5 Fall Prevention Tactics for Home Care Providers
Too often, falls are seen as inevitable. Home care providers know they aren’t.
Out of fear, older adults who have been diagnosed with conditions that increase the likelihood of falling may become inactive. Family members may begin looking into residential care — especially in cases where one fall has already occurred.
It’s understandable. According to Alberta’s Injury Prevention Centre, 1 in 3 older adults will fall. Most of these falls will occur at home.
If you’re involved in the operation of a home care agency, you’ve probably heard the statistics. But you also know from experience that the majority of patients are happier in their own homes.
Still, providing home care for those at risk of falling comes with serious challenges. Patients receiving at-home care have greater freedom to make their own choices – including choices that make them more likely to experience serious falls.
In addition, as the demand for services booms, many agencies are finding it difficult to implement reliable standards and procedures to deal with adverse events.
Luckily, some fall prevention tactics are applicable across agencies – and surprisingly feasible. This post will look at a few of these tactics, which will be of interest to those in management and on the front lines.
1) Match Caregivers and Clients Appropriately
This one may seem like a no-brainer, but matching clients with service providers who have the skills and experience to deal with their conditions is crucial. Of course, whenever possible, it’s also best to send a client a caregiver that she or he is already familiar with.
The role that well-matched, consistent care can play in fall prevention is often overlooked. Extensive knowledge of a client’s condition can translate into better ongoing risk assessment and a better care plan. Dementia and diabetes are very different conditions – it’s no surprise that the symptoms they cause can lead to very different fall scenarios.
Consistency is also important. Clients are far more likely to accept physical help with risky tasks and advice related to their behaviour when it comes from caregivers they know and trust.
Some home care providers operating in Canadian locations – such Qualicare and Home Instead – view superior client-caregiver fit and caregiver consistency as major priorities. Smaller agencies can also benefit from this kind of thinking, which makes the most of human resources.
2) Encourage Staff to Look for Sneaky Risk Factors
We all know the common risk factors for falls. Dementia, visual impairments, gait and balance issues, benzodiazepine use, and (of course) previous falls are well-known examples.
Most nurses know the potential hazards of these conditions, and many PSWs have practical experience with them. Falls are frequently prevented because caregivers see a clear risk factor and implement the right safety measures.
But not all falls have such obvious causes. According to some estimates, infections are responsible for between 20 and 45% of all falls. In clients with preexisting risk factors (such as dementia) infection can be the catalyst for an adverse event.
Sleep problems are another often-overlooked factor. Poor sleep and frequent awakening can lead to decreased cognitive functioning and walking late at night – both of which are associated with a greater likelihood of falling.
Home care agency decision-makers can reduce falls by encouraging staff members to be aware of less common risk factors and continuously expand their knowledge of potential signs of trouble.
3) Provide Staff with Resources and Educational Opportunities
As the demand for home care continues to grow, many agencies are working to develop more rigorous caregiving standards. Training, education, and access to relevant resources can help caregivers meet new expectations.
Falls are the single biggest cause of home care client hospitalizations from injuries; fall prevention should be a major focus of agency decision-makers looking to educate staff.
As part of a recent initiative that looked at person-centred home care training, Saint Elizabeth developed general guidelines for organizations trying to developing internal education. The initiative included “train the trainer” sessions, which focused on teaching personal support supervisors to run workshops for staff.
If your agency doesn’t have the resources for education development, you can still incentivize or encourage staff members to continue building their skills by pointing them towards authoritative resources and courses (like, for example, the Alzheimer’s Association’s online dementia care training program).
4) Implement a Team Approach to Fall Prevention
An interdisciplinary approach is often the best way to address complex healthcare challenges. When it comes to fall prevention, nurses, physiotherapists, occupational therapists, and nutritionists (among other practitioners) can work together to reach better outcomes.
In the home care landscape – where providers are often described as “silos” who work separately from one another – interdisciplinary and team approaches can be particularly challenging. But as falls in communities increase, interest in team approaches is growing.
Even in smaller organizations, home care providers will likely have varied skill sets and real-world experiences. Arranging care in a way that allows you to capitalize on the many strengths of your team can help you develop new, person-centred tactics for preventing falls.
5) Implement Fall Detection Technology for At-Risk Clients
Sadly, no amount of staff education or guidance can completely eliminate serious falls in older adults. There are times when caregivers just can’t be with their clients. And when clients are alone, accidents can happen.
For those who are most at risk, fall-detection technology can be a lifeline. Wearable emergency products have come a long way in recent years. Sensors can actually determine if a client has fallen and send instant notifications to caregivers, emergency personnel – even family members.
Using the right system, caregivers can initiate instant, two-way communication with clients to assess the potential seriousness of a fall immediately after it’s occurred.
While fall-detection solutions are most valuable for the life-saving emergency care they facilitate, they play a role in prevention, too.
Studies show that significantly limiting physical activity out of fear can actually increase the chances of falling, as can ignoring the possibility of a fall altogether.
Wearable fall detection provides security for older adults so that they can carry out day-to-day activities without feeling anxious. It serves as a reminder for older adults who are less likely to consider falls that they should complete at-home tasks in the safest way possible.
The Big Picture
As healthcare in Canada moves increasingly into homes, home care providers are under increased pressure. Finding solutions to some of the biggest problems in the field – such as the ever-increasing number of falls in the community – will provide a huge challenge in the years ahead.
Through it all, home care professionals are committed to providing clients with security, comfort, and independence. With these aims in mind, agency owners, directors, and managers can start shaping fall prevention strategies that draw on their greatest resources: caregivers.
Feature Image Courtesy: David Amsler
