A Refresher on Fall Prevention Strategies

As the Delta variant of COVID surges through the country, long-term care facilities are forced to revisit the effects of closure, social distancing, and isolation on residents.  This variant has caused healthcare professionals to reframe thinking from potentially leaving a pandemic behind, to best practice strategies to mitigate an ongoing response pattern. Facility staff should revisit the impact moving in and out of isolation has on residents. Consequently, a refresher on fall prevention strategies is appropriate.

Isolation has detrimental effects including reduced mobility, decreased cognition, increased depression, weight loss, and increased risk for falls. While the list of obstacles at times seems insurmountable, keen interdisciplinary teams can be a shining light to our residents by constantly adapting, advocating, evolving, and simply showing up. Though increased isolation may lead to residents spending more time alone, unsupervised in their rooms, putting them at an increased risk for falls, there are ways to reduce this risk through a proactive, interdisciplinary team approach.

Consider implementation of these simple tips to help mitigate the risk of falls:

  1. Keep frequently used items within reach, especially the call button.
  2. Educate new staff on residents’ preferences and nighttime routines: lights on/off, TV on/off, toileting schedule, bed positioning, etc.  
  3. Make time to reassure residents who are feeling isolated and lonely.  Even 2-3 minutes of non-task-oriented company is beneficial. Set up virtual visits with family and friends. Decreased anxiety and agitation lead to calmer residents, and hopefully, fewer falls.
  4. Place any mobility devices in the best position for self-transfer; remove if unable to self-transfer to avoid fall risks.
  5. Take extra care to reduce clutter and ensure clear pathways in the residents’ rooms. Remove any throw rugs or items that may be blocking pathways.
  6. Ensure exercise programs, including therapy, stretching, and balance activities are available to all residents as appropriate. Improved strength and balance can assist with fall prevention and help lessen injuries should a fall occur.
  7. Identify residents’ interests and collaborate with the interdisciplinary team to facilitate creative ways for them to participate in preferred leisure activities.  
  8. Refer to physical therapy for balance strategies, assistive device assessment and training, strengthening, transfer training, gait assessment and training, bed mobility training, education on fall prevention, and floor transfers.
  9. Refer to occupational therapy for strength training, balance training, transfers and bed mobility training, facilitation of self-care independence, adaptive equipment training, education on safety awareness, room modifications, and/or cognitive training.
  10. Refer to speech therapy for expressive and receptive communication skills training and strategies, memory, attention to task, sequencing, and safety awareness training techniques.

Educate staff to watch for signs and/or changes which may reflect an increased risk for falls and proactively adapt environments at every level. With a team approach of collaboration and communication, facilities are well equipped to not only reduce the risk of falls for this vulnerable population, but also to ensure that No Patient is Left Behind.  

Clinicians Who Inspire: August 2021 Shannon Rasmussen

Through the Clinicians Who Inspire series, we continue to share motivation, creativity, and inspiration from clinicians in the field. This month we spoke with Shannon Rasmussen, Champion Level II Therapist, and SLP at Pecan Tree Rehabilitation & Healthcare in Texas. Shannon states that working through the pandemic was the most trying time of her SLP career.  What kept her encouraged during those times is the advice she now gives other clinicians, “remember why you became a therapist.” Shannon stresses the importance of staying focused on remembering that we are in our field of work to help others. This focus is what motivated her to use her vocation to provide a positive, meaningful impact during the pandemic. When social isolation became a reality in her facility, Shannon decided to tackle a very real consequence of isolation- weight loss. She met with the dietary manager, and together they initiated a snack cart, filled with a variety of the residents’ favorite snacks. This cart would make its rounds at the facility and provide a real pick-me-up (and additional calories) to the residents spending increased time in their rooms. As in many facilities, another area of concern was the loss of communal meals. Shannon recognized that residents spending increased time in bed could negatively impact their cognitive and communication skills. She worked with the IDT to ensure residents were up and enjoying mealtimes. She even facilitated roommates enjoying socially distanced meals together while seated and facing each other to promote mealtime conversations and socialization. These seemingly straightforward strategies are just a couple of examples of Shannon and her IDT communicating, brainstorming, and working together to bring back some sense of normalcy during demanding times and a reminder to us to focus on our calling to provide patient-centered care. Thank you, Shannon, and team, for being clinicians who inspire each other, your patients, and all of your therapy peers! Keep up the amazing work you do each and every day!

Condensed Version:

Through the Clinicians Who Inspire series, we continue to share motivation, creativity, and inspiration from clinicians in the field. This month we spoke with Shannon Rasmussen, Champion Level II Therapist, and SLP at Pecan Tree Rehabilitation & Healthcare in Texas.  What kept her encouraged during trying times is the advice she now gives other clinicians, “remember why you became a therapist.”  When social isolation became a reality in her facility, Shannon decided to tackle a very real consequence of isolation- weight loss. Together with the dietary manager, they initiated a snack cart, filled with a variety of the residents’ favorite snacks. Another area of concern was the loss of communal meals. She facilitated roommates enjoying socially distanced meals together while seated and facing each other to promote mealtime conversations. These are just some examples of Shannon and her IDT working together to bring back some sense of normalcy during demanding times and a reminder to us to focus on our calling to provide patient-centered care. Thank you, Shannon, and team, for being clinicians who inspire each other, your patients, and all of your therapy peers! Keep up the amazing work you do each and every day! #CareMatters