Falling is an ever-present concern and challenge for nursing homes, and falls at home is often the reason why family members decide to move their loved one to a nursing facility. Too often, however, staff and residents’ fear of falling can lead to a vicious cycle:
- An ambulatory resident falls and gets hurt.
- The resident recovers physically, but may now be afraid to walk for fear of falling.
- The staff also fear that the resident will fall again, so they continually tell the resident to “sit down so you don’t fall,” reinforcing the resident’s fear.
- The resident then sits more and walks less (if at all), and consequently becomes weak (which is just one of the many negative effects of immobility).
- One day, the resident tries to walk or transfer without assistance (common among people with dementia who forget they need help) and falls because he/she is now so weak.
…And the cycle begins again.
How do we break this cycle?
Tricks of the trade:
- Review with staff why people with cognitive decline (who may not be able to communicate their needs verbally) want to get up and walk on their own. Are they bored? Do they hurt from sitting for a long period of time? Do they need to use the bathroom? Do they forget they need help to walk?
- A supervised 5-minute walk could be enough to satisfy their need to move for a while, and may help decrease negative behaviors later on due to boredom or discomfort.
- Instead of saying, “Sit down, you might fall!”, try to get in the habit of saying something like, “I see you want to walk. Please wait and someone will help you very soon.” …then take the individual for a short walk/ a quick stand up for a moment or two / a hug and a dance…..
- Perform fun “sit to stand” exercises throughout the day with residents….put on some music, have them grab the rails along the hallway and do 5 minutes of sit to stands with them!
- Spread the love and encourage physical function…..ask the resident, “Could you stand up and give me a hug?” –The reward back is a big hug from you!