural way, more hesitant and irregular. Fear of falling can make you walk contantly looking at the floor and shuffling your feet.
Fear of falling can make you tighten your muscles and joints and make contact with the floor ever so much more jarring.
Falling could be embarassing – fear of making a scene
Falling may mean injury,making a scene in public, being on the floor and unable to get up. Falling in public could require someone helping you up and then they getting hurt themselves. Elderly people are very concerned about causing problems or difficulties for others.
Fear of falling causes an elderly person to restrict their activities
Betty is a 83 year old woman with diabetes, she fell outside six months ago and and she has subsequently fallen multiple times since. Betty has restricted her outside activities because of her fear of falling.
Since becomeing housebound Betty has developed muscle weakness from disuse. Due to Bett’s muscle weakness she has now begun falling from the toilet and she is becoming depressed.
Fear of falling usually leads to decline in function and strength
Living with fearfulness causes feelings of dissatisfaction with life, a depressed mood and increased frailty. As the elder experiences decreased mobility and participates in fewer social events they become more frail. Diminished agility, muscle strength and balance often contribute to more falls and related injuries.
Increase activity not decrease (Part III of Predictable Falling)
Virginia Garberding, R.N.
Director of Education, The Wealshire, Lincolnshire, Illinois
Author: Please Get To Know Me – Aging with Dignity and Relevance
www.pleasegettoknowme.com
Posted on April 15, 2010 - by Nurse Virginia
FALLS IN THE ELDERLY ARE PREDICTABLE EVENTS RELATED TO RISK FACTORS – PERSONAL AND ENVIRONMENTAL
(PART I )
Environmental Factors
“Mom fractured her ankle in three places.”
“I didn’t know your mother was still living,” I replied to my friend. “You never mention her.”
“Well, we don’t go to see her very often,” she replied. “Why is that?” I asked.
“Because there is no place for us to sit” she said.
Now I understood, Mom was a hoarder and fell over her clutter and fractured her ankle. Yes, that’s what it was. Mom was in her early 70’s and this could have been a predicted fall because of the cluttered environment she lived in.
Personal Factors
Marge is 80 years young, lives alone and still drives. She has decreased ability to focus her eyes due to aging. It is a bright sunny day and Marge drives herself to the grocery where she walks into the store and immediately falls. With age it takes eyes longer to re-focus to different levels of light. Most falls in stores are at the entrance due in part to wet surfaces, change in surfaces. (Environmental factors) But many times due to personal factors and the reduced ability for elderly eyes to adjust to different levels of light. (The elderly shopper can easily fix this by grabbing a shopping cart when they park and pushing it into the store with them. This way they have something to hold onto.)
History of Falls
In 1900 the average life expectancy was 49 years. At that time people were dying from infectious diseases; TB, pneumonia, influenza etc. Advances in public health, with improved sanitation, antibiotics, and vaccines increased the age expectancy to 68 yrs by the 1940’s.
Now that there was an older population, there also was an increase in falls. Over the years since then, the thinking regarding the cause of falls in the elderly has changed.
Previous thinking on the cause of falls in the elderly:
- The first thinking was “this is an act of God” a chance event with no explanation
- That turned into “Falls are purely accidental” it happened to you, so you had some bad luck.
- Then, its “normal” to fall,” look at your age, what can you expect?”
- Falls are a matter of personal negligence – “You should have been more careful.”
Falls Today
Now falls are no longer considered normal or just part of aging. They are considered to be predictable events related to environmental and personal factors.
Virginia Garberding, R.N.
Director of Education, The Wealshire, Lincolnshire, Illinois
Author: Please Get To Know Me – Aging with Dignity and Relevance
www.pleasegettoknowme.com
Posted on July 8, 2009 - by Nurse Virginia
Caregiver Tips: 4 Questions the family should ask when the elderly fall in the Nursing Home
When the family member hears that the elderly loved one fell, ask first:
• Did anyone see the fall?
• Did the elder hit their head?
• Does the elder seem to be in pain?
• Are there any outward signs of injury?
Did anyone see the fall?
Very important to know who witnessed the fall and what was the elder doing. If walking did they trip over something, did they look unsteady? Was the floor wet? If the fall happened at night was the elder on the way to the bathroom, and becoming incontinent, fell on a wet floor? Having an eye witness to a fall can help with prevention in the future.
Did the elder hit their head?
If the answer is a yes, then the next question should be did they loose consciousness? If they hit their head are there cuts, bruises or swelling? For any head injury, the elder should be checked at regular intervals for at least 24 hours. Any change in behavior, personality, unable to wake up or agitation should be reported.
Does the elder seem to be in pain?
After a fall it can be several hours before the elder expresses pain. If the elderly fall they most assuredly will be sore and stiff the next day. Being aware of and on the look out for signs of pain following a fall incident are good practice.
Are there any outward signs of injury?
Looking for the elder seeming to hold a body part or try to protect it. Or an extremity that doesn’t look normal, or seems out of place. Also of course ask about cuts, bruises and swelling. Many medications cause increased bruising especially in the elderly who have very thin fragile skin.
Always ask what preventive measures the Nursing Home has put in place for the elder who has fallen.
Posted on March 8, 2009 - by Nurse Virginia
AGING: Fall – a four letter word to Senior Citizens
Fear of falling – one of seniors worst fears.
“Fall” a four letter word that can strike terror in the heart of any senior citizen as well as their loved ones. What senior hasn’t worried about what the ramifications would be in the event of a fall? Public perception of falls has changed in the last century. At one time people thought that a fall was an “act of God” and therefore nothing that an individual could do about it. Then the common thought was that a fall was unavoidable because you had bad luck or that this is something that you should expect to happen as a normal hazard of aging.
Seniors falls can be predicted.
Now the health care community knows that in fact falls are predictable events and the result of many environmental hazards as well as problems related directly to the individual. Problems such as medications or medication side effects, balance problems, vision problems lack of safety awareness due to memory loss.
Long term effects of falls for seniors.
Why do we care so much about the subject of falls? A fall can result in minor injury of a bloody nose or soft tissue damage to major injury resulting in a fracture. There are reported 220,000 hip fractures annually among people 65 and older. Recovery from a fracture may be pain, decreased flexibility in that extremity, loss of feeling and the possibility of developing Arthritis.
When the fall results in injury to the lower extremities and affects the individual’s ability to walk, their very independence is threatened. Any loss of mobility results in increased dependence on others, the very thing that seniors do not want.
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