Care of the Older Person for Recreational Safety - myassignmenthelp

Question: Discuss about theCare of the Older Person for Recreational Safety. Answer: Falls Among Older Adults: A fall is a sudden event that cause a person to come to rest on the ground or lower level unintentionally due to some major inherent events like stroke and seizure. This is mostly seen in elderly people that threaten their independence and cause many socioeconomic consequences. They are more prone to this event because they undergo normal changes in muscular activity due to aging. Along with this, they have poor eyesight, poor hearing, less strength and balance. Side effects of some medication such as medicines for depression, high blood pressure and some sleeping peels can also cause this event. Unsteadiness of feet may also occur due to some medicines for diabetes and improper heart conditions. One out of five falls event there are instances of serious injuries. It results in the hospitalization and in the extension of staying period that often cause many adverse conditions and complicated consequences. Many falls do not cause any serious injuries but only one out of all five falls that cause serious injury includes broken bone and head injury. Broken bones include bones in wrist, ankle, arm and hip fractures as well. Head injury may result due to intake of medications like blood thinners that may cause brain injury like hematoma. Some falls may results in psychological problems as well. There are many instances that many people who fall are even not injured, but a fear of falling engulfed them that in turn hampers their everyday activities. They become weaker that again increases their chance of falling. It has been reported that over 800,000 patients are hospitalized in a year due to fall injury like head or hip fracture (Cdc.gov, 2018) Fall has both intrinsic and extrinsic risk factors. Some studies suggested that reduced executive function in elderly people acts as a predictor of risk of fall (Mathias et al. 2016). One of the most important intrinsic factor is age, as incidence in fall generally increase with age. Gender also acts as a factor. As compared to young men and women, it has been found that elderly women are more prone to fall and are more likely to occur fracture during fall. Beside all these, medicines like benzodiazepine, psychotropic, class I a anti-arrhythmic medications, sedatives increase the risk of fall significantly (Milos et al. 2014). Some diseased conditions like if a person suffering from chronic obstructive pulmonary disorder, circulatory diseases, depression and arthritis is also at increased risk of falling (Hakamy et al. 2018). Another important risk is nutritional deficiencies like vitamin D deficiency and a low body mass index. These are most common in elderly people that often lead to muscle weakness and osteoporosis that also increase their risk of falling (Uusi-Rasi et al. 2015). Extrinsic risk factors includes environmental hazards like poor lighting, unevenness in surfaces, slippery floors, inappropriate footwear and clothing also increases the chances of falling. Falls can be prevented by various means like taking healthy and nutritious foods and drinking enough amount of water. If a healthy and an active lifestyle is maintained by doing regular exercise like tai chi, muscle weakening and stiffening of joints can be reduced (Wayne et al. 2015). Taking only prescribed medicines, wearing comfortable, firm fitting shoes, avoiding walking in shocks, using walking aids during movement are also some preventive measures. If a person in suffering from eyesight impairment, it is advised to check eyes regularly to avoid falling. Home should be made clear so that pathways remain even and clean. The current strategic approach for preventing falls and fracture comprises of three stages. Firstly, it identifies those older people group who are suffering from high risks, secondly it assesses the risk factors for falls and injury in detail and lastly it gives some interventions to reduce the risk factors that are identified (Ambrose, Cruz and Paul 2015). Nursing assessment includes assessing the circumstance that is associated to increase the fall risk level upon admission and any cognitive or physical alteration. This can be assessed by using standard assessment tools. Assessment on history of falls, changes in mental status, symptoms related to disease and medication should be done. The Fall Risk Assessment Tool ( FRAT) comprises of many scales and are readily available, but some health care professionals are often unaware of many existing scales and do not even know how to select an appropriate one. There are several scales present in this tool that can be confidently used to prevent the risk of fall. Generally, nursing assessment tools that are used to assess intrinsic characteristics of patients, are considered as the most appropriate and potent tool for preventing the risk of fall (Matarese et al. 2015). The above mentioned knowledge is required for my future nursing practice. Being a new graduate nurse, I should learn to take proper action to prevent this risk of fall and severe injuries. I should give nursing interventions to patients after admitting to hospitals or nursing homes. This will be better to provide a secure wristband to patients who are at high risk of falling. I should transfer patient to a room that is nearby to nurses station. This in turn helps to provide a constant observation to patients and quick response to their calls. I should keep the bed at the lowest possible heights from the floor to reduce the risk of falling and serious injury. It is better to place mattress on the floor that reduces the fall risk significantly. I should place items like call light, water, telephone and urinal that are used by the patient within their easy reach. This may reduce the risk of falling. I should quickly response to call light to stop the patient from getting out of bed. I s hould provide bed to patients with side rails. Using side rails on bed can prevent some disoriented or confused patient from falling, since they are more likely to fall seeing one of the