How Ohio Service Providers Can Prevent Falls

 

Falls are the leading cause of injury-related deaths and the most common cause of hospital admissions for trauma in older Ohioans. Health care and other service providers, like doctors, nurses, physical therapist, pharmacists, home health aides, senior center staff and others, are uniquely positioned to actively assess their consumers' risk and teach them prevention strategies.

Older adults account for a disproportionate share of fall-related injuries. While Ohioans age 65 and older are 13.7 percent of our population, they account for more than 80 percent of fatal falls.

  • For about 1 in 3 older Ohioans, falls lead to injuries that result in a doctor visit or restricted activity.
     
  • Most fractures among older adults are caused by falls. Falls account for more than 90 percent of all accidental hip fractures.
     
  • Fall-related emergency room-visit and inpatient hospitalization rates are higher for falls than all other injuries combined.
     
  • The risk of falling increases significantly after age 75.

 

Medical professionals

The CDC recommends a four-step approach for doctors to help patients avoid falls and fall-related injuries.

  1. Be proactive. Ask all patients age 65 or older if they have fallen in the past year.
     
     
  2. Identify and address fall risk factors:
     
    • Lower body weakness;
       
    • Gait and balance problems;
       
    • Psychoactive medications;
       
    • Postural dizziness;
       
    • Poor vision
       
    • Problems with feet or shoes; and
       
    • Home safety

     
  3. Refer as needed to specialists or community programs.
     
     
  4. Follow-up with patient within 30 days.

Adapted from "Preventing Falls in Older Patients: Provider Pocket Guide," published by the Centers for Disease Control and Prevention, National Center for Injury Prevention and Control.

STEADI: Stopping Elderly Accidents, Deaths and InjuriesIn clinical settings, an effective falls intervention involves assessing and addressing an individual's fall risk factors. The Ohio Department of Health and the Ohio Older Adult Falls Prevention Coalition encourage all Ohio health care providers to adopt the STEADI (Stopping Elderly Accidents, Deaths & Injuries) toolkit.

STEADI is a suite of materials created for health care providers to help assess, treat and refer older patients based on their falls risk. STEADI can help you:

  • Make fall prevention part of your practice;
     
  • Get background information about falls;
     
  • Read case studies featuring patients at risk of falling;
     
  • Use validated tests to assess your patients' falls risk factors;
     
  • Offer your patients a medical referral;
     
  • Offer your patients encouragement, resources and referrals; and
     
  • Earn reimbursements for fall screenings and fall prevention reimbursable services.

Learn more about STEADI and download materials from the Ohio Department of Health.

Additional tips for health care professionals and their staff:

  • Create a policy for falls prevention and ensure staff are aware of and understand it. View a sample policy.
     
  • Post signs designating your office or facility as a "Fall-Free Zone." Encourage patients to ask for help and report slipping and tripping hazards to staff. Download and print our sample signs.
      Smiling staff member in an office setting.
  • Empower staff to offer assistance to patients who appear to be having trouble getting around. Download a tip sheet on how to assist an older adult who appears to need help.
     
  • Identify patients who use a walker or other assistive device and plan time that is sufficient to provide the services they need.
     
  • When the weather is snowy or icy, contact older patients who have appointments that day and offer to reschedule so that they don't feel obligated to go out in hazardous conditions.
     
  • If someone falls in your office or facility, document the incident and examine the cause so that you can prevent future accidents. View a Sample Slips, Trips and Falls Incident Report.
     
  • Call to check on any older patient who misses an appointment. Have alternate phone contacts for all older patients.
     
  • Train staff to recognize patients who regularly wear safety alert devices or use walkers, canes or wheelchairs. Empower staff to start a conversation with these consumers if they see them not using their assistive devices.
     
  • Be aware of extreme patient weight loss or gain. Improper nutrition may lead to muscle weakness and dizziness, which could result in a fall.
     
  • Ensure that patients who wear glasses or hearing aides are wearing them and that they fit properly.
     
  • If a patient has a history of falling, document his or her activities and look for patterns.
     

 

Resources

Fall Prevention Center of Excellence

Prevention of Falls in Community-Dwelling Older Adults (U.S. Preventive Services Task Force)

Falls: assessment and prevention of falls in older people (Agency for Healthcare Research and Quality)

Senior centers

  • Offer a variety of exercise classes that help to improve strength and balance.
     
  • Allow members to watch exercises classes before signing up so they can assess their ability to safely participate.
      An older man drinks coffee and reads.
  • Add a routine fall risk assessment activity into your calendar of events. Encourage members to take the online self-assessment.
     
