Watch Out With “Fall Prevention”

Old people fall. Period. In listening to Community Ed alumni recently, some have had challenges in California where the Community Care Licensing Division (CCLD) is expecting strong intervention. While we all want the best care for our residents, we must understand we will never eliminate falls. To lead families, residents, or even the State’s Licensing Program Analysts (LPAs) to believe we can prevent ALL falls is misrepresentation. At the same time we must recognize that we admitted the resident; thus, we have an obligation to meet his or her needs. Admission disclosure is important. Everyone must understand we cannot restrain a resident, and we cannot guarantee a resident will never get up without supervision.

The question remains, can we meet the resident’s needs? First and foremost, a medical evaluation is important once a resident has fallen. Other important considerations include:

  • Would a bed or chair alarm be beneficial?
  • Pharmacist review of medication routine–Can just re-timing medications make a difference?
  • Is my resident properly hydrated?
  • Can I place a bell or other device near the resident at all times to summon assistance?
  • Will physical therapy be beneficial?
  • Does my resident need a new or different assistive device?
  • Would moving the resident’s room location help?

Purchase Fall Precautions in Assisted Living Training DVD

Ultimately for some residents who will not follow instructions to request assistance, the answer is 1:1 care. It is not the residential community’s fault the resident falls, but it is a requirement we do not just “let it happen.” If the resident cannot pay for that level of care, lack of money is not an excuse to retain the resident without the appropriate level of assistance. Immediate steps for relocation should start.

I find it is helpful to keep the family involved every step of the way. Also, keep the service plan up-to-date and signed, ensuring that the community alone does not make medical decisions about fall interventions. Always work with the resident’s physician.

5 Responses to “Watch Out With “Fall Prevention””

  1. I`ve been in this caregiving job, and I alway`s happens to have problem and want to know cause it`s the same questions with the family who get`s involves. The questions is how come that we calles restrained the residence if we only want them to protect from falling… this is in regarding of the full bed rails and seat belt for the wheel chair? since we recomend this to children, as a car seat and infant chair for the car?

  2. In response to Estelita’s concern, I realize “restraint” is a harsh word. The bottom line is that research has shown us that depriving a resident from freedom of movement actually INCREASES falls, not decreases. Many elderly people have actually become entrapped in full rails and dies as a result. The Food and Drug Administration (FDA) has actually come out with mandates that prohibit the use, so it is not just a Community Care Licensing issue. I know it is frustrating, but 1:1 supervision really is the safest. Thanks for caring so much for your resident safety.

  3. You`ve made a list and it`s all taken care off, but we know that fall is an issue with every RCFE and it`s not the questions of the needs of care, it`s just a simple question`s about seat belt and bed rails. your answer is what we keep providing them. And I know that we cannot stop them from accident in our place or their place before they brought them to our facility. It`s every where you are. That`s why it`s called accident and fall! And yes, almost all medication had that effect! Thank you very much!

  4. Is it required to have a physicians approval before we allow a resident to use a wheel chair?

  5. can we have a tab alarm for a resident when they are in a wheelchair in assisted living facility? if so what are the requirements

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