Managing Complex Falls in Care Homes: Strategies and Updates
Managing
complex falls
in Care Homes
Content
•
Overview and update on the falls
in Care Home work
•
Use of the “Purple Poster”/other
falls tools
•
Practical strategies when dealing
with complex falls
•
Open discussion
Aims of the session
•
To update Care Home staff on the
work in Care Homes to tackle falls
•
To improve confidence when
dealing with falls management
•
To provide practical advice in
assisting with complex falls
•
To facilitate sharing of
experiences with regards falls in
Carer homes
Care Home Update
•
!0 Care Homes in NW have access to an
enhanced therapy service providing
•
Early intervention, initial assessment within
10 working days
•
Exercise intervention delivered by support
workers. Two individual treatments a week
for a three month period
•
Delivery of once weekly chair based
exercise class in 7 out of 10 of the Care
Homes
•
Advice ,guidance and support for senior
staff in assessing and problem solving
issues around falls
•
On going training of care staff in falls
awareness
•
Data collection
Number of falls in 2013 to
2014 in 6 Care Homes
There was an overall reduction of
falls by
•
32.9%
•
2013 to 2014
Purple Poster
Common complex issues
1.
Patients with advanced
dementia
2.
Slipping from beds and chairs
3.
Repeat falls non compliance
4.
Supervision issues
5.
Equipment provision for falls
reduction
Patients with dementia
•
Promote basic health monitoring
( nutrition, hydration, footwear, monitor for
infection, meds review , dementia review ,
review of medical conditions )
•
Sensor mats
( chair, mattress, floor
)
best interest form needs
completing if patient does not
have capacity
•
Supervision (
moving room, being in
public areas)
•
Involvement in purposeful
activities
Slipping off beds and
chairs
•
Check bed and chair heights ,
higher or lower as appropriate (
care Home to purchase any
equipment )
•
OT assessment if required
•
Pressure mattresses can cause
slipping, consider alternative with
DNs
•
One way slip mats
•
Use of bed levers
Non Compliance
•
Difficult to manage
•
Mental health review request ?
•
Find out what motivates the
patient to take risks
•
Goal setting around risky
behaviours
•
Refer for CBT
•
Document non compliance clearly
in care plan if patient has capacity
to understand the risks
Supervision issues
•
Huge problem . Patients cannot be
monitored 24 hours
•
Look for patterns in the individual falls
history for clues as to when
supervision should be increased ( eg
patient falls in early am ? Toileting
issues)
•
Sensor mats
•
Increasing nightly checks
•
Extreme cases 1:1 continuing care
funding can be applied for .Discuss
with manager , Dementia outreach
team can complete the forms
Equipment Provision
•
Assess what the patient needs for
safety and falls reduction
•
Clearly state the need for the
equipment and the impact on falls
reduction and patient safety
•
Care Homes responsibility to provide
equipment eg bed, chair, rotunda,
crash mats, wedges
•
Cot sides can only be used with a
completed cot sides risk assessment
form completed and in the care plan
•
Change room arrangements to reduce
risk of falls
Open discussion
What is your experience?
End of session
•
Thank you for
coming
This comprehensive resource provides an overview of managing complex falls in care homes, including practical strategies, updates on falls in care home work, access to enhanced therapy services, and insights into common complex issues such as patients with advanced dementia and slipping from beds and chairs. The content also includes information on reducing falls, promoting basic health monitoring for patients with dementia, addressing non-compliance issues, and practical solutions for managing challenging situations in care home settings.
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Presentation Transcript
Managing complex falls in Care Homes
Content Overview and update on the falls in Care Home work Use of the Purple Poster /other falls tools Practical strategies when dealing with complex falls Open discussion
Care Home Update !0 Care Homes in NW have access to an enhanced therapy service providing Early intervention, initial assessment within 10 working days Exercise intervention delivered by support workers. Two individual treatments a week for a three month period Delivery of once weekly chair based exercise class in 7 out of 10 of the Care Homes Advice ,guidance and support for senior staff in assessing and problem solving issues around falls On going training of care staff in falls awareness Data collection
Number of falls in 2013 to 2014 in 6 Care Homes There was an overall reduction of falls by 32.9% 2013 to 2014
Common complex issues 1. Patients with advanced dementia 2. Slipping from beds and chairs 3. Repeat falls non compliance 4. Supervision issues 5. Equipment provision for falls reduction
Patients with dementia Promote basic health monitoring ( nutrition, hydration, footwear, monitor for infection, meds review , dementia review , review of medical conditions ) Sensor mats ( chair, mattress, floor) best interest form needs completing if patient does not have capacity Supervision ( moving room, being in public areas) Involvement in purposeful activities
Slipping off beds and chairs Check bed and chair heights , higher or lower as appropriate ( care Home to purchase any equipment ) OT assessment if required Pressure mattresses can cause slipping, consider alternative with DNs One way slip mats Use of bed levers
Non Compliance Difficult to manage Mental health review request ? Find out what motivates the patient to take risks Goal setting around risky behaviours Refer for CBT Document non compliance clearly in care plan if patient has capacity to understand the risks
Supervision issues Huge problem . Patients cannot be monitored 24 hours Look for patterns in the individual falls history for clues as to when supervision should be increased ( eg patient falls in early am ? Toileting issues) Sensor mats Increasing nightly checks Extreme cases 1:1 continuing care funding can be applied for .Discuss with manager , Dementia outreach team can complete the forms
Equipment Provision Assess what the patient needs for safety and falls reduction Clearly state the need for the equipment and the impact on falls reduction and patient safety Care Homes responsibility to provide equipment eg bed, chair, rotunda, crash mats, wedges Cot sides can only be used with a completed cot sides risk assessment form completed and in the care plan Change room arrangements to reduce risk of falls
Open discussion What is your experience?
End of session Thank you for coming
