Fall Risk Prevention for Older Persons: Intervention Plan

Introduction

Falls in the elderly is a serious public health concern. They are the source of numerous health problems such as “pain, disability, loss of independence, and premature death” (Al-Faisal, 2006, p. 5). In fact, fall-related injuries are among the leading causes of deaths in the elderly over 65 years since nearly 30 percent of people belonging to this age group fall each year (Tiedemann & Lord, 2013). For this reason, a comprehensive intervention plan aimed at decreasing fall risks is necessary.

Designing Intervention Plan

Designing a comprehensive intervention plan is a challenging task because it should be based on a multidimensional approach and include multifactorial activities. That is why this paper will offer two intervention plans with regard to the environment of the elderly – home and community or a nursing home. Nevertheless, the foundation of all plans is the combination of a safe environment, training, and medication review.

Intervention Plan for the Elderly Living at Home and Community

The elderly living at home, especially the lonely dwellers, make up the group of people, who are exposed to falls risks the most. The case is even more severe if they do not have relatives or cannot afford professional nurses to provide them with needed care. Still, the first step of the intervention plan is to assess their homes with the aim of identifying any hazards such as sharp corners, rickety chairs, or other elements of furniture, broken stairs, etc. This step implies identifying and making them safe in order to create a hazard-free environment. The same can be said about community – it should be safe.

Other steps call for the promotion of strength and balance training. Such programs should be community-based. They might include muscle strengthening and balance programs offering enough exercise to diminish the risks of falling but not overloading the heart and musculoskeletal system. Moreover, this step might imply cardiac pacing and providing walking aid (National Institute for Health and Care Excellence, 2013). Another significant constituent of the intervention plan is the review of medications.

For example, it is recommended to withdraw sedative and antidepressant drugs because they increase the risks of falls and prescribe vitamins instead to decrease it (Australian Commission on Safety and Quality in Healthcare, 2009). The primary challenge, however, is the ability to control the medications intake and review prescriptions. Moreover, all steps require the involvement of the elderly motivated by their desire to avoid falls.

Intervention Plan for the Elderly Living at Nursing Homes

One more option is to offer an intervention plan for the elderly living in nursing homes. In this case, it is easier to minimize the risks of falls because of the availability of professional nurses and care. The first step as well implies creating a safe environment. One of the recommendations is to provide adequate contrast such as using luminous seats, lighting, and night sensor lights in order to ensure safety during nights. Those people, who experience mobility difficulties, should be provided with transportation services.

As for physical training, it should become part of the lifestyle. The primary idea is to make it social and attractive. One of the options is to introduce Thai Chi at nursing homes because it provides enough exercise to reduce the risks of falls and is simple enough to become involved in (Merom et al., 2013). Speaking of medications, the idea is similar to that mentioned above, i.e. withdrawing sedatives and prescribing vitamins.

Formative and Summative Approaches to Evaluation

Formative and summative evaluation techniques are necessary to estimate the effectiveness of intervention plans. Formative evaluation refers to measures used during the implementation of the plan. It involves the assessment of individual needs and the process of implementation itself. As for the summative evaluation, it is the combination of assessment tools aimed at measuring the results of the program and its impact on the affected individuals (Borycki, Bartle-Clar, Househ, Kuziemsky, & Schraa, 2011).

Developing Evaluation Plan

The evaluation of the intervention plan will consist of two consecutive steps – formative and supportive evaluation. Some of the formative evaluation tools include constant monitoring aimed at estimating the change of individual needs and the process of introducing changes. For example, the popularity of physical training and adapting exercises in order to satisfy the needs will be analyzed. In addition to it, satisfaction with the interim outcomes of the plans will be studied to see whether any changes are required. As for the second step, summative evaluation, will focus on measuring the cases of falls, i.e. it is vital to determine whether their number decreased after the intervention plan was implemented.

Another significant measurement is drawing the connection between the instances of falls and interventions, i.e. finding out whether those, who were actively involved in the proposed activities, were among the patients. One more tool, which will be used for evaluating the effectiveness of the intervention plan, is feedback reports reflecting the stand of nurses and the elderly on the implemented changes.

Conclusion

The severity of the falls problem and its health-related consequences points to the necessity of implementing decisive intervention plans. Even though it is vital to adapt them to a particular environment and individual needs, all of them are based on eliminating hazards, physical strength and balance training, and medication regimens. Still, in order to guarantee the effectiveness of the interventions aimed at minimizing the fall risks in the elderly, it is paramount to review them on a timely basis, recognize the necessity of systematic exercises and plan revisions, and involve the elderly to support the proposed activities.

References

Al-Faisal, W. (2006). Falls prevention for older persons. Web.

Australian Commission on Safety and Quality in Healthcare. (2009). Preventing falls and harm from falls in older people. Web.

Borycki, E. M., Bartle-Clar, J. A., Househ, M. S., Kuziemsky, C. E., & Schraa, E. G. (2011). International perspective in health informatics. Amsterdam, Netherlands: ITCH.

Merom, D., Cumming, R., Mathieu, E., Anstey, K.J., Risse, C., Simpson, J.M., …Lord, S.R. (2013). Can social dancing prevent falls in older adults? A protocol of the Dance, Aging, Cognition, Economics (DAnCE) fall prevention randomized controlled trial. BMC Public Health, 13(1), 477-486.

National Institute for Health and Care Excellence. (2013). Falls in older people: Assessing risk and prevention (NICE guidelines). Web.

Tiedemann, A., & Lord, S.R. (2013). The role of exercise for fall prevention in older age. Motriz, Rio Claro, 19(3), 541-547.