OASIS Alert

Before you start: Consult the experts -- your therapists.

A patient's fall is not a random event, so your falls assessment program shouldn't be hit or miss.

As you evaluate what you need to do to prepare for OASIS C, one of the most important areas to consider is your falls prevention program. Falls are the leading cause of serious or fatal injuries among people over 65, studies show. One-third of those over 65 and half of those over 80 fall each year, reports the Home Safety Council of the National Council on Aging.

Many of the underlying reasons for falls are well known: poor vision, previous falls, postural hypotension, etc. Some, such as pets and a walking exercise program, are less familiar (see Eli's OASIS Alert, Vol. 10, No. 7, p. 67).

"We highly recommend that agencies consider implementing a falls risk assessment tool to drive care planning and best practices," says Patricia Tulloch, senior consultant with Staatsburg, NY-based RBC Limited. Many software vendors are refining their falls risk tools in preparing for OASIS C, she tells Eli. Or agencies can use one of the many free tools available (see Eli's OASIS Alert, Vol. 10, N0. 7, pp. 71-72).

Most fall risk assessments will focus on these issues, says Judy Adams, president and CEO of Adams Home Care Consulting in Chapel Hill, N.C.:

• history of falls,

• any mobility problems,

• living situation, especially if the patient lives alone and has a decreased ability to transfer safely and ambulate,

• home safety environmental assessment and recommendations,

• and a careful review of medications including consultation with the physician about possible changes if the patient is taking medications that have side effects of drowsiness or lightheadedness.

The better falls risk assessment tools have a scoring system that leads to specific interventions, Adams says. For example, the intervention may be a physical therapy evaluation to improve specific functional issues or address other problems that might be contributing to a higher falls risk. Or an occupational therapist could perform a home safety evaluation and assist with rails, grab bars, and other safety devices that might be needed inthe home, she suggests.

Smart idea: Involve your therapists in your falls prevention program, experts stress. PTs are specially trained in falls prevention in general as well as in evaluating specific falls risk assessment tools. A therapist also can help train staff in using the assessment tool you choose.

(Look for more information about involving your therapists in future issues of OASIS Alert).