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Patient Safety: Don’t Let Falls Trip You Up
For someone recovering from surgery, illness or an accident, the threat of falling can be as much of a concern as complications from the medical condition itself.
At best, a fall can result in a set-back in recovery. At worst, it can result in an injury that can lead to loss of function that may never be recovered.
Wendy Fishman, former director of rehabilitation services for Visiting Nurse Association of Ohio, said preventing falls is one of the primary concerns of home healthcare professionals. She said once a patient falls, he or she is at greater risk of falling again.
“After someone has fallen, they have a fear of falling,” Fishman said. “That causes a whole cascade of negative effects.”
That cascade could look something like this:
- When patients have a fear of falling, they are more hesitant to walk freely.
- They may take only small steps, which could cause them to lose their balance.
- They don’t want to go out, so they become more homebound.
- They may become depressed because they aren’t getting out and meeting people.
- Patients who have fallen tend to avoid moving, so they become weaker, which also could cause them to fall more easily.
Types of Fall Hazards
Fishman said falls stem from extrinsic -- or outside -- factors, such as trip hazards in the home or ice in the driveway. But they also result from intrinsic factors, including behavior, low vision, weakness or decreased balance from conditions like Parkinson’s disease, or certain medications.
When VNA of Ohio’s home healthcare nurses first assess a patient who has fallen, they first determine what caused the fall. Sometimes the fall reveals a previously undiagnosed condition, Fishman said.
As part of their initial assessment of all patients, nurses and therapists conduct the Timed Up and Go test (TUG). Patients are asked to sit in a chair, stand up and walk 10 feet, turn around and walk back to the chair then and sit down again. The ability to perform this test – and the time it takes -- is one way to determine how at-risk a patient might be to fall.
That information helps determine the care plan. But the concern over falls does not stop here. Each member of VNA of Ohio’s homecare team is trained at every visit to observe any changes in the patient’s circumstances that could lead to a fall.
Fishman said once a patient has fallen or is found to be at risk, VNA of Ohio’s homecare team may suggest the use of a walker, cane, handrails and other devices to ensure safety in the home. With the help of VNA of Ohio rehabilitation therapists, the patient may be able to rebuild their strength to improve balance and regain independent mobility.
But, there are instances when the only way to prevent a patient from falling is to encourage them to avoid walking altogether, Fishman said.
“If someone is going to be falling every day, it’s better for them to use a wheelchair,” she said. “If you fall, you have the risk of breaking a hip or a rib. Recovering from a hip fracture that requires surgery – or even just recovering from a fall when nothing is broken – is very difficult.”
Call VNA of Ohio Today
Learn more about VNA of Ohio rehabilitation therapy services, or call us today at 1-877-698-6264.