Among elderly residents of nursing homes, it's a story that repeats far too often.
A nighttime trip to the bathroom, an accident because of incontinence, a slippery wet floor and ... a fall.
"The individual felt like he needed to go to the restroom, didn't call the nurse for help and had an accident. The floor was wet, and he slipped and hurt himself," nursing home director and Kansas House member Bob Bethell said.
For nursing home residents, falls are the leading cause of injury and death. Nationally, an estimated 50 percent of residents fall each year, with 10 percent resulting in serious injury, especially hip fractures.
In an effort to reduce those numbers, Kansas Department of Aging Secretary Pamela Johnson-Betts has created a work group of a dozen individuals connected to the nursing home industry. Their mission: identify and determine policies aimed at managing falls.
With the elderly, falling is obviously a given, Bethell said. A part of the issue is that as people age, they experience a loss of muscle tension. Combined with poor balance and other physical slowdowns, they are prone to falls.
"I don't know that we can prevent the falling, but we can try to minimize the effects of the fall," he said.
At Sandstone Heights retirement home in Little River, director Kim Halbert, a member of the state group, added variables: a lack of proper shoes, failure to use a cane or walker and not wanting to ask for assistance.
"Normally we all like to be as independent as possible," she said.
The group's collaborative efforts will provide nursing homes with sample forms and suggestions for tracing data, along with guidelines for changing policies, Johnson-Betts said.
Halbert has suggested teaching each resident, as an individual, what the problem is and what they need to do.
Physical therapy aimed at strengthening muscle tone is another of several ways of trying to prevent falls, she said.
For nursing home residents, as well as older residents who have remained in their homes, Sara Forbes-Holmes, associate nursing professor at the University of Kansas, named getting rid of clutter as an important first step in preventing falls.
Clutter includes things "... from the small area rug we've had in the family for 40 years and don't want to get rid of to magazines, newspapers and small tables," she said.
Exercise will strengthen muscles and balance and help lower blood pressure as well. No one is too old to participate, and it's extremely important, she said.
Forbes-Holmes also suggested evaluating the combination of medicines and a blood pressure check from lying down to standing up.
The results of the study group won't be a prescription but will reflect an opportunity for the nursing home industry to take a look at research, along with looking at other states where a similar group has studied the problem, Bethell said.
Questions the data is expected to answer include what kind of staffing is available at the times the falls occur and how can the opportunities for falling be minimized.
"Even as we age we want to keep our independence," Bethell said. "The worst thing in the world we can do is remove a person's independence."
Families have to be involved with this, as well as the residents themselves, he said.
"There will be times there's nothing we can do to prevent that fall," he said. "We want to make those times very seldom that it happens."
Falling is the first of a series of issues the group expects to study, Bethell said.
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