Preventing_Falls

Falls Prevention Falling down is experienced by everyone in their life and is seen as an ordinary occurrence. But this ordinary occurrence has dire effects on some such as the elderly folk and also new born babies (Sandra, Barbara & Charles , 2013). There are different categories on falling, in some cases falling is dangerous for everyone if they were to fall from a height or fall on the ground injuring the sensitive part of the body (Sharon & Wendy, 2004). These kinds of falls are general and individuals are conscious of these and try to prevent them from happening but in the case of elderly this is a whole new concept with different implications. The discussion in this particular essay revolves around the falling of the elderly, the effects it has on them and how to prevent falling in clinics and nursing homes. The results of falling range from light injuries to heavy injuries and even death. In the case of the elderly, falling either leads to heavy injuries causing disability or fatality (Sharon & Wendy, 2004). Injuries that cause disability greatly decrease the standard of living of an individual and put an immense pressure on the patient cost wise. Different statistics from around the world show the importance of this topic to be addressed extensively. In Japan, falling is the foremost cause of disability (leading to immobility) and morbidity in the citizens over the age of 65 (Dagmar, Martina & Katrin, 2012). In England, the incidence of falling amongst the elderly, over the age of 75, increases from 25% to 35% (Jane & Mark, 1999). The stats also show that 50% of the elderly people who experience the incidents of falling do so repeatedly. It is reported that falls are more common in the nursing homes; the ratio of falling is 1600 per 1000 patients annually (Jane & Mark, 1999). Women are found to fall more often than the men before the age of 75 but after that there is no difference between the two sexes in relation to falling. The rate of falls mentioned in the stats is not related to falls cause by extraordinary events such as car accidents, stroke or any type of violence. Injuries are ranked 6th in the foremost causes of death in individuals over the age of 65 and more than half of these injuries are results of falling. A more accurate data is that around 9500 fatalities in persons over the age of 65 are caused by falls (Jane & Mark, 1999). The 90% of falls that does not cause any injury have other serious repercussions such as psychological trauma and decreasing of activity out of fear of falling. Once an elderly has fallen he/she will have a tendency towards decreasing their activity which leads to other medical problems in the elderly. Falls is one of the strongest reasons of the elderly being admitted to nursing homes and facilities. Falls are an important clinical problem because of reasons that include frequency and the physical and psychological consequences that are related to it. Statistics from the year 1994, In United States, showed that the total cost of injuries that were related to falls in the elderly persons was $20.2 billion (David, 2008). This data also pointed out that by the year 2020 the cost would go up to $34.4 billion. The average cost per patient due to this problem is calculated to be $19,440 (David, 2008). Considering these monetary consequences makes falls’ prevention even more important in multiple countries all over the world (Dagmar, Martina & Katrin, 2012). These costs that were mentioned earlier represent the costs of extra medications, rehabilitations, and extra days in the hospital as well as surgery (David, 2008). It has been noted that event after the realisation of the repercussions that falls can have, it has been increasing in the nursing centres. The rate of incidence in falls has become now the essential measure of quality in care (Haines & Hill , 2005). The topic of falls is a nurse sensitive indicator that effects the reputation of any organisation (Caroline , Keith & Lewin, 2010). Nurses need to keep fall prevention as a top priority while research needs to be carried out in order to form better strategies. While some cases of falls are pure accidents due to external environment reasons such as objects in the pathway or slippery surfaces, there are others that are of graver concerns (Joseph, 2008). As a human being grows older there is a decrease in the sensory and perceptual system alongside changes in the bone and muscle structures (Sandra, Barbara & Charles , 2013). These changes worsen the miss-fit between individuals and their environment, increasing the probability of falling and falls related injuries (Sandra, Barbara & Charles , 2013). There are three important changes that occur in a human being which contribute to falling incidences and these changes are in the visual system, physiology and in perceptual system. Presbyopia is something that occurs in a patient, mostly between the age of 40 and 50, which decreases the ability of an individual of recognising the original distance between themselves and any object (CIT, 2012). This is a change in the visual system that develops further and causes the patient to be more prone to falls. With age the bone density along with muscle mass and muscle strength decreases also contributing to falls from happening. The cartilage in the joints starts to wear out as the body gets older and this causes the bones to rub together causing pain and making it hard to climbing up and down stairs (CIT, 2012). When the bone density decreases in the body there is more of a risk for hip fractures and spinal injuries due to weakness. The decrease in the muscle strength and mass also leads to a sarcopenia condition which is worsened by less exercise or activity (CIT, 2012). All these changes in the physiology change the way in which the aged walk and this is directly related to the risk of falling. The elderly take smaller steps and have more stride frequency due to weak calf and thigh muscles making them more prone to slipping and losing balance (Tiedemann, Sherrington & Close, 2011). The perception system in the brain grows weaker as the brain ages and makes it harder for an individual to perceive the temperature, weight and texture of objects (CIT, 2012). The elderly find it difficult to grasp the objects and manipulate them. The motor senses are connected to this