As age, physical changes, health conditions, and sometimes the medications used to treat those conditions, make falls more likely. In fact, falls are one of the leading causes of injury among the elderly. To a large extent, they can be prevented, as long as we know the risk factors of the patient.
A protocol is understood in terms of a system that includes the autonomous or delegated activities performed by the HHA regarding health promotion, treatment, rehabilitation, and readaptation of the hospitalized patient in all stages of the hospital stay.
A Home Health Aide can identify that the patient may fall when:
a) Detection of cognitive impairment
b) Detection of depression
c) Detection of postural hypotension
d) Alteration of postural stability
e) Balance disturbances
f) Visual disturbances
Can falls be prevented?
a) Control of risk factors
• Postural hypotension: recommendations such as raising the head of the bed, reducing the dose of antihypertensives, substituting diuretics for other types of antihypertensives, recommending slow postural changes, first going through the sitting position for a few minutes.
• Medication prescription: review medications with your GP to determine if their interactions can promote falls.
• Inability to safely make postural changes: train such changes, put handles, toilet risers, etc.
• Environmental risk of falls and trips: put a furniture that is safe, of the correct height and more stable, handrails in corridors and stairs, etc.
• Insecurity to walk: balance exercises, train safe postural changes, modify the environment to reduce the risk of falling.
• Decreased muscle strength or mobility in the legs: exercises to strengthen the legs and improve the mobility of your joints.
b) Assistive devices for walking:
• People with diseases of the legs that present with pain, instability, lameness, etc. of different causes, have an increased risk of falling.
c) Adaptation of the environment:
• The best way to prevent falls and accidents of the elderly is to adapt the environment that surrounds them to their circumstances and their possibilities.
When a patient falls…
1. Guide the fall:
Help patients fall with the least possible impact. If close to a wall, push the patient gently against the wall to slow the fall.
2. Transfer of a fallen patient:
Patients who have collapsed may feel dizzy or weak; Reassure them while you determine if they have been injured, and if so, first address the injury. If the patient has not been injured, prepare to transfer him to his bed or to a gurney.
When to call the doctor?
• Call your provider if the patient has fallen or nearly fallen.
• Also call if vision has worsened. Improving the patient’s vision will help reduce falls.