Mobility, Exercise, & Fall Risk.pdf

PHYSICAL ACTIVITY & EXERCISE/ FALLS & FALL RISK REDUCTION Chapter 18 & 19 Copyright © 2020 by Elsevier, Inc. All rights re Mobility and the Elderly Regular physical activity throughout life is essential for healthy aging  Enhances health and functional status while decreasing the number of chronic...

PHYSICAL ACTIVITY & EXERCISE/ FALLS & FALL RISK REDUCTION Chapter 18 & 19 Copyright © 2020 by Elsevier, Inc. All rights re Mobility and the Elderly Regular physical activity throughout life is essential for healthy aging  Enhances health and functional status while decreasing the number of chronic illnesses and functional limitations  A protective factor for depression  Health benefits of physical activity (Box 18.1)  Copyright © 2020 by Elsevier, Inc. All rights reserved Healthy People 2020: Physical Activity Copyright © 2020 by Elsevier, Inc. All rights reserved Mobility and Aging  Age related changes include         Changes in muscles and joints Decreased strength and flexibility of muscles Decreased ROM (range of motion) Normal wear and tear reduces cartilage of joints Movement is less fluid Gait changes Steps are shorter Decrease in step height Copyright © 2020 by Elsevier, Inc. All rights reserved Promoting Healthy Aging: Gerontological Nursing Assessment    Assessment of function and mobility are components of a health assessment for older adults Exercise counseling should be provided as part of the assessment Frail individuals will need more comprehensive assessment to adapt exercise recommendations to their abilities to ensure benefit without compromising safety Copyright © 2020 by Elsevier, Inc. All rights reserved Mobility Screening  CDC “Growing Stronger” program  The Exercise and Screening for You (EASY) Tool: used to determine a safe exercise program for older adults on the basis of underlying physical conditions   www.easyforyou.info The Hendrich II Fall Risk Model includes the Get-Up-and-Go test, which can be used to assess mobility, gait, and gait speed Copyright © 2020 by Elsevier, Inc. All rights reserved Promoting Healthy Aging Interventions  The nurse should be knowledgeable about  recommended physical activity guidelines,  educate individuals about the importance of exercise and physical activity  provide suggestions on ways to incorporate exercise into daily routines  Nurses can design and lead exercise and physical activity programs Physical Activity Guidelines  Guidelines for physical activity for adults 65 years of age or older who are generally fit and have no limiting health conditions are presented in Box18.4*  Guidelines for teaching about exercise (Table18-1)*  Suggestions for incorporating into lifestyle  Tips for adoption of physical activity Box 18.5 & exercise Copyright © 2020 by Elsevier, Inc. All rights reservedsafety Box18.6 Maintaining Function in Acute Care Settings       Growing awareness to focus on hospitalized older adults Hospitalization is associated with significantly greater loss of total, lean, and fat mass strength in older persons A baseline assessment of functional ability is important and can assist in setting appropriate goals for hospitalized individuals The plan of care should include interventions to maintain or improve function for all acutely ill older adults Positive effects of Exercise in LTC (Box18.7) Tips for Function-Focused Care in acute care (Box 18.8) Copyright © 2020 by Elsevier, Inc. All rights reserved Question 1 How much time should be devoted to moderate activity in order to improve health? a. 30 minutes three times a week b. 60 minutes daily c. 45 minutes two times a week d. 30 minutes daily 5 times a week Copyright © 2020 by Elsevier, Inc. All rights reserved Question 2 In order to effectively incorporate physical activity into lifestyle, a person: a. doesn’t need expensive gym equipment. b. incorporates muscle strengthening exercises without weight bearing. c. considers group exercise for its social and emotional health benefits. d. all of the above. Copyright © 2020 by Elsevier, Inc. All rights reserved Geriatric Syndrome: Falls The leading cause of morbidity and mortality for people older than 65 years. 