As eruptions of violence and disasters — natural and manmade — seem to arise more often, long-term care providers have their hands more full than ever. Nursing home residents are continually exposed to threats of all kinds, from falls, elopement and adverse drug reactions to potential identity theft and infectious diseases. Don’t forget natural disasters such as floods and fires. Experts provide coping advice here.
1. It begins with recognizing the depth of possible risks from resident security lapses. Among the top concerns is wandering, which exposes nearly a quarter of elopers to dangerous conditions annually, said Gerald Wilmink, PhD, chief business officer at CarePredict.
Others include physical violence, which exposes up to 10% of all nursing home residents to injury, and fires (up to 2,000 incidents every year), and natural disasters. Among the most costly risks of all are falls, which impact up to half of all nursing home residents annually.
“The biggest vulnerability related to falls is the lack of staffing,” said Shirley Nickels, chief operating officer of SafelyYou. “Without the appropriate staffing levels, the ability to mitigate fall risk or implement effective interventions to avoid future falls is extremely challenging.”
The ebb and flow of friends, relatives, and vendors also can pose risks, said Charles Mann, founder and chief sales officer of Accushield. Keeping tabs on credentials and visitor management protocols is critical.
Besides germs and other pathogens, cyberthreats are among the most unwelcome visitors, said Patrick Hardy, president of Hytropy. Such threats increased during the pandemic.
2. Assessing threat levels can minimize the number of risks most nursing homes are exposed to on any given day. Hardy recommends annual facility-wide risk assessments to identify needed interventions. Video cameras, detection systems, smart floor-based systems, wearables and personal emergency response systems can detect and trigger impending falls, added Wilmink. Geofencing systems can safely ward off elopement. Panic buttons and two-way voice wearables have shown to be good physical violence deterrents.
“Ask your residents and staff how safe they feel,” added Mann. “Gather feedback from visitors and evaluate what processes are in place to not only prevent a security threat, but how the facility would respond.”
Similarly, Nickels said regularly engaging residents and staff can prevent and avoid falls.
“The two best ways to assess fall risk are a comprehensive assessment at admission, during any change of condition or set frequency by clinical support teams,” she said.
3. Prioritize security spending. At a minimum, define three top threats, advised Hardy. Then, develop mitigation measures while balancing things preparedness, response and recovery. Mann recommended solutions that address more than just one need.
“Technologies that enable proactive care yield more significant ROI, increased revenue, and cost savings,” added Wilmink.
Nickels said taking a hard look at root causes and a facility’s fall record usually takes the doubt out of most falls mitigation investments.
4. Experts agree: A facility that is constantly vigilant and conducts drills puts itself in a strong position of minimizing and avoiding risks of all kinds. Keeping a constant eye on the bigger picture is also critical.
“Don’t simply focus on the ‘obvious’ threats,” Hardy said. “A complete document examination of government threat assessments, a conversation with local emergency management agencies and other threat-based agencies is an excellent path to ensure no threats are missed
From the July/August 2022 Issue of McKnight's Long-Term Care News
