falls

  1. We all know falls are a big challenge. Even when a careplan is in place Rts will fall. We assess Rts monthly re; risk for falls and revise care plans when a fall occurs. One Rt in pariticular is a puzzelment to us. Poor lower body strengh. refuses PT. pretty unsocial, refusing to be in an area we can observe. Has a dementia. learing isn't going to take place. lately a fall a day. running out of intervention. haven't tried velcro yet. [/LIST]null
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  2. 10 Comments

  3. by   night owl
    Let's face it, res. are going to fall no matter how hard you try to prevent it. If he/she has loss of lower body strength and refuses PT or anything else, maybe it's time for the w/c. Never thought of the velcro thing, just might work! Only kidding of course, but make sure you document,document and document some more...
  4. by   bubblymom
    We have the same problem where I work too. State wants residents restraint free but don't want them to fall either. Can't win. I would suggest looking at what time of the day most of the falls happen. Possilby a need at the time toileting, hunger,etc isn't being met. Also if the resident is in a w/c could you use a lap buddy? It is a cushion that fits on the w/c and doesn't allow the resident to stand. A big plus with this is if the resident can remove it, it is not a restraint. Good Luck!!!
  5. by   Stacey Tortorice
    Lap buddies are good if the patients keep them on or if you do not have a family member that will refuse to let you do that.I did have a patient that did try and stand up in the W/C while that was on they did however
    understand me when I said please sit back down before you fall use it for about a week then found out that it was starting to make patient mad so It was decided to take it off and see what the patient dose and we did and she did find for a few days with out it and then back to trying to get up again.Know how the state feels that is forsure they do not want the patients to fall but yet when you are trying to keep them safe they tell you that they have the right to fall.Their is no way that you can keep all residents from falling.I have a patient right now who has parkinson and is always falling daily just about and he is alert and when I suggest to hime to sit down take a break he tells me that he has the right to do what ever said you are right about that.So he has made the choice to fall on his own.when he dresses suggest to hime that he should sit down and dress and at frist he tells me yep good ideal then he is back up standing up dressing and I will say please sit and finish he will just stand their and do what he wants to do.staceyweb page
  6. by   nursenel
    When ALL else fails....the ultimate responsibility goes back to the facility. If the facility is unable to meet the residents needs, the resident is requested to move. We put residents in low beds and or put a mattress on the floor next to the bed. We also have "ANGELS". volunteers who 's job it is to SIT with the resident. Of course, the POA can always be approached to obtain privae duty. Hopefully the POA is fully aware of all past circumstances and everything is documented properly.
  7. by   Heather Plate
    HAVE YOU CHECKED FOR A UTI? SOMETIMES THIS CAN MAKE THEIR MENTAL STATUS WORSE, INCREASE RISK OF FALLS,ETC. ALSO, DEPENDING ON WHAT YOUR FACILITY ALLOWS YOU MIGHT TRY A MERI-WALKER. GET A PHYSICAL THERAPY SCREEN AND HAVE THEM SUGGEST A MERI-WALKER AND THIS MAY HELP STATE EXCEPT THIS. IT ALLOWS THEM FREEDOME OF MOBILITY, HAS A SEAT TO SIT DOWN WHEN TIRED OF WALKING AND PROVIDES ASSISTANCE FROM INCREASE FALLS. REMEMBER IF YOU DO USE IT BE SURE YOU PUT IN YOUR CARE PLAN THAT IT IS TO PROVIDE SAFETY WHILE INCREASING/MAINTAINING MOBILITY AND DECREASES FALLS. HOPE THIS MIGHT HELP.
  8. by   ltc
    Have you ever used a Merry Walker?
    They work great for some people. It has
    really allowed independence and decreased
    falls.
  9. by   netrn
    Have you tried the personal safety alarms?
    I the res. is w/c bound, we "fix" or "tape"
    the alarm to the w/c and then attach the pull
    alarm cord to the res. clothing. If the
    res. tries to get up from the w/c with out help from the staff or family, the cord is pulled out and staff can assist them with transfers/amb. before they fall. We also use
    this if they are sitting at the table, lounge chair or in bed with a care plan covering this and it is not considered a restraint but a reminder to have assistance.
  10. by   nursejanedough
    Personal alarms do work, but they are so dadgum loud, they scare the you know what out of the residents and the staff. But I guess it's better to be scared than fall and break a hip. It's too bad that so many nursing homes are like a "cattle coral" (that's what I thought of when I would look across a crowded dayroom packed with elderly wheelchaired people). Maybe the government is right with all the Medicare and Medicaid cutbacks. Families should take care of their own.
  11. by   Heather27
    Sure, Jane...families SHOULD take care of their own...what of those who CAN'T? It's sad, yes, to see the end of a life reduced to a few pictures and their favourite chair in their "new home"...but, I know, personally, our facility REALLY strives to keep a sense of self and home for our residents. Most of us have been there so long, it's like our extended family. I promise, Jane...if you're ever in MY nursing home, I'll take good care of ya, and won't crush your pills loudly. Would you prefer jam or applesauce with that?

    Peace
  12. by   HaveOrNot
    Believe it or not, our facility actually got cited by the state for NOT restraining a resident after repeated falls! They said it's our responsibility to keep the resident safe if other alternatives have failed. Can't win for losing with the state! LOL

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