How do falls occur
- result of a loss of balance and an inability to recover balance.
- The complex set of conditions and circumstances that lead to this loss of balance are referred to as falls-related risk factors.
Factors affecting fall risk include:
Biological risk factors
Behavioral risk factors
Environmental risk factors
Social and economic risk factors
The fall cycle
Fall
Fear of falling again
Less activity
Decreased muscle strength and balance
Increased risk of falling
Biological/Intrinsic Factors
Pertaining to the human body and related to natural aging and chronic, acute or palliative health conditions.
- Advanced age, decreased mobility and balance
- muscle weakness
- visual impairment
- acute/chronic illness
- disability (including dementia
- stroke etc.)
- Some conditions are unchangeable, such as gender or age
- others are preventable or compensated for, such as muscle weakness or poor vision.
Behavioural Risk Factors
Include actions, emotions or choices of the individual.
- history of falls
- fear of falling
- poor nutrition and/or hydration
- lack of physical activity
- inappropriate footwear and clothing
- taking multiple medications (particularly psychoactive medications).
Social/Economic
Includes income, education, housing and social connectedness. These factors all bear a strong relationship to one’s health, level of disability, longevity and cognitive function.
- low income
- low education
- inadequate housing
- lack of support networks
- limited access to appropriate health or social services
increase the risk of having the chronic health conditions that are highly associated with an increased risk of falling or being injured from a fall.
Environmental Hazards
There can be hazards within the home, in institutions and in the community, that can increase the risk of falls.
HOME:
- presence of clutter
-lack of stair railing
- loose rugs or other tripping hazards
- lack of grab bars in the bathroom
- poor lighting, especially on stairs.
Community
- unsalted walkways,
- snow-filled sidewalks
- damaged crumbling walkways
Universal Falls Precautions (SAFE)
S- Safe environment
A- Assist with mobility
F- Fall risk reduction
E- Engage patients and families
Before leaving a patient/resident’s room ask 3 questions:
Do you need to use the bathroom?
Do you have any pain or discomfort?
Do you need anything before I leave?
How to prevent falls
- Multi-factoral Risk Assessment (on admission, on schedule, after change, after fall or near fall)
- Communication and education about fall risk (patient, family, health-care team)
- Implementation of prevention strategies with those who are at risk of falling (client/organization)
- Individualize interventions for those at highest risk of fall-related injury
