Many factors can lead to falls, so it makes sense that multiple approaches be used to prevent them. Research repeatedly shows that fall prevention interventions with a multi-component approach (not including the one you see in the cartoon below!) that include input from all members of the interdisciplinary team are most successful. Examples of these approaches include:
- Educating your team about preventing falls (remember that education alone is not sufficient!)
- Using your facility’s mobility assessment tool (such as the UMOVE at University of Maryland hospitals)
- Helping patients perform exercises that we know can effectively decrease fall risk (such as those that improve balance and resistance exercises)
- Deprescribing medications that increase fall risk (such as psychotropic medications and opioids)
- Decreasing environmental risks (removing clutter, having appropriate seating in areas where patients may walk, and making sure patients can easily access glasses, hearing aids, walker)
- Addressing pain, sleep, delirium, and sensory changes
A key point is that the approaches used need to be individualized for each patient and focus on their specific risks for falling. This could mean prioritizing deprescribing medications and facilitating exercise for one patient and, for another patient, might include making some changes to their environment and reducing their anxiety.
Just as a salad buffet allows you to pick and choose certain foods to your liking—and who gets just one item at a buffet?—fall prevention requires a variety of individualized interventions. While this requires planning, communication, and teamwork, the end result—a patient who is free of falls and maintains their strength, function and mobility while in your care—is well worth the effort.
Function Focused Care 