A fall is probably the greatest contributor to the loss of independence and health decline experienced by the elderly. In long term care, preventing falls is no easy task. Our mandate is a precarious balance between encouraging independence and protecting a resident from falling when we are presented with a dichotomy of needs:
- Motivating the reluctant resident to continue to walk or transfer who is resistant because of his/her fear of falling or previous history of falling.
- Holding back the resident who feels more capable than he/she really is.
- Convincing family members that their loved one can or can no longer transfer or walk without assistance.
- Convincing some staff to allow a resident to walk or transfer even though it takes considerable time or not allowing a resident to walk or transfer who appears to be able to do so or demands to be left alone.
- Determining how to address the unique risk factors presented by those who are cognitively impaired who do not understand what is safe or retain any related health teaching to mitigate their risk.
Communicating, teaching, monitoring and assessment are our primary tools to reduce falls risk. However, reducing falls risks admits one simple fact – in some instances, despite our interventions and supports, certain residents will fall. When those falls or ‘near misses’ occur they communicate volumes in determining the measures and supports needed to prevent any further falls. Electronic clinical health records are necessary tools in our battle against falls providing us with:
- Falls assessment tools;
- Detailed reports of all falls;
- Detailed falls care plans with "measurable" goals and "dated" reviews of those goals;
- An analysis of overall falls patterns when examining QI data;
- RAPs assessments related to falls risk.
Falls risk in Long Term Care are inevitable but using an effective EHR system could help mitigate these risks and ensure the health and safety of your residents.