1:3 people age 65 and older falls each year Leading cause of both fatal and nonfatal injuries Two-thirds of falls may be preventable Define Etiology of falls is complex and a fall multifactorial Copyright © 2020 by Elsevier, Inc. All rights reserved Consequences of Falls  Hip Fractures    Traumatic Brain Injury (TBI)     95% of hip fractures are caused by falls Hip fractures are associated with considerable morbidity and mortality Persons over the age of 75 years have the highest rates of TBI-related hospitalization and death Falls are the leading cause of TBI for older adults Signs and symptoms of TBI (Box 19.2) Fallophobia  Fear of falling is an important predictor of general functional decline and risk factor for future falls Copyright © 2020 by Elsevier, Inc. All rights reserved Multifactorial Nature of Falls: Cues        Seven types of fall classifications (Box 19.3) A history of falls is an important risk factor because... Gait & Foot Disturbances Orthostatic hypotension Cognitive Impairment Vision & Hearing Copyright © 2020 by Elsevier, Inc. All rights reserved Medications Fall Risk Factors for Elders box 19.4         Conditions or Intrinsic 4 or more medications Previous fall or fx Chronic pain Foot problems Fear of falling Orthostatic hypotension Osteoporosis      Situations or Extrinsic Urinary incontinence, urgency, nocturia Environmental hazards Improper use of assistive devices General clutter Copyright © 2020 by Elsevier, Inc. All rights reserved Assessment for Falls    Fall risk assessment should be an integral part of primary health care for the older adult Individuals admitted to acute care or LTC should have an initial assessment on admission, after any change in condition, and at regular intervals during their stay Commonly used fall risk instruments in acute and long-term care: STEADI  Morse Fall Scale  Hendrich II Scale  2020 by Elsevier, Inc. All rights reserved Minimum Copyright Data© Set (MDS) Postfall Assessment Determination of why a fall occurred is important WHY?  The purpose of the postfall assessment is to...  Components of a postfall assessment include...  Is an incident report completed?  Is an incident report documented in the medical record? Box 19.10  Copyright © 2020 by Elsevier, Inc. All rights reserved Identify Possible Interventions         Fall risk reduction interventions Box 19.11, fall prevention acute care Box 19.12 & environmental safety Box 19.13 Resources available Vision screening, Medication reduction, CV assessment Hip protectors/assistive devices Education Environmental modifications Safe Patient Handling Box 19.15 Copyright © 2020 by Elsevier, Inc. All rights reserved Restraints and Side Rails    Compare and contrast the difference between a physical restraint verses a chemical restraint. Identify a serious consequence of restraint use? Is a side rail a restraint? https://caregiverconnection.org/wp-content/uploads/ 2017/09/maxresdefault-e1511900426424.jpg Copyright © 2020 by Elsevier, Inc. All rights reserved Restraints and Side Rails (Cont.) Restraint-Free Care  Is now a standard of practice and an indicator of quality care in all health care settings, although the transition to the standard of care is still in progress  Tips for dealing with tubes, lines, and other medical devices Box 19.17  Suggestions from APRN’s Box 19.18  Alternative strategies to restraints Box 19.19 Copyright © 2020 by Elsevier, Inc. All rights reserved Question 1 Risk factors for falls include: a. OH. b. cognitive impairment. c. vision and hearing problems. d. foot deformities. e. all of the above. Copyright © 2020 by Elsevier, Inc. All rights reserved Question 2 The use of restraints can lead to which of the following? a. Death b. Depression c. Exacerbation of agitation d. Asphyxiation e. All of the above Copyright © 2020 by Elsevier, Inc. All rights reserve d References 22 Touhy, T., & Jett, K. (2020). Ebersole and Hess’ Toward Healthy Aging Human Needs & Nursing Response. (9th ed.) St. Louis. MO: Elsevier.  Statement of Copyright and Fair Use The author of this PowerPoint believes that the following presentation contains copyrighted materials used under the Multimedia Guidelines and Fair Use exemptions of U.S. Copyright law applicable to educators and students. Further use is prohibited. If owners of images used in this presentation feel otherwise, please contact the author and they will be taken down if other amicable resolutions cannot be agreed upon.  Copyright © 2020 by Elsevier, Inc. All rights reserved