Falls & Residence Options Flashcards
Falls are the most common cause of nonfatal injuries in those > 65. True / False
True
60% of community-dwelling individuals > 65 fall each year. True/ False
False 30%
Falls are the most common cause of accidental death in those > 65. True/False
True
Falls account for up to 80% of re-hospitalizations in the first month post hospital d/c. True / False
False 15%
What is a fall?
“An unplanned descent to the floor (or extension of the floor, e.g., trash can or other equipment) with or without injury. All types of falls are included, whether they result from physiological reasons or environmental reasons.”
What are some community risk factors for falling?
BUM-PEC
- Benzodiazepine or sedative-hypnotics (prescribed for anxiety and/or insomnia)
- Use of 4 or more prescription medications
- Muscle or joint impairments
- Postural hypotension
- Environmental hazards
- Co-morbidities (DM, Alzheimer’s, CVA…..)
What are some predictors of fractures after a fall? (7)
FAB-CHOW
- Female sex
- Age > 75
- BMI < 22.8 kg/m2
- Cognitive impairment
- History of CVA
- One or more ADL impairments
- White race
What are some fall prevention strategies?
CHEF-EVE
- Cataract surgery
- Home visits for safety evaluations
- ED fall risk assessment
- Fall prevention clinics
- Exercises (such as Tai Chi)
- Vitamin D supplements
- Elastic hose/binding
Name of tool that assesses fall risk in Inpatient setting?
- what does it evaluate? (5)
- advantages/usefulness
EViL T2’s
Called STRATIFY Risk Assessment Tool: Evaluates Hx of falls, Visual impairment, Level of agitation, Toileting needs, Transfer ability.
- Easy to administer and effective at predicting falls in 1st week of inpatient admission
(Source: http://www.ahrq.gov/professionals/systems/hospital/fallpxtoolkit/fallpxtk-tool3g.html)
What are some complications asssociated with falls?
- Delayed healing
- Post-fall anxiety syndrome
What are some challenges we are faced with after patients (older adults) fall?
- Reluctance to report falls as fear that will lose independence
What are some types of senior living?
- In-home care
- Assisted living
- Living w/family
- Living independently- Medical alerts, personal care aides, CNAs
- Nursing homes
- Homes for those w/Alzheimer’s
- Continuing care
Who are Personal Care Aides (PCA) and what do they do?
Individuals that provide at-home, non-medical assistance (helping with keeping house, preparing meals, transportation, medication reminders, dental care, toileting)
- Non-medical assistance may include respite and/or companion care services
- May visit home multiple times/week, 2-8 hrs. /visit
- BLS national hourly wage average is $10.20/ hr (@ 8 hrs./day for 250 days = $20,400/yr.)
- Those employed by agencies more likely to be insured and bonded
- Local services include Home Instead, Right at Home, Visiting Angels
What type of training / schooling does PCAs require?
PHI National Study showed that:
Few states have well-defined training standards
- 12 states have no training requirements
- 27 states leave training to the agency-employer
- 14 states require no more than 40 hours of entry-level training
Those states that have training lack uniformity (across state)
A growing number of PCAs are employed directly by beneficiaries
Is there any training resuirements for PCAs in Georgia?
- PCAs employed by agencies are required to complete at least 40 hours of agency-provided training
- PCAs employed by beneficiaries must complete 12 hour certification course
