1. Health Promotion: Safety and The Elderly Population
Chelsea Kimbel
Kim Larson-Hunt
Sandra Kolk
Nathan Griswold

2. Vulnerable Population: Elderly
Persons 65 or older
Why? Fall Risks
Physical/Mental Impairments
Vulnerable Population: Elderly

3. Generalized Risk factors amongst the elderly
Injury
Nutrition Deficit
Social isolation/Depression
Dementia, Alzheimer
Muscle atrophy/weakness
Compromised Immune system

4. Statistics
“Elderly individuals were reported to be 10 times more likely to be injured by falling on the floor (Kim, Moonyoung & Duk-Hyun, 2013, p.651).
“The prevalence of falls in the elderly is high and strongly correlated with age, increasing from 30% in subjects over the age of 65 to 50% in subjects over the age of 80 . Falls represent the commonest accident of daily living (Annweiler, Montero-Odasso, Schott, Berrut, Fantino, Beauchet, 2010, pg.1)”.
“It is estimated that a fall accompanied by injuries in community-residents aged 72 and over resulted in increased total costs of $19,440 ($5323 nursing home, $11,042 hospital). The mean hospital costs were estimated at $16,030, close to that for acute care by Teresi, et al. (2013, p. 450).

5. Literature Review/Evidence
-Elderly 10x more likely to be hurt from a fall
-Fall prevention exercise programs appear to be effective
-Cognitive functioning is an important factor

6. Literature Review/Evidence
Most common unexpected death among the elderly
Vitamin D correlates with improved balance and walking
Vitamin D deficiency related to muscle weakness

7. Healthy People 2020
“Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death.”
Strength and balance training will help to build muscles, decreasing generalized weakness, and increase prevention of falls, allowing for a higher quality of life.
Group exercises with functional balance exercises will allow the elderly to participate in a group setting, improving social interaction and improving physical mobility, and exercise also helps to prevent diseases and increase heart health.
Comprehensive geriatric assessments in nursing homes can help address areas that can focused on to help improve fall risk issues such as balance and generalized weakness.
Targeted hospital interventions will help prevent further injury when the elderly return home which could potentially result in death.

8. Fall Risks and the Elderly: Current
CDC- “Stopping elderly accidents, deaths, and injuries” created for Physicians
Risk Assessment by physician
Treatment of risk factors
Referral to fall prevention programs in the community
Australian “Stay on your feet” program.
Raising awareness, policy development, education, home hazard reduction
Fall risks among the elderly is an urgent public health challenge (Klein, 2014).

9. Poulos et al. Australia and New Zealand Health Policy 2007 4:6 doi:10

10. Fall Risks: Trending
“A 2008 meta-analysis showed the greatest effects on fall rates were from programs that included a combination of a higher total dose of exercise (> 50 hours during the trial period) and challenging balance exercises, and the 2010 AGS and BGS guidelines recommend the development of an individualized exercise regimen strength, gait, and balance exercises; Tai Chi or physiotherapy for all patients at risk and is grade A recommendation” (Al-Aama, 2011, page. 773).
According to the CDC article “ Be mindful of medications. Some medicines or combinations of medicines can have side effects such as dizziness or drowsiness. This can make falling more likely. Having a doctor or pharmacist review all medications can help reduce the chance of risky side effects and drug interactions" (Center of Disease control And Prevention 2013, para. 3).
An article by the American Academy of Orthopedic Surgeons- A poor diet and not getting enough water will deplete strength and energy, and can make it hard to move and do everyday activities” (American Academy of Orthopedic Surgeons 2012, para. 4).

11. Fall Risk in hospitals 65+ are automatically a fall risk
Fall risk assessment
Yellow rubber soled socks
Fall Risk bands, gait belt
Fall Risk in hospitals

12. Life Alert: Since 1987
-Used for many different medical emergencies including falls
-Very beneficial to elderly with high fall risk, who live alone, or who have a history of repeated falls

13. Literature Review/Evidence
Research/Findings
Falls increase morbidity and mortality among elderly
Burden on caregiver
Increased hospital visits
Increase Physical Activity and reduce or modify risks
Implement exercises classes for older people
Increasing the knowledge, skills, and attitudes about fall prevention in the community

14. Health Promotion: Plan of action
Education of elderly and caregivers on Fall Risks
Setting and Time
At discharge from hospital stays; “Falls account for 90% of the more than 352,000 hip fractures in the U.S yearly (Maville, 2013, pp.288)
When starting medications that affect balance or dizziness
In long term care facilities
Education points for Implementation
Exercise- strengthening
Willingness to learn and implement!!
Environmental factors
Effects of medication

15. Plan of Action Additional safety tips Mobility aids (canes, walkers)
Grab bars in bathrooms
Rubber Soled shoes
De-clutter the home
Remove rugs and other hazards
Consider alternatives for indoor pets
“Falls in the home are the leading cause of fatal and nonfatal injuries to people 65 years and older” (Maville, 2013, pp. 267).

16. Dorothea Orems Theory
“Self-care is a human need, self-care deficits require nursing action” (Taylor et al., 2011, pg. 74)
Falls place a burden on family members
“Needs Theory describes people as whole, with many complex needs that motivate behavior” (Maville & Huerta, 2013, pg.30).
Generalized weakness limits the ability to perform many self care needs
Shower
Cook
exercise

17. References
Al-Aama, T. (2011). Falls in the elderly: Spectrum and prevention. Canadian Family Physician, 57(7),
Annweiler, C., Montero-Odasso, M.,Schott, A., Berrut, G., Fantino, B. (2010). "Fall prevention and vitamin D in the elderly; an overview of the key role of the non-bone effects.“ Journal of Neuroengineering and Rehabilitation 7(5), 1-13.
Guidelines for Preventing Falls-OrthoInfo - AAOS. (n.d.). Guidelines for Preventing Falls- OrthoInfo - AAOS. Retrieved July 27, 2014, from
Klein, D, Kilian R, Kupper M, Becker C, Fischer T (2014). "A population-based intervention for the prevention of falls and fractures in home dwelling people 65 Years and older in south germany." JMIR Publications 3.1
Lynn, P.A., LeMone, P., Lillis, C., & Taylor, C. (2010). Fundamentals of Nursing: The Art and Science of Nursing (7th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.

18. References
Maville, J.A., & Huerta, C.G. (2013). Health Promotion in Nursing (3rd ed.). Clifton Park, NY: Delmar, Cengage Learning. pp
Preventing Falls Among Older Adults. (2013.) Centers for Disease Control and Prevention. Retrieved July 25, 2014, from
Teresi, J., & Ramirez, M., & Remler, D., & Ellis, J., & Boratgis, G., & Silver, S., Lindsey, M., & Kong, J., & Eimicke, J., & Dichter, E. (2011). Comparative effectiveness of implementing evidence-based education and best practices in nursing homes: Effect on falls, quality-of-life and societal costs. International Journal of Nursing Studies, pp
Won-Jin, Kim, Moonyoung, C., and Duk-Hyu, A. (2013). "Effects of a community-based fall prevention exercise program on activity participation." Journal of Physical Therapy Science 26(5) pp