four side rails in down position (Vandenberg et al. 2017). I should inform the hospital authority to light hospital rooms properly especially during night time in order to limit the risks of fall for patients having reduced visual capacity. I, being a new graduate nurse, should encourage patients to put on nonskid footwear. This provide sure footing and also diminish foot and toe lifting while walking. I should not rearrange the furniture for familiarizing the patient about the layout of the room. Heavy furniture should be provided that will not tip over when patient used this as a support. I should maintain the primary pathways clear and straight as much as possible. I should provide patient a firm seated chair having arms on both sides that will help them to get out easily. As mentioned earlier, c ertain medication can also enhance the risk of falling. I should collate with other health care members to examine the peak effects of prescribed drugs. It has been reported that taking many medications at a time can increase drug-drug interactions and hence amplify the side effects. This results in dizziness, drowsiness, hypotension like symptoms and enhance the risk factor fall (Stam et al. 2016). So, I should allow patient to participate in regular exercise and gait training program. This will results increase in muscular strength, improvement of balance and enhancement of bone density. I should inform patient who are suffering from eyesight problems and hearing difficulties, to wear eyeglasses and put hearing aids respectively. This will reduce the risk since visual impairment can greatly increase the risks of fall. During transformation of patients from bed to chair, I should provide them with gait belts to promote safety. Beside this, I can also provide other assistive aids such as walkers, wheelchairs and canes for improving their stability and balance during ambulating. Patients who are at high risk, I should arrange a hip pa d for them that may reduce the risk of hip fracture in case of further falling. It has been reported that patients suffer from delirium are associated with high risk of fall (Babine et al. 2016). Those who are facing the onset of confusion and restlessness, I should provide them with reality orientation that decreases their confusion and also reduces the risk of fall. I should tell them not to use wheelchairs as much as possible as they serve as a limitation in moving. I should teach them to use handrails in bathroom for more safety. Improvement of home supports can also relieve anxiety in patients. I should inform their family members to provide them proper nutrition to increase vitamin D level. Calcium and vitamin D supplements are needed by the patients to increase bone strength (Halfon, Phan, and Teta 2015). This can be concluded that though risk of falls are highly associated with elderly people yet there are many preventive measures available. This essay mentioned that due to some risk factors older people are more prone to this risk. It also proposed some strategies of prevention and some measures that will guide them properly to control their movement. It also highlighted that several drug interactions may also increase the risk of fall largely. Some dietary supplements and regular exercises can increase their bone density and musclular strength. Lastly, it reflected on gaps in knowledge and plans for various nursing interventions that a newly graduate nurse should follow to cope up with this situation. References: Ambrose, A.F., Cruz, L. and Paul, G., 2015. Falls and fractures: a systematic approach to screening and prevention. Maturitas, 82(1), pp.85-93. Babine, R.L., Hyrks, K.E., Bachand, D.A., Chapman, J.L., Fuller, V.J., Honess, C.A. and Wierman, H.R., 2016. Falls in a tertiary care hospitalassociation with delirium: a replication study. Psychosomatics, 57(3), pp.273-282. Cdc.gov. (2018). Important Facts about Falls | Home and Recreational Safety | CDC Injury Center. [online] Available at: https://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html [Accessed 30 Apr. 2018]. Hakamy, A., Bolton, C.E., Gibson, J.E. and McKeever, T.M., 2018. Risk of fall in patients with COPD. Thorax, pp.thoraxjnl-2017. Halfon, M., Phan, O. and Teta, D., 2015. Vitamin D: a review on its effects on muscle strength, the risk of fall, and frailty. BioMed research international, 2015. Matarese, M., Ivziku, D., Bartolozzi, F., Piredda, M. and De Marinis, M.G., 2015. Systematic review of fall risk screening tools for older patients in acute hospitals. Journal of advanced nursing, 71(6), pp.1198-1209. Mathias, P.A., Jidesh, V., Kanagaraj, R.R. and DSouza, V., 2016. Is Executive function a significant predictor for risk of fall among elderly population?A cross sectional study. International Journal of Therapies and Rehabilitation Research, 5(4), pp.126-129. Milos, V., Bondesson, ., Magnusson, M., Jakobsson, U., Westerlund, T. and Midlv, P., 2014. Fall risk-increasing drugs and falls: a cross-sectional study among elderly patients in primary care. BMC geriatrics, 14(1), p.40. Stam, H., Harting, T., Sluijs, M.V.D., Marum, R.V., Horst, H.V.D., Wouden, J.C.V.D. and Maarsingh, O.R., 2016. Usual care and management of fall risk increasing drugs in older dizzy patients in Dutch general practice. Scandinavian journal of primary health care, 34(2), pp.165-171. Uusi-Rasi, K., Patil, R., Karinkanta, S., Kannus, P., Tokola, K., Lamberg-Allardt, C. and Sievnen, H., 2015. Exercise and vitamin D in fall prevention among older women: a randomized clinical trial. JAMA internal medicine, 175(5), pp.703-711. Vandenberg, A.E., van Beijnum, B.J., Overdevest, V.G., Capezuti, E. and Johnson, T.M., 2017. US and Dutch nurse experiences with fall prevention technology within nursing home environment and workflow: A qualitative study. Geriatric nursing, 38(4), pp.276-282. Wayne, P.M., Hausdorff, J.M., Lough, M., Gow, B.J., Lipsitz, L., Novak, V., Macklin, E.A., Peng, C.K. and Manor, B., 2015. Tai chi training may reduce dual task gait variability, a potential mediator of fall risk, in healthy older adults: cross-sectional and randomized trial studies. Frontiers in human neuroscience, 9, p.332.