Slips, Falls and Fractures

Elderly Couple Walking

A simple fall can change your life. Just ask any of the thousands of older men and women who fall each year and break a bone. Falling is the number one cause of death due to injury for people over 75 years old and the second leading cause of death due to an injury among those 45-75 years old.

Over 80% of fatal slips and falls occurred among seniors, ages 65 or older. Though falls are more devastating to seniors, they can be just as fatal to younger people, regardless of age.

Risk Factors for Injurious Falls Client’s Reduction Risk
Risk – By evaluating one’s risk for falls, he/she can make accommodations to reduce that risk Intervention – The more you take care of your overall health and well-being, the more likely you’ll be to lower your chances of falling.
Impaired vision or hearing Have your vision and hearing tested often. Even small changes in sight and hearing can make you less stable. So, for example, if your doctor orders new eyeglasses, take time to get used to them, and always wear them when you should or, if you need a hearing aid, be sure it fits well.
Cognitive impairment, impaired judgment, confusion, disorientation Consider hiring a caregiver to keep the client safe.
Impaired balance, gait, or strength

Impaired mobility or range of motion, limited activity tolerance

Neurological problems such as stroke, Parkinson’s disease, and syncope

Musculoskeletal problems such as arthritis, joint replacement, deformity, and foot problems

Always stand up slowly after eating, lying down, or resting. Getting up too quickly can cause your blood pressure to drop, which can make you feel faint.

Limit the amount of alcohol you drink. Even a small amount can affect your balance and reflexes.

Use a cane, walking stick, or walker to help you feel steadier when you walk. This is very important when you’re walking in areas you don’t know well or in places where the walkways are uneven. And be very careful when walking on wet or icy surfaces. They can be very slippery! Try to have sand or salt spread on icy areas.

Talk with your doctor and plan an exercise program that is right for you. Regular exercise helps keep you strong and improves muscle tone. It also helps keep your joints, tendons, and ligaments flexible. Mild weight-bearing exercise—such as walking, climbing stairs—may even slow bone loss from osteoporosis.

Chronic diseases such as osteoporosis, cardiovascular disease, lung disease, and diabetes Ask your doctor about a special test—called a bone mineral density test—that tells how strong your bones are. If need be, your doctor can prescribe new medications that will help make your bones stronger and harder to break.
Medications (more than four prescription medications and blood pressure lowering medications) Find out about the possible side effects of medicines you take. Some medicines might affect your coordination, balance or blood pressure. If so, ask your doctor or pharmacist what you can do to lessen your chance of falling.

GENERAL CONSIDERATIONS

Find out about buying a home monitoring system service. If you fall or need emergency help, you just push the button to alert the service.

Orient yourself to any new environment.

Stay away from a freshly washed floor.

Don’t stand on a chair or table to reach something that’s too high—use a “reach stick” instead.

Hold the handrails when you use the stairs. If you must carry something while you’re going up or down, hold it in one hand and use the handrail with the other.

Wear rubber-soled, low-heeled shoes that fully support your feet. Keep walkways obstruction and spill free.

Don’t let your home get too cold or too hot… it can make you dizzy. Get more than five hours of sleep every night. If you are over the age of 70 and get fewer than five hours of rest per night, you are more prone to falling.

Environmental Risk Reduction

You can help prevent falls by making changes to unsafe areas in your home. Take a look around your home. Your living room, kitchen, bedroom, bathroom, hallways and stairways may be filled with hazards. To make your home safer:

In all living areas

  • Make sure there is good lighting with light switches at the top and bottom of the stairs.
  • Keep areas where you walk tidy. Maintain carpeting and floorboards.
  • Pick up toys or other objects from the floor to clear your path. Keep electric cords and phone wires away from walking paths.
  • Arrange furniture so they are not in your walking path.
  • Have handrails on both sides of all stairs—from top to bottom—and be sure they’re tightly fastened.
  • Keep light switches and telephone near your bed.

In bathrooms and powder rooms:

  • Mount grab bars near toilets and on both the inside and outside of your tub and shower.
  • Place non-skid mats, strips, or carpet on all surfaces that may get wet.
  • Keep night lights on.
  • Don’t attempt to place a child in or take them out of the tub by yourself. Once a child is over 20 pounds it becomes dangerous to both of you to attempt this.

When a Fall Occurs

The majority of people do not see their doctor after falling, although doing so is vital to a good recovery and the prevention of future falls. Recovering from a slip-and-fall accident is multi-pronged and may involve physical therapy, exercises, rest and analgesics.

The staff member discovering the fall will attend to the patient’s immediate needs:

  1. A nurse will assess the client immediately. Provide appropriate first aid measures, stop any bleeding, apply ice to bruises, bumps or cuts.
  2. If there is a suspected broken bone, keep the client still and call for transport to the hospital.
  3. Notify the attending Physician promptly to determine the need for further evaluation.
  4. Neurological checks and vital signs as ordered or appropriate for injury.
  5. The client’s family will be notified of any fall, including injuries in a timely manner.
  6. The fall will be documented in the progress notes.
  7. The caregiver witnessing a fall or finding a patient after an un-witnessed fall will complete an incident report and send to the Nurse Manager or designee.
  8. Teaching about falls and safety will be reinforced to client and family as needed.
  9. Continue to assess client for any unidentified injury and for response to treatments or recovery.

For individuals after a fall or slip injury:

  • Make an appointment with your doctor. He will make sure you have not sustained any injuries. The doctor will check your medications and look for any that have dizziness as a side effect. He may recommend an appointment with an ophthalmologist or eye doctor.
  • Follow your physician’s recommendations. Use hot or cold packs and analgesic medication as directed.
  • Keep your appointment with a physical or occupational therapist. These professionals will show you how to do simple exercises to help you heal from any injuries. They also may recommend exercises to improve your balance and teach you how to get up properly if you do fall. Tai chi, walking and strength training may be suggested.
  • Use properly fitting adaptive equipment, such as a walker or cane, as recommended by the physical or occupational therapist. Do not borrow this equipment from a friend or family member; it must be fit to your body. The therapist also may suggest sitting on a wedge, lowering your bed and elevating your toilet seat.
  • The physical therapist can analyze your home for hazards. He may suggest backing your throw rugs with non-slip grip matting or getting rid of them completely. Other recommendations may include fixing any loose carpet or flooring and keeping clutter picked up off the floor.