CNA logoFour Initiatives to Help Keep Clients Safe

Falls involving the elderly—most of which occur at home—are a major cause not only of pain and suffering, but also of medical expenses and professional liability claims. The following statistics indicate the extent of the problem:

The following measures can help home care providers minimize risk:

Initiative One: Screen the client.
A qualified staff member should visit the home and evaluate client fall risk, document findings and develop a service plan. This evaluation involves using a reliable screening tool to determine fall risk, as well as compiling history from the client and/or family concerning the following issues, among others:

  • previous falls and near misses
  • gait/balance concerns
  • cognitive impairment
  • stroke/seizure experience
  • dizziness and postural hypotension
  • vision/hearing difficulties
  • bladder/bowel dysfunction
  • medication list

Initiative Two: Assess the home environment.
A qualified staff member should evaluate the client’s home for environmental fall hazards, focusing on the following areas:

  • Living rooms and hallways should be adequately illuminated and clear of clutter, obstacles, underfoot wires or cords, and loose rugs or carpets.
  • Stairs should be in good repair, with evenly spaced steps, firmly installed handrails and nonslip safety treads.
  • Toilets should have a raised seat with nearby grab bars.
  • Tubs/showers should be equipped with anti-skid strips, shower chair, hand-held showerhead and grab bar, as well as a nonskid mat outside the tub.
  • Bedrooms should have night-light illumination marking a path to the bathroom, and the bed should be set at an appropriate height for the client.
  • Kitchens should be organized so that frequently used and heavy objects are within easy reach. In addition, there should be a nonskid rug in front of the sink and a sturdy step stool for higher shelves and cupboards.

Initiative Three: Discuss risks.
A qualified staff member should discuss both individual and environmental fall hazards with the client and family, suggesting the following risk control strategies:

  • Advise clients to stay active in order to maintain strength and balance. In addition, ensure that clients use assistive devices correctly, wear proper clothing and shoes, schedule regular medical and vision checkups, and ask their physician to review all medications.
  • Identify high-risk areas in and around the house and suggest practical safety measures.

Initiative Four: Instruct caregivers.
A qualified staff member should educate and train personal caregivers about identifying and addressing fall-related risk factors. This involves:

  • recognizing signs of change in clients’ fall risk status, and documenting and reporting these changes to the supervisor
  • remaining vigilant regarding environmental fall risks, and reporting changes in the environment and other concerns to family members and supervisors
  • practicing safety-minded housekeeping – e.g., keeping walking paths clear and promptly replacing burned-out light bulbs
  • reminding clients of household hazards and teaching them safe behaviors

By implementing and documenting these fall-reduction initiatives, home care providers can protect clients against potentially serious injury while reducing their own liability exposure.

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