Elderly Falls and Trips
In the United Kingdom, the number of patients readmitted to hospital after treatment for a fracture had risen significantly since 2008/9.
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Trips and falls can be a major hazard for any elderly person. A fall can have serious and life changing implications for a patient, and the fear of falling can impact negatively on their lifestyle and the activities they enjoy.
It is vitally important that a comprehensive falls risk assessment is completed for all patients and any issues associated with, or increasing, the risks of falls are identified.
This risk assessment must be reviewed at least monthly or more regularly if the patient’s condition changes, because any deterioration or slight changes in the patient’s condition can increase their risk of falling.
The objective of any person centred Care Plan is to ensure the patient’s issues and needs are set out in great detail and are very much at the core of the Care Plan.
The starting point is a detailed consultation with the patient and their relatives. Any issues which might increase a patient’s risk of falling are discussed and a plan to address the issues is formulated and agreed.
Many factors can increase a patient’s risk of falling, such as their mental state and the impact that may have on memory and poor or impaired eyesight.
Hearing difficulties can sometimes cause balance problems also increasing the risk.
A patient’s mobility, steadiness and gait and any issues they have with that, or an inability to ask for help, can increase the risk of falls.
Any medication which causes drowsiness including sleeping tablets may result in falls.
A patient’s room and day rooms must be kept clear of potential trip hazards and where possible the patient should wear well fitting shoes, and not slippers, even though they may be more comfortable.
You should consider any of these issues which are causing an increase in the risk of falling and where possible suggest or agree a plan which will address or improve the issues and record this.
Anything, however simple, that can be done to help should be recorded and implemented, such as ensuring the environment is free of clutter and ensuring a call buzzer or alarm is given to the patient.
Safety of the patient is of course paramount, and a key consideration when preparing this Care Plan.
You need to look at ways of ensuring the patient’s safety, which may involve the use of a pressure mat next to the bed to alert staff when the patient gets up, bed rails to prevent a patient falling out of bed or a lap strap in a wheelchair.
Any form of restraint must be assessed as a benefit to the patient and agreed with the patient and relative. You need to record your assessment in detail.
You need to look at any equipment which the patient will be using, such as a zimmer frame or walking aid and assess what risks they might have by using them.
When considering the issues central to a falls Care Plan, you need to strike the right balance, and look at what risks prevail in promoting and encouraging the patient’s independence, but at the same time minimise as far as possible the risks of falling.