Falls in Older Persons: Prevention and Management in Hospitals and Nursing Homes Rein Tideiksaar; Colorado: Tactilitics, Inc., 1 993, 1 35 pages, $21.00, softcover.
This is quite possibly the most useful book ever published on the subject of falls and older adults. Health care professionals who are developing and maintaining a fall prevention environment will find this text invaluable in both acute and long-term care settings.
Dr. Tideiksaar, a recognized authority on the topic of falls, has addressed the subject clearly and concisely throughout the book. The text is wellorganized into six chapters, six appendices and a comprehensive bibliography. Chapter One covers the consequences of falls with regard to outcomes for patients, families and institutions. Chapter Two addresses causes of falls including age-related physiological changes and pathological conditions, medications, and environmental factors associated with falls and fall risk. Clinical assessment and evaluation of falls and fall risk is found in Chapter Three. Preventive strategies to reduce fall risk are addressed in Chapter Four. Modifications to environmental factors such as lighting, ground surfaces and furnishings to enhance mobility and decrease fall risk are discussed in Chapter Five. Chapter Six focuses on the issue of physical restraints related to fall prevention and management.
Each chapter provides an excellent discussion of its intended topic and the chapters come together to offer a current and comprehensive reference text. The chapters are useful individually as well as part of a sensible and orderly progression of related and1 relevant topics. Each chapter is filled with excellent charts, tables, graphs and illustrations highlighting key components. The appendices provide tools, references, and contacts on performanceoriented mobility screening, ambulating device measurement and utilization, bed and chair alarm systems and restraint alternatives.
This text advocates the importance of individual fall risk assessment and management. It presents a wellorganized, comprehensive blueprint for fall prevention. It provides innovative ideas aimed at enhancing quality of life for older persons, even at the welcome risk of challenging "the way it's always been done." Information is supported with current and classic research. The bibliography is organized into the topics of acute care, nursing home, and restraints and is cleverly annotated to identify references containing information about fall prevention programs and/or fall risk assessment tools.
With the blossoming of the elderly population has come a need among health care professionals to address a number of problems critical to the well-being of this cohort. One of the most pressing problems is falls. Falls account for two-thirds of all accidental deaths among older adults. If an older individual falls inside there is usually a more serious outcome than a fall outside. The outcome is generally more serious still if that fall occurs inside a hospital, and most serious of all if that fall occurs in a nursing home. It is estimated that up to 50% of nursing home residents fall annually, with over 40% having repeat occurrences. It is reported that up to 84% of hospital incident reports are related to patient falls. Persons aged 65 and older make up the majority of the victims in these incidents. One-fourth to two-fifths of nursing home admissions are related to a fall event. Among older persons hospitalized due to a fall, 50% can be expected to die within a year.
Even if a fall event does not result in death, it can result in physical and psychological trauma. In attempting to prevent falls and associated injuries, health care professionals have traditionally instituted protective measures such as reducing mobility and using physical restraints. However, these measures have proven ineffective and have sometimes even unintentionally inflicted harm. Unfortunately, there still exist many institutions which rely upon these traditional methods of fall prevention and management. The best way to eliminate this practice may be through education of health care professionals about a better understanding of falls among older adults. An excellent resource to begin doing that is found between the covers of this book.