Falls Leading Cause of Injury, Death in Elders

MDS 3.0 Guidelines Help Providers Minimize Risk

falls and seniors
Falls is the leading cause of injury and death among seniors. MDS 3.0 Guidelines help providers prevent falls and achieve a better quality of life for seniors. Getty Images

Falls are a leading cause of injury, morbidity, and mortality in older adults. MDS 3.0 Fall guidelines help providers minimize fall risk with the goal of achieving the best quality of life for residents. Preventing falls is a serious issue. Here's information to help.

Fall Indicators

A previous fall is one of the most important predictors of risk for future falls and injurious falls. Persons with a history of falling may limit activities because of a fear of falling.

Providers need to determine the potential need for rehabilitation or assistive devices. And the physical environment and staffing needs should be evaluated as well.

Steps for Assessment

  1. Ask the new resident and family or significant other about a history of falls.
  2. Review transfer information.
  3. Review all relevant medical records.
  4. Note any fractures related to falls.

Care Planning

  • Identification of residents who are at high risk.
  • Falls may be an indicator of functional decline.
  • External risk factors include medication side effects, use of appliances and restraints, and environmental conditions.
  • Review all available sources for any fall since the last assessment.
  1. Review nursing home incident reports.
  2. Ask the resident and family about falls during the look-back period.

Fall Prevention Tips

The American Geriatrics Society offers these fall prevention tips:

  • Adaptation or modification of home environment
  • Withdrawal or minimization of psychoactive medications
  • Withdrawal or minimization of other medications
  • Management of hypertension
  • Management of foot problems and footwear
  • Exercise, particularly balance, strength, and gait training
  • All older adults who are at risk of falling should be offered an exercise program.
  • Multi-component intervention should include an education component complementing and addressing issues specific to the intervention being provided.
  • Exercise programs should take into account the physical capabilities and health profile of the older person.
  • The exercise program should include regular review, progression and adjustment of the exercise prescription as appropriate.
  • An older person should be advised not to wear multi-focal lenses while walking.
  • Vitamin D supplements of at least 800 IU per day should be provided.
  • Identification of foot problems and appropriate treatment should be included in fall risk assessments.

This is Serious, Folks

Three in 10 elderly patients who sought care in an emergency room after a fall were admitted to the hospital for treatment of their injuries.

Since 2006, fall-related health costs are believed to have increased substantially because of a larger number of seniors suffering falls, and because of the higher costs of treating the fractures, open wounds, and head traumas they cause.

Falls are the most common cause of non-fatal injuries in the senior population. The industry needs to step up and become active in showing seniors how to prevent falls whether in a facility or at home and elsewhere, perhaps partnering with architects to show caregivers how to protect mom and dad's home.

It is actually good business sense. Keep people healthier and in a better quality of life for more years and should the time come they need the extra help of an assisted or nursing facility they will think of the people who contributed to their extended good health.

Source: CMS’s RAI Version 3.0 Manual

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