Frailty in the Home

[spartan_nurse]

I'm relatively new to geriatric care and definitely new to homecare and I have a question for you all. A client lives at home with her husband and grown son. She is in her late 50's with a complicated medical hx. Hx includes hx of myelodysplasia syndrome, GvH in her lungs (lung function ~30%), Avascular necrosis in right hip, COPD, GERD, Aortic insufficiency. She is on a million meds including beta-blockers and steroids. She has a past history of falls which leads to my question. She was found on the ground the other day at home. She had fallen 10 minutes before I had found her. Her husband was out of town and her son was at school. She stated that she tripped over her oxygen tubing. She has a home concentrator with 50 ft of tubing. I drove her to the ED where they did x-rays of her right arm and hip. She has been diagnosed with a simple fracture and an avulsion fracture at the greater trochanter. She has a difficult time doing ADLs but with good family support manages well (although reluctantly -- she is not ready to give up independence). Since the fall, we have removed all trip risks including clutter and throw rugs (the bane of my existence). We have done all the things we can do right now, but what can I do about the darn tubing? She likes having so much because she can go anywhere in the home (a 1 story ranch style) and out to her car to get groceries. We've discussed carrying her cell phone with her at all times incase this happens again, but that tubing is still a major tripping hazard.