Promoting Mobility and Reducing Falls by Individualizing Care and Eliminating Alarms

The Institute for Person-Centered Care (formally the Western New York Alliance for Person-Centered Care) -- the first of its kind in the United States -- is designed to provide better delivery of services to frail and vulnerable people, particularly the elderly, and support advocacy and public awareness of their needs, through a program of cross-disciplinary research, education and practice development. This new interdisciplinary institute will bring together researchers, educators, health care providers and community-based programs to develop and disseminate evidence-based care of the frail and aging citizens in our society. We have secured culture change expert Joanne Rader, RN, MN, PMHNP to assist us in this effort. Joanne has published numerous articles and books addressing the emotional needs and behavioral symptoms of persons with dementia including Individualized Dementia Care: Creative, Compassionate Approaches, and Bathing Without a Battle which received the AJN Book of the Year award in 1996, 2002 and 2008.

Promoting Mobility and Reducing Falls by Individualizing Care and Eliminating Alarms:

Is a one and one-half hour prerecorded webinar that will review alarm use which has become the standard of practice, as restraints were, for plans of correction as it relates to accident and incidents as well as prevention of falls. We are now in a period of rethinking their use, as we understand more about their damaging effects, and about the role mobility plays in reducing falls with injury. “If you don’t use it, you lose it”, is factual. We now have evidence that the best way to minimize injury from falls is to maintain mobility because only through weight-bearing activity do you maintain strong healthy bones. According to Mary Tinetti, MD, in The Patient Who Falls, JAMA 2010, the most effective strategies for reducing falls are exercise, physical therapy, cataract surgery, and medication reduction. As Ms. Rader will explain, restricting mobility contributes to falls and falls with injury. Alarms, like restraints, restrict mobility. Alarms have negative impacts on strength and gait, sleep, skin, appetite and digestion, social engagement and mood. They (alarms) have devastating effects on autonomy and well-being. With the proliferation of alarm use, has come alarm fatigue, where so many alarms go off, that staff are desensitized to the sound. The sound also contributes to agitation for elders and families and may actually contribute to people falling. Night time alarms wake other elders who may then try to go to the bathroom and fall. The common response, “sit down,” doesn’t get at what individuals actually need. The same process used for removing restraints works for eliminating alarms - individualized assessment, consistent assignment, learning people’s patterns and looking at the “antecedent” to someone’s rising.

Program Objectives:

·         Identify at least two reasons why elders are more prone to falling

·         Describe a process for eliminating the use of alarms

·         Create individualized  care plans that support mobility as a fall and injury reduction

Target Audience: For leaders (defined as those who have direct reports) at every level including household leaders, supervisors, managers, directors and administrators. Direct care staff, therapists, social workers, and nursing staff will also benefit greatly from this quality initiative.