  • Keep hallway areas clear so no one is discouraged from using their wheelchair, cane or walker.
     
  • Have railings on both sides of staircases.
     
  • Monitor parking lots and building entrances regularly for slipping and tripping hazards.
     
  • If your center is a congregate meal site, offer to help members by carrying their meal tray to their table and clearing it when they are finished.
     
  • Provide plenty of space between tables in dining and activity rooms.
     
  • Install grab bars in restrooms.
     
  • Provide seating areas throughout the building so that members have an opportunity to rest between activities.
     
  • Educate staff about falls risks so they can identify and remove slipping and tripping hazards. Use our Slips, Trips and Falls Hazard Checklist.
     
  • Create a policy for falls prevention and ensure staff are aware of and understand it. View a sample policy.
     
  • Empower your members to notify you of slipping, tripping, and falls hazards by placing suggestion boxes in your facility. Download and print sample "Fall-Free Zone" signs.
     
  • Notify your local media if you have a weather-related closing so that members do not travel in poor conditions.

 

Meal providers

  • Plan your delivery schedule so that staff time with the older adults you serve is not rushed.
     
  • Identify consumers who use a walker or assistive device, and plan to spend extra time when delivering their meals.
     
  • Monitor homes for falls hazards (cords, rugs, etc.) and educate consumers about what they can do to reduce their risk of falling. Use our Slips, Trips and Falls Hazard Checklist.
      A woman wears sunglasses and is active outdoors.
  • During winter months ask consumers if they have someone to help them keep their driveway and sidewalks clear, and provide resources if needed.
     
  • Have and call alternate phone contacts for all consumers in case a consumer does not answer the door on a scheduled delivery day.
     
  • Train staff to recognize consumers who regularly wear safety alert devices or use walkers, canes or wheelchairs. Empower staff to start a conversation with these consumers if they see them not using their assistive devices.
     
  • Ask the consumer if they need assistance with opening or preparing the meals.
     
  • Designate congregate meals sites as "Fall-Free Zones" and encourage consumers to report falls risks to staff. Download and print sample "Fall-Free Zone" signs.
     
  • At congregate meal sites, offer to assist older adults by carrying their meal tray to their table and when they are finished, offer to clear their tray.
     
  • At congregate meal sites, keep aisles clear of obstructions and provide plenty of space between tables.
     
  • Be aware of extreme consumer weight loss or gain. Improper nutrition may lead to muscle weakness and dizziness, which could result in a fall.
     
  • Create a falls prevention policy for your agency and ensure that staff are aware of and understand it. View a sample policy.

 

Home health agencies

  • Identify consumers who use a walker or other assistive device and plan time that is sufficient to provide the services they need.
      An older woman smiles for the camera.
  • Monitor homes for falls hazards (cords, rugs, poor lighting, etc.) and educate consumers about what they can do to reduce their risk of falling. Use our Slips, Trips and Falls Hazard Checklist.
     
  • Have and call alternate phone contacts for all consumers in case a consumer does not answer the door on a scheduled care day.
     
  • Train staff to recognize consumers who regularly wear safety alert devices or use walkers, canes or wheelchairs. Empower staff to start a conversation with these consumers if they see them not using their assistive devices.
     
  • Be aware of extreme consumer weight loss or gain. Improper nutrition may lead to muscle weakness and dizziness, which could result in a fall.
     
  • Have a nurse monitor consumers' prescriptions and check to see they are taking their medications as directed. Problems with medications should be communicated to their case manager and physician.
     
  • Identify and report to case managers any needs for home modifications or assistive devices that could reduce falls, and include them in the consumer's care plan.
     
  • Encourage consumers to ask their doctors about a falls risk assessment and for help identifying appropriate physical activity, especially if they have fallen or have a fear of falling. Use the falls risk self-assessment to help get the conversation started.
     
  • Ensure that consumers who wear glasses or hearing aides are wearing them and that they fit properly.
     
  • If appropriate, assist the consumer with clearing their driveway and sidewalk or provide them with resources.
     
  • If a consumer has a history of falling, document his or her activities and look for patterns.
     
  • Include a falls risk assessment in the initial and on-going assessments of each consumer.
     
  • Create a falls prevention policy for your agency and ensure that staff are aware of and understand it. View a sample policy.
     
  • Have at least one staff member trained in home hazard risk assessment (check with your local health district for training opportunities).

 

Print and Go!

Tip Sheet: How Medical Professionals Can Prevent Falls

Tip Sheet: How Home Health Agencies Can Prevent Falls

Tip Sheet: How Meal Providers Can Prevent Falls

Tip Sheet: How Senior Centers Can Prevent Falls