Here’s my latest article on McKnight’s Long-Term Care News:
Falls: A closer look
Part of my job as a geropsychologist is to conduct reviews of falls with my patients after they occur.
Through discussion with the resident, I analyze what happened and assess how they’re doing after what can be a traumatic event. Together, we identify ways they can prevent future falls.
This exercise can be very revealing not only about the particulars of a situation but also about why falls occur in general.
The trauma of falls
Falls can be traumatic for a number of reasons. Sometimes an individual is badly hurt in the event, leading to a hospitalization and/or a decline in their physical and mental condition.
Occasionally, a person isn’t found immediately, resulting in a period of time on the floor in pain with negative thoughts about themselves, staff, the facility and life in general. A spill can also trigger thoughts about similar past distressing episodes, such as a reminder of a fall at home that precipitated hospitalization and placement.
In addition, falls can decrease residents’ confidence in their physical abilities, leading them to become overly cautious in rehab and resulting in increased physical dependence.
Why residents fall
There are many reasons that people fall, including forgetting their inability to walk, dizziness due to medication side effects, pain and restlessness.
This 2014 article in Managed Healthcare Connect provides excellent examples of how to conduct a thorough “root cause analysis” and a discussion of many of the elements that contribute to falls and how to address them.
Falls are typically multifactorial, but my own experience with residents over the years — bearing in mind that I speak only with residents who are cognitively intact and able to benefit from psychological services — suggests one major cause of falls in this cohort: not getting help in a timely fashion.