OASIS Alert

Published on Thu Apr 24, 2008 PDF

Learn from these 3 successful HHA programs.

Falls are a primary reason for emergent care -- which attracts surveyor attention and shows up on Home Health Compare. Check out the latest Falls Free Coalition Home Safety Workgroup report for falls prevention help.

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 who live in the community fall each year, reports the Home Safety Council of the National Council on Aging.

In a report focusing on a study of creative practices in home safety assessment and modification, Bonita Beattie of NCA and Elizabeth Peterson of the University of Illinois-Chicago provide detailed information about 10 programs across the country that advance falls prevention strategies, spotlighting three home health agencies. Providing information about these programs "can reduce home hazards through replication in community-based organizations," according to a press release from the Coalition.

Why? Increasing the number of organizations focusing on falls risk is important because older adults who have fallen previously or who stumble frequently are two to three times more likely to fall within the next year, the report's authors say.

The Creative Practices in Home Safety Assessment and Modification Study offers these observations about falls programs:

• Home assessments and subsequent modifications are complex activities that require careful planning, oversight and follow-up at all stages.

• Strategically established partnerships with organizations such as schools of nursing or homebuilders associations served as a common element across the selected programs.

• Some programs need specialized people to implement them effectively such as occupational therapists, and in some communities it may be difficult to access them.

Strategies: The report also identified several creative strategies such as collaborating with first responders and other key partners, making use of trained volunteers, and integrating a fall risk assessment program into a larger safety program aimed at keeping older adults in their homes, the Coalition noted.

Three home care agencies highlighted their falls prevention programsin the report: Saint Elizabeth Home Care Services in Lin-coln, NE; VNA of Care New England in Warwick, RI; and Holy Redeemer Home Care in Philadelphia.

Example: Holy Redeemer provides its LifeAssess program to all patients 85 and over and to younger patients at high risk for falls. The program includes a comprehensive falls prevention screening and evaluation, followed by recommendations and an action plan.

For detailed descriptions of the programs and contact information, check out the report at http://www.homesafetycouncil.org/policy_makers/policy_fallsfree_w003.aspx.

Another report, this time from the Quality Standards Subcommittee of the Amer-ican Academy of Neurology, indicates that patients with neurologic or general conditions associated with an increased risk of falling should be asked about recent falls and further examined for the presence of specific neurologic deficits that predict falls.

What to look for: These deficits include gait and balance disorders; deficits of lower extremity strength, sensation, and coordination; and cognitive impairments. If substantial risks of falls are identified, consider appropriate interven-tions described in evidence-based guidelines. The report appears in the March issue of Neurology.