September 22nd, the first day of Fall, is also the National Fall Prevention Awareness Day sponsored by the National Council on Aging's Falls Free Coalition. Falls are among the most common and serious problems facing the elderly. Falling is associated with: Mortality (death), morbidity (disease), reduced function and premature nursing home admissions. (Journal of American Geriatric Society AGS 49: 664-672, 2001).
Celtic Healthcare has initiated a comprehensive fall prevention program throughout the entire organization in central/western Pennsylvania and northeast Ohio. All clinical staff, including nurses, therapists, social workers and even home health aides, is aggressively working on reducing avoidable falls. This interdisciplinary fall program includes a 4 step ongoing process:
1. Fall Risk Assessment
2. Fall Intervention
3. Resident/Caregiver Education
4. Fall Evaluation
So what is different about Celtic's fall program than other fall programs? This comprehensive program is using evidence-based tools and resources that have been specially selected for the elderly population in the service areas. What are evidence-based tools? Fall screenings, fall assessments techniques, etc., that have been tested internationally and/or nationally and have been proven to be effective in reducing falls or the severity of injury related to falls. Additionally, Celtic completes a very detailed fall evaluation and investigation for all (witnessed and un-witnessed) falls.
One of the main focuses for this fall season for Celtic is to improve their assessment of patients at risk for falls. Research identifies certain factors that make patients a higher risk for falls. The following are key risk factors that have been built into the agency's screening for all homecare patients. Fall risk factors include: Age (greater than 65 years), female gender, mental impairments (e.g. dementia), Parkinson's disease, history of a fall, weakness of feet/legs, walking or balance problems, problems with hearing or vision, specific medications or if patient is on 4 or more medications, arthritis, pain affecting function, and urinary incontinence.
Fall assessment must go beyond just a screening. Celtic is utilizing 3 specific evidence-based assessment techniques to do a detailed risk assessment for falls by nurses and therapists. They are assessing a patient's ability and speed to safely walk, their balance while moving and standing and their ability to perform daily activities. These evidence-based assessments require the nurses and therapists to use stopwatches, rulers and measuring tape to score patients and determine risk level.
A fall prevention plan will be developed for each high risk patient using key interventions that have been shown to be effective in reducing avoidable falls. Patient/Caregiver Fall Education sheet was created for all patients to reinforce the education from the homecare staff. Fall prevention interventions can include environment safety modifications, medication management, physical and therapy referral (to improve strength, balance, walking), occupational therapy referral (improving safety with bathing and other activities of daily living and adaptive equipment), exercise programs, vision care, and balanced diet and fluids.
It is essential for healthcare providers, families, caregivers, and even patients to be aware of fall prevention and to work together to reduce avoidable falls. Not only do falls financially impact the healthcare system, but also creates fear of falling for patients themselves which predisposed to repetitive falls (Centers for Disease Control and Prevention (CDC)). Celtic Healthcare has rolled out a detailed fall education program for employees, Assistive Living Facilities/Personal Care Homes, and patients and families.
For more information about Celtic's Fall Prevention Program please email info@celtichealthcare.com