part of the brain hence when the perception weakens they system become uncoordinated and results in falls, as it becomes hard for the elderly to respond to the environment appropriately. Other problems that lead to falls in the elderly especially in the nursing homes include environmental hazards. These environmental hazards can be wet floors and poor lighting. The medication that is given to the elderly patients also increases the risk of falls (Digby, 2010). Because some of the drugs have an effect on the nervous system, these drugs can be sedatives and anxiety drugs. Especially in the case of medication changes the incidence of falls increases (Digby, 2010). In order to develop and implement a successful intervention strategy for falls prevention it is necessary to carry out research including controlled experiments to check the viability and effectiveness of each method. A researcher by the name of Thurman Lockhart commenced experiments in his laboratory at Virginia Tech (Lockhart, 2011). Thurman wanted to understand the changes that caused the increase in falls and wanted to find out what methods could be used to prevent falls from happening. Thurman is a professor with a background in the biomechanics and human motor control system research. The research was funded through Centres for Disease Control and the National Institutes of Health (Lockhart, 2011). In the research Thurman suited up young and older volunteers in a vest holding a network of sensors to test the muscle and neurological changes during slips and recoveries by the volunteers. All the data from the sensors was put into a computer which provided information on the volunteer’s gait and the body movements while slipping and recovering from it. The tests were run on 60 subjects who were divided into three age groups 18-35, 40-55 and 60 above (Lockhart, 2011). Through these tests the changes in the responses to slipping and recovering and the manner of walking was identified leading to helpful conclusions. This research showed the difference in the gait of the subjects along the age groups (Lockhart, 2011). In another case an experimental intervention was carried out in Shanghai to evaluate it effectiveness. The subjects in this study were the seniors over the age of 60; these subjects were designated in a controlled safe community (Zhang, Dalal, Yin & Yuan, 2012). The intervention was carried out in two stages; the first stage consisted of spreading awareness and training activities. The second stage involved in changing the environment according to fall prevention modifications (Zhang, Dalal, Yin & Yuan, 2012). Surveys were also taken before the intervention as well as after the intervention. In the first phase different types of fall/injury prevention and safety promotion of safety materials were distributed amongst the subjects. Professionals also provided balance training to the elderly through exercises (Zhang, Dalal, Yin & Yuan, 2012). The second phase was to improve the outdoor exercising places, putting in new night lights, putting in hand rail on the stairs and using slip proof mat in the bathrooms. Knowledge was provided to the elderly of how to prevent falling through wearing appropriate sized shoes and regular exercise to maintain their balance and posture. The surveys were carried out at the end of 2008 (before intervention) and then in the end of 2009 (after the intervention) (Zhang, Dalal, Yin & Yuan, 2012). The surveys were carried out by trained personnel with the use of questionnaires. Twenty surveyors were selected and trained by experts to perform the surveys. These interviewers had a minimum of high school education and were well familiar with the safe community sector and had knowledge of the local welfare system. A total number of 2,889 elderly persons were interviewed in the year 2008 of which 2,838 were used in the study due to the screening process of all the interviews. By the year end in 2009, 3,021 elderly were interviewed. After the screening process again the number of interviews used in the experiment was 2,988 (Zhang, Dalal, Yin & Yuan, 2012). It was found out that due to the implementation of intervention there were improvements in the fall related incidences. The results showed that the knowledge about the fall related issues was over 60%. Due to this knowledge majority of the elderly were cautious and used the training provided to them for preventing falls from happening. The elderly understood that the injuries that are the result of falling were preventable and lower incidence of injury leads to higher improvement of life quality. The most significant change was found in the behaviour of the elderly towards balance exercise and caution towards falling. This shows that the implementation of intervention was successful and had positive effects not only on the decrease of falling incidences but also the general improvement of health in the elderly as well. The researches mentioned in the essay prove that intervention methods can be helpful to lower the risk of falls. Multiple recommendations are presented in order to reduce fall in the elderly both inside the clinics and generally outside. If the aged people can prevent the incidence of falling it is safe to say that quite a significant percentage would not have to be put in nursing homes and clinics. The research by Thurman Lockhart recommends that wet surfaces should be avoided, the changes in the elevation of surfaces should not be too much, anti-skid mats and coverings should be used in places like the bathrooms and kitchens, handrails in the bathroom and stairs are very important and colour contrast is essential to make it easier for the elderly to clearly see the surfaces (Lockhart, 2011). There should be a falls risk assessment in all the nursing homes and clinics. Different patients have different incidence ratios of falling and need to be taken care of accordingly (Stephen, 2011). The nurses should know the history of falls with the patients in order to allocate intensive and moderate care. Falls prevention programmes need to be implemented in the nursing clinics and homes with regards to toileting, monitoring, bed safety and behaviour management (Stephen, 2011). References Bonuel. , Lockett, , & Becknell, G. (2011). Best practice fall prevention strategies. 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