Falls in Older Persons: Prevention and Management (2nd ed.) by Rein Tideiksaar; 1998; Baltimore, MD: Health Professions Press; 185 pages; son cover; $23.50
This second edition, soft cover book has been updated from thè previous edition. The contents would be a useful addition to the practice of any nurse caring for older adults, whether in a hospital, longterm care facility, nursing home, or community. Falls represent a major problem in care of older adults, with up to 89% of all reported incidents in hospitals being falls and more than 50% of all nursing facility residents experiencing a fall each year.
Falls represent a ripple effect, not only decreasing the freedom and independence of the older adult but causing increased costs and death rates. Families are impacted by the increased costs, guilt, frustration, and changes in status. Any type of institution involved is affected by the increased costs, equipment, and staffing that ensue. Staff members are faced with not only greater patient acuity but the accompanying loss of confidence and morale.
The causes of falls usually are multifactorial, consisting of both extrinsic and intrinsic factors. Assessing the individuals, as well as the environment, for potential risks often averts falls and their subsequent consequences. The author of this book states falls are a predictable event and, therefore, often are preventable. An acronym (SPLATT) is presented for reviewing a patient fall history, as well as a fall-risk checklist. An extensive performance-oriented environmental mobility screen (POEMS) is provided to assist in determining potential risk. Tideiksaar shows how the Minimum Data Set (MDS) can be adjusted to include it.
The chapter on preventive strategies is the best in the book, with explicit diagrammed exercises, footware suggestions, and proper assistive devices. Educational materials, teaching programs, and handouts all are included.
A chapter on modification of the environment presents excellent material regarding lighting, floor surfaces, hallways, beds, bathrooms, chairs, and tables. Bed and chair alarms are discussed also.
In general, the level of content is at a high lay level, with definitions of technical terms, tables, and diagrams to amplify the text. Each chapter contains a list of supportive references and a general bibliography in the appendix, which is quite inclusive of classic, mostly current items from a variety of medical and health care sources. A set of 10 small case studies are in the appendix, with questions and answers which would be helpful for group discussion. Several of the materials such as ambulation device measurement, ambulation device utilization, and use of restraints could be used for inservice or handouts to staff or patients.