I assist with evaluations for new admissions, and I also do the assessment when a resident is admitted. What are some areas I should look at if a resident has been falling even before we admit them, as this may be the main reason for admission?
The first thing, of course, is to have a comprehensive assessment by a physician or GNP to see if there is something happening physically to cause the falls.
I would approach this systematically:
• Gather all of the information that you can from the facility or family you are admitting the resident from. Look at the medical history for any reason for the falls,
• Observe the environment: Perhaps there are throw rugs or poor footwear that may be causing them to fall.
• Involve your interdisciplinary care team—don’t think you can see all and know all, without some assistance.
• Look at the medicine: Are there new medications? Who is administering the medicine? If the resident is administering alone, are the proper amounts remaining?
• Does the resident have new glasses or hearing aids? Both can cause unsteadiness.
• Also, make sure they have not been treated by their next-door neighbor. In assisted living more than skilled care, residents tend to treat one another. Some think that if they made it to 80, they automatically have obtained a medical degree.
Do a 72-hour log (or longer if needed). Have the staff write down everything they are doing for three days.
Your staff needs to learn their normal routine, and when they may need assistance, or become unsteady, as well as if they might get forgetful or confused. All of these bits of information will be critical to meeting these residents’ needs.
I encourage you to look at all of the surroundings. A fall can be caused by something as simple as sun glare.
From the August 01, 2008 Issue of McKnight's Long-Term Care News
