Chapter 5a. Presentation Content

The Falls Management Program Manual

On This Page:

Slide 1. Facts About Falls

Facts About Falls

Opening slide of this Falls Management Program presentation.

Slide 2 Facts About Falls (continued)

Facts About Falls on the General Population: 34.9 million people ≥65 years of age; one in three elderly persons living in the community fall each year; of deaths caused by a fall, 60% involve people who are ≥75 years of age; falls account for 87% of all fractures in people ≥65 years of age.

  • General Population
    • 34.9 million people ≥65 years of age
    • One in three elderly persons living in the community fall each year
    • Of deaths caused by a fall, 60% involve people who are ≥75 years of age
    • Falls account for 87% of all fractures in people ≥65 years of age

Slide 3. Facts About Falls (continued)

Slide 3 image from the Falls Management Program Manual presentation. See caption immediately following for descriptive text.

  • Nursing Facilities
    • The average age at admission to a nursing facility is 82.6 years
    • Over 50% of those admitted to a nursing facility have three or more admitting diagnoses
    • One in two patients in nursing facilities fall every year
    • Of those patients who fall, 30-40% will fall again
    • People ≥85 years are 10-15 times more likely to experience hip fractures than those people who are 60-65 years

Slide 4. Intrinsic Fall Risk Factors

Slide 4 image from the Falls Management Program Manual presentation. See caption immediately following for descriptive text.

  • Effects of Normal Aging
    • Vision - decreased acuity, decreased contrast sensitivity, increased sensitivity to glare, decreased peripheral vision, decreased night vision
    • Hearing - decreased hearing sensitivity
    • Changes in gait and balance - reduced arm swing, decreased step length, slowed reaction time, slower movements
    • Urological - feelings of urgent need to urinate and having to urinate frequently

Slide 5. Intrinsic Fall Risk Factors (continued)

Slide 5 image from the Falls Management Program Manual presentation. See caption immediately following for descriptive text.

  • Acute and Chronic Diseases (Parkinson's, Alzheimer's, stroke, arthritis, depression, cancer, osteoporosis)
    • Confusion, disorientation, agitation, impaired judgment
    • Weakness, dizziness, fainting
    • Paralysis, tremors
    • Loss of joint mobility, contractures
    • Lower extremity weakness
    • Drop in blood pressure upon standing, after meals or after voiding
    • Incontinence

Slide 6. Intrinsic Fall Risk Factors (continued)

Slide 6 image from the Falls Management Program Manual presentation. See caption immediately following for descriptive text.

  • Side Effects of Medications (antidepressants, sedatives/hypnotics, and antipsychotics)
    • Dizziness
    • Confusion, impaired judgment
    • Weakness, impaired gait
    • Sedation, slowed reaction time
  • Drug interaction and/or polypharmacy

Slide 7. Extrinsic Fall Risk Factors

Slide 7 image from the Falls Management Program Manual presentation. See caption immediately following for descriptive text.

  • Environment
    • Clutter
    • Inadequate lighting, glare
    • Uneven or wet floors, raised thresholds, missing tiles or linoleum
    • Unstable or lightweight furniture
    • Insecure toilet seat or handrail
    • Hard-to-reach personal items
    • Unstable wheels
    • Low toilet seat
    • Lack of handrail support in bathroom

Slide 8. Extrinsic Fall Risk Factors (continued)

Slide 8 image from the Falls Management Program Manual presentation. See caption immediately following for descriptive text.

  • Personal Safety
    • Unsafe shoes or slippers
    • Hard-to-manage clothing

Slide 9. Extrinsic Fall Risk Factors (continued)

Slide 9 image from the Falls Management Program Manual presentation. See caption immediately following for descriptive text.

  • Equipment
    • Missing wheelchair parts
    • Incorrect wheelchair fit
    • Inadequate wheelchair seating
    • Broken parts

Slide 10. Physical Restraints

Slide 10 image from the Falls Management Program Manual presentation. See caption immediately following for descriptive text.

Physical restraints increase the likelihood of serious injury resulting from a fall.
Not a method of fall prevention

Slide 11. Consequences of Falls

Slide 11 image from the Falls Management Program Manual presentation. See caption immediately following for descriptive text.

  • Serious injury such as hip fracture
  • Increased risk of death associated with hospitalization and complications
  • Loss of independence and decreased ability to function
  • Loss of self-confidence and fear of falling
  • Reduced quality of life
  • Increased need for care

Slide 12a. Staff Strategies To Reduce Fall Risk

Slide 12a image from the Falls Management Program Manual presentation. See caption immediately following for descriptive text.

  • Falls assessment to determine problems with medications, behavior, vision, gait, and mobility, or presence of postural hypotension
  • Medical evaluation
  • Medication review
  • Gait and balance training

Slide 12b. Staff Strategies To Reduce Fall Risk (continued)

Slide 12b image from the Falls Management Program Manual presentation. See caption immediately following for descriptive text.

  • Hip protectors
  • Individualized wheelchair seating
  • Low beds, mats
  • ½ or ¼ side rails
  • Toileting
  • Alarms/sensors
  • Activities and exercise programs
  • Behavioral strategies

Slide 13. How You Can Help

Slide 13 image from the Falls Management Program Manual presentation. See caption immediately following for descriptive text.

  • Remove clutter from room and bathroom
  • Provide safe shoes and slippers
  • Promote safety during transfer and bathroom use
  • Use low blood pressure precautions when needed

Remove clutter from room and bathroom - Provide safe shoes and slippers - Promote safety during transfer and bathroom use - Use low blood pressure precautions when needed

Slide 14. Remove Clutter

Slide 14 image from the Falls Management Program Manual presentation. See caption immediately following for descriptive text.

  • Help keep pathways around bed and to bathroom clear
  • Provide only stable furniture from home
  • Remove items no longer needed

Slide 15. Provide Safe Footwear

Slide 15 image from the Falls Management Program Manual presentation. See caption immediately following for descriptive text.

  • Shoes and slippers should have tread, fit well, have a firm shape, and have low, even heels.
    Examples: tennis shoes with Velcro fasteners, oxford style shoes, canvas or leather slip-on shoes, fitted, soft slippers with tread.

Slide 16. Promote Safety During Transfer

Slide 16 image from the Falls Management Program Manual presentation. See caption immediately following for descriptive text.

  • Call for help when unsure about safety
  • Provide easy-to-manage clothing with elastic waist and Velcro fasteners
  • Lock wheelchair brakes before transfer
  • Keep all seating items in wheelchair

Slide 17. Use Low Blood Pressure Precautions

Slide 17 image from the Falls Management Program Manual presentation. See caption immediately following for descriptive text.

For residents with low blood pressure:

  • Sit on edge of bed and dangle feet before rising
  • Flex feet backwards several times before rising
  • Do not tilt head backwards
  • Get up slowly and use assistance - Report dizziness
Page last reviewed February 2010
Internet Citation: Chapter 5a. Presentation Content: The Falls Management Program Manual. February 2010. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/systems/long-term-care/resources/injuries/fallspx/chap5slide1.html