Quality Of Care Guidelines To Prevent
Fractures In Elderly After A Fall |
Many of the ideas in this section were taken from the American
Academy of Orthopedic Surgeons publications entitled, "Don't
Let a FALL be Your Last TRIP." Many of these suggestions
should be implemented in elderly housing, assisted living
facilities, and institutions which house elderly patients.
-
Over the age of 50, get an annual
physical and eye examination, particularly an evaluation
of cardiac, vascular, and neurological problems.
-
Maintain a diet with adequate dietary
calcium (1200 milligrams for people older than 50) and
vitamin D (400 international units {IU} for anyone over
age 51 and 800 IU's for anyone age 71 and older). Women
who are in or past menopause should discuss the use of
estrogen or other drugs i.e., tamoxifen, in the prevention
of osteoporosis.
-
Participate in an exercise program
for agility, strength, balance, and coordination.
-
Keep an up-to-date list of all medications
and provide it to all doctors with whom you consult (including
herbal products and over the counter medications).
-
Know the side effects and interactions
of your medications (including herbal products and over
the counter medications).
-
Try to walk only in well-lit areas,
as much as possible. Medications should be clearly
labeled and stored in a well-lit area according to instructions.
-
Wear properly-fitting shoes with
non-skid soles.
-
Light switches should be installed
for easy access upon entering or leaving a room, hallway,
or staircase. Glow-in-the-dark switches may be
helpful.
-
Multiple telephones, a portable telephone,
or a service such as lifeline may be necessary for people
with a tendency to fall.
-
Avoid excessive alcohol intake.
-
Do not smoke.
-
When getting up in the morning, sit
on the edge of the bed and make sure you are not dizzy
before getting out of bed.
-
Eat breakfast every morning. Skipping
meals can lead to dizziness.
-
Be careful around pets - animals
can get in front of people's feet or jump on people.
-
Unsteady persons should use a can
or walker. Worn rubber tips should be replaced
right away on these devices.
-
Wear glasses if necessary, but remove
reading glasses before walking.
-
Wear clothes that fit properly. One
can trip on a coat, pair of pants, or bathrobe that is
too long.
-
Clutter, such as clothes and newspapers,
should not be left on the floor.
-
Cabinet drawers should be closed
so one won't stumble over them.
-
Balance training programs, such as
Tai Chi exercises, may improve balance.
Bathroom Safety
-
Never grab a towel rack, shampoo
holder, or soap tray for support in the shower. These
will not always hold a person's weight. If you
are prone to falling, use a shower chair and a hand held
shower attachment. Unsteady persons or those who
cannot lower themselves to the floor of the tub should
install a sturdy, plastic seat in the bathtub.
-
Grab bars should be installed on
the bathroom walls near the toilet and along the bathtub
or shower.
-
Move around the shower only after
the soap suds have gone down the drain. Turn slowly
and cautiously.
-
Clean up puddles of water immediately.
-
Don't lock the bathroom door so as
to allow help to get inside if needed.
-
A slip-resistant rug should be placed
adjacent to the bathtub for safe exit and entry.
-
A liquid soap dispenser should be
installed on the bathtub/shower wall. It may be
difficult to pick up a slippery bar of soap.
-
Nonskid, textured strips should be
placed on the bathtub/shower floor.
-
Glass shower enclosures should be
replaced with non-shattering material.
-
Stabilize yourself on the toilet
by using either a raised seat or a special toilet seat
with armrests.
Stair Safety
-
Carry packages that allow you to
see the next step.
-
Keep at least one hand on the handrail.
-
Flashlights should be kept nearby
in case of a power outage.
-
Handrails should be located on both
sides of the stairway. Use on for going up, the
other for coming down.
-
Objects should not be left on the
stairs.
-
Motion detector lights, which turn
on automatically and light stairways should be installed. Dark
or deep-pile carpeting should not be used. Solid
colors show the edges of steps more clearly.
-
Non-slip treads should be installed
on each bare-wood step.
-
Loose area rugs should not be located
at the bottom or top of stairs.
-
Loose stairway carpeting or boards
should be replaced immediately.
Bedroom Safety
-
Place a lamp and a flashlight near
the bed.
-
Night-lights should be installed
along the route between the bedroom and the bathroom.
-
Sleep on a bed that is easy to get
into and out of.
Living Area Safety
-
Furniture should be arranged so as
to create clear pathways between rooms.
-
Low coffee tables, magazine racks,
footrests, and plants should be removed from pathways
in rooms.
-
Loose area rugs should be secured
with double-faced tape or slip-resistant backing. These
rugs should be rechecked periodically.
-
Electric, appliance, and telephone
cords should be kept out of pathways, but cords should
not be placed under rugs.
-
Wobbly chairs, ladders, and tables
should be eliminated.
-
Sit in chairs or on sofas that are
high enough to make changing from sitting to standing
easy.
-
Carpeting should be placed over concrete,
ceramic, and marble floors to lessen the severity of
injury in the event of a fall.
-
Loose wooden floorboards should be
replaced immediately.
-
A sliding closet door may be easier
to open without a loss of balance than a hinged door.
Kitchen Safety
-
Throw rugs should be removed.
-
Any liquid, grease, or food spilled
on the floor should be cleaned up immediately.
-
Food, dishes, and cooking equipment
should be stored at easy-to-reach waist-high level.
-
Step stools with a handrail should
be used to reach upper cabinets.
-
Loose flooring should be replaced.
-
Nonskid floor wax should be used.
|
