Question

(Implement falls prevention strategies)

Case study  

Sally is preparing a falls prevention strategy for Angelo, who she supports in an aged care facility. Angelo is 86, and had two mini strokes that caused him to fall in the past. One fall caused Angelo a minor head injury, and he was momentarily concussed. Both times, Angelo was unable to get up on his own. Angelo is frightened of falling again, so avoids walking around unnecessarily.

Sally wants to encourage Angelo to live independently and safely. Sally uses the facility’s risk assessment forms to assess Angelo’s risk of falling, and has organised Angelo’s carer (his son, Michael) to also be present for the assessment process.

During assessment, Sally interviews Angelo about his feelings about previous falls. Angelo is embarrassed, and doesn’t want to talk about it. When Sally talks to Angelo’s son, Michael, about the falls, Michael says Angelo feels his integrity as a strong man has been weakened by the falls.

Sally in concerned because the falls mean that Angelo refuses to walk unless he really has to. He is not going outside for exercise, and avoids stairs or any uneven surfaces, which limits the activities he can do.

Sally is also concerned that Angelo smokes heavily. She does not know if this increases Angelo’s risk of stroke, but she is worried about his health in general. Angelo also has a poor diet. He doesn't’ eat many vegetables or diary, but eats a lot of sweet food, like pastries.

Sally organises a meeting with Angelo, Michael, two other workers and her supervisor to discuss and plan the falls prevention strategy for Angelo. The meeting runs for an hour. Sally brings Angelo’s medical history, his medication and blood pressure chart. She also brings a letter of recommendation from Angelo’s GP, which recommends that Angelo decrease his cigarette consumption as it increases the risk of stroke.

Sally and Angelo’s care team decide to use the following strategies to monitor the success of the falls prevention strategy:

• Interviewing Angelo formally every week and informally daily about strategies
• Reviewing incident reports
• Calling a weekly meeting with the team to discuss
• Reviewing Angelo’s falls diary every day

After one month, the following had occurred:

• Angelo nearly slipped and fell when using stairs to access a new physical activity on the lawn.
• Angelo nearly fell when tripping over a fallen branch in the garden.
• Angelo did not decrease his cigarette intake.
• Angelo did not regularly take vitamin D supplements.

1. How can Sally work with Angelo and Michael to review and measure the outcomes of the falls prevention strategy?
2. Why should Sally share and celebrate any positive results with Angelo, Michael, other workers, her supervisor or health professionals as appropriate?
3. Identify when and why strategies are not having the desired result and any indicators of increased risk.
4. Determine future strategies and actions, including referral to other services.
5. Why should Sally consider when completing, maintaining and storing all relevant documentation and reports about Angelo?

Answer 1

iNTRODUCTION

Falls can result in hip fractures, broken bones, and head injuries. And even falls without a major injury can cause an older adult to become fearful or depressed, making it difficult for them to stay active.

The false prevention strategy made by sally was not sufficient to make improvemnt in Mr. Angelo because the results are showing that. Some suggestions we can give that

Sally should also consider the following measures

1.First of all she should provide anxiety and fear controlling measures with the help of a psychologist.She can provde hom some medications with the doctors order and can encourage him for mind diversion therapy like songs.And also instruct his son to be with him as much as possible and talk with him.Provide him psychological support.

2. Sally should consider about his vision because In the aging eye, less light reaches the retina—making contrasting edges, tripping hazards, and obstacles harder to see.She should suggest for eye check up. If any problem it should be corrected.

3.Notice if he is holding onto walls, furniture when walking or if he appear to have difficulty walking or arising from a chair.These are all signs that it might be time to see a physical therapist. A trained physical therapist can help him improve his balance, strength, and gait through exercise. They might also suggest a cane or walker and provide guidance on how to use these aids. Make sure to follow their advice. Poorly fit aids actually can increase the risk of falling.

4.Medications: Some prescriptions and over-the-counter medications can cause dizziness, dehydration or interactions with each other that can lead to a fall.

5. Environmental safety: Ensure adeuate lighting when he gets up.Stairs: Make sure there are two secure rails on all stairs.If not someone should accompany him. Bathrooms: Install grab bars in the tub/shower and near the toilet.Make sure that his pathways in the outdoor are also safe check it and remove if any obstacles.

6.Educate and encourage him to avoid smoking and have adeuate diet and also to reduce sweety foods.

Sally should share all the positive results to Angelo and others it will help him to gain mental support.And also she should document everything because documentation can legal value if any further complaints or complications occur.It will also a guide for further planning of care.