Long-Term Care

Trainer’s tip: Understanding fall risk

LTC Nursing Assistant Trainer, September 9, 2010

Three primary risk factors account for the majority of falls in long-term care facilities:

  • Over age 65
  • History of previous falls
  • Cognitive impairment

Of these, the strongest predictor of fall risk is the history of a previous fall. The most common cardiovascular risk factor for falls is orthostatic hypotension. This is a drop in blood pressure when a resident rises after sitting or lying down. Unfortunately, this is not a well-known fact. Monitoring orthostatic blood pressure is a critical part of the fall risk assessment and a post fall evaluation. Many medical problems can cause orthostasis. It is commonly seen in dehydration/volume depletion, hypotension, and as a side effect of certain medications. Syndromes that cause syncope may also precipitate hypotension and falls, such as cardiac dysrhythmias, paroxysmal cough from chronic bronchitis, and post voiding in elderly males who void upon awakening.

This is an excerpt from the HCPro book, The Long-Term Care Nursing Desk Reference, Second Edition, by Barbara Acello, MS, RN.

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