Helping Family Caregivers with Fall Prevention in the Home

“Because mobility in later life results in positive health benefits but increases exposure to falls, many researchers and health care providers in geriatric nursing and medicine have called for ensuring safe mobility while protecting older adults from harm. It’s especially important to identify strategies that can potentially reduce the risk of fall-related injuries in older adults.This increasing focus on fall-injury prevention—in addition to fall prevention—represents a major shift in safety practice.”

(Click image to enlarge)

How can nurses best help family caregivers?

How can nurses help family caregivers identify fall risk in their family members, prevent falls, and respond to them if they occur?

According to the authors of “Preventing Falls and Fall-Related Injuries at Home“—the latest in our ongoing series of articles and videos, Supporting Family Caregivers: No Longer Home Alone—the need for better education and resources on such topics is widespread among family caregivers:

“In a national survey of caregivers who provide unpaid care to a relative or friend, 46% reported they assisted with medical and nursing tasks. Of these, 43% said such help involved the use of assistive mobility devices, such as walkers or canes. Almost half of family caregivers are also known […]

2018-01-25T10:24:11-05:00January 25th, 2018|family caregiving, family caregiving, Nursing, patient safety|0 Comments
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PTSD and Falls: For the Elderly, a Lost Sense of Safety and Control

Jack lowers his head and presses his temples with his thumbs. He whispers, “Am I going crazy?”

In the weeks after his fall and trip to the emergency department, something has gone painfully awry. He’s been having episodes of anxiety when transferring from bed to chair as well as difficulty sleeping. His once unflappable optimism has been blunted by intrusive memories and ruminations about the fall and a sense of foreboding about the future.

Psychological Aftereffects of a Fall

Though he sustained no serious injury and had been quickly returned to the assisted living facility where he lives, the fall has left him with symptoms of posttraumatic stress disorder (PTSD). Most health care professionals are unaware that falls in the elderly can cause posttraumatic stress symptomatology, acute stress disorder, even PTSD. Indeed, in some settings falls occur frequently enough to insulate nurses and other medical staff from the awareness of how terrifying such an event can be or how it can undermine one’s sense of safety and control, particularly when it results in injury and/or invasive medical treatment.

Although Jack was under hospice care at the time of his fall, the facility sent him to the hospital because of its policy on ruling out head injury. Most hospices and facilities have protocols governing their response to falls. These typically include […]

2017-07-19T07:34:30-04:00July 19th, 2017|Nursing|2 Comments
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A Measure of Contentment: One Patient’s Daily Ritual

By Annelisa Ochoa for AJN By Annelisa Ochoa for AJN

“A Measure of Contentment,” the August Reflections essay in AJN, describes the daily ritual of a resident in a long-term care facility. As author Nancy Ngaruiya shows us, nurses and other health care providers can sometimes notice, and support, the small pleasures and routines that make life worthwhile for patients.

Of this patient, she writes:

We make our own happiness. We define what makes us content, what actions help us find that happiness. Sometimes the recipe takes just a few ingredients. Even in an environment where freedom is limited, where rules dictate when to wake up and go to bed, what days of the week we will get assistance with a full bath and who will do it, what meals and activities are or are not available, he has defined what makes him content, perhaps even happy.

The patient in question happens to be one of those who often get frustrated, who aren’t always grateful or helpful—those who tend to be labeled as “challenging” or “difficult” by overworked providers. It’s easy to notice only the frustration of people who’ve watched their worlds shrink bit by bit as their freedoms and abilities diminish along with their health.

2016-11-21T13:01:02-05:00August 3rd, 2016|Nursing, nursing stories, patient experience|2 Comments
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‘Applying QI to Care in Nursing Homes’: A Nurse’s Take on the Tools Needed for Change

nursing homeA colleague once remarked, “Isn’t it strange that the universal response to hearing that someone has gone into a nursing home is ‘Ugh’?”  As nurses, we might hazard a guess as to what kind of care the new resident may receive. But is there a way to reenvision the care that we provide in nursing homes?

In AJN‘s April Viewpoint essay, NP Heather Walker argues that there is, and that quality improvement (QI) can be an effective tool for change. Walker suggests that QI can do for nursing homes what it has done for acute care: focus attention on the systemic issues that stand in the way of good nursing. As she says in the article,

“QI doesn’t negate personal responsibility, but it broadens the focus so that systemic problems are taken into account.”

The QI process fosters reflection, accountability, and teamwork, which in themselves can improve the work environment and residents’ living experience. For more information about this approach, read the short article, here.—Betsy Todd, AJN clinical editor, MPH, RN, CIC

 

2016-11-21T13:01:19-05:00March 31st, 2016|career, Nursing|0 Comments
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The Challenge of Caring for a Graying Prison Population

Photo by Ackerman + Gruber An elderly prisoner in hospice care. Photo by Ackerman + Gruber

Inmates 54 or older are the fastest growing age demographic in U.S. prisons. According to the U.S. Bureau of Justice Statistics, the percentage of inmates who are 54 or older jumped from 3% to 8% in two decades (1991–2011). Criminal justice experts say the increase is probably an effect of the longer sentences of 1980s antidrug laws.

A 2014 report by the Vera Institute of Justice asserts that “prisons and jails are generally ill-equipped to meet the needs of elderly patients who may require intensive services” for their medical conditions. Correctional staff often lack training for treating age-related illnesses and prisons typically don’t have the ability to monitor chronic health issues or employ preventative measures. Inmates are often sent off-site for medical treatment beyond what prisons can provide.

Older adults with physical disabilities or cognitive impairments are also more vulnerable to injury, abuse, and psychological decompensation in the prison setting. “ [T]he prison environment is, by design, an extremely poor place to house and care for people as they age or become increasingly ill or disabled,” said a 2013 American Civil Liberties Union report. Even reliance on devices like wheelchairs, walkers, or breathing aids can present logistical hardships for inmates in facilities that were designed to […]

2016-11-21T13:01:23-05:00March 15th, 2016|Nursing, nursing perspective|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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