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alls are a serious health risk for the older adult. An estimated one-third of all people age 65 years and over who live at home fall each year. Over one-half to two-thirds of nursing home residents fall, and almost one-half of hospitalized patients fall. Older adults with physical and/or cognitive impairment are at the highest risk for falls.[1] Eight percent of persons over age 70 present to emergency departments each year due to a fall. Fall-related injuries account for six percent of all medical expenditures for persons age 65 and older in the United States.[2]
       Aside from injury, other consequences of falling include loss of function, decreased independence caused by fear of falling, and caregivers discouraging activity of the at-risk elderly. Healthcare costs related to fall-related fractures are in the billions of dollars, while falls not resulting in injury can swell nursing home care costs because of increased staff time required for injury assessment, observation, and reporting.[3]
       The option to restrain a patient raises concerns, such as infringement on patient autonomy, limits on freedom of movement, claims of battery, and risk of physical and/or psychological injury resulting from the restraints. When using restraints, healthcare professionals must weigh the benefits of the restraint and should consider whether alternatives to restraint are available. Restraints may be used to ensure physical safety of the resident and other residents and only pursuant to a written physician order specifying the duration and circumstances for which restraints may be used.[4]
       One way to minimize falls and improve the quality of life for residents is to implement a restraint-free fall prevention system in your facility.
       The Tabs® fall prevention monitors (Stanley-Senior Technologies, Lincoln, Nebraska) offer options without the use of restraints. The available monitors are suitable for use in hospitals, long-term care facilities, assisted living, and personal home care environments. A single unit may be attached to a door, a bed, or a wheelchair depending on the needs of a resident or patient. The portability of the monitors allows for increased resident mobility and independence.
       Four types of monitors are available ranging from a basic pull cord and clip assembly unit to a professional unit depending on the needs of the facility. The basic battery-powered cord and clip device attaches, for example, to the backrest of a wheelchair. A cord attaches to the neckline of the resident’s clothing. If the resident attempts to stand, the cord is pulled and triggers the monitor alarm. The monitor can also be fastened to the outside of a doorway. If a resident attempts to open the door, it will pull the cord and signal the alarm. Up to four different tones and sounds are available on the higher-end models to distinguish between residents in the same area of the facility.
       The advanced Tabs® models offer additional features. A voice reminder feature allows staff or family members to record a message that is played if the monitor is activated. Residents with mild dementia may need a familiar voice to prompt them to use a walking aid or other device before attempting to stand, hopefully preventing or reducing the risk of a fall. An optional monitoring feature utilizes a resident-specific radio signal that is sent to a receiver at the nurses’ station. The receiver has an audible alert and flashing light to notify staff that the resident needs assistance. A silent alarm is also available when the device is connected to the nurse call receiver.
       In addition to portable devices, bedside and chair monitors can be used. A full-size pressure pad can be placed under the mattress for discreet monitoring and will put an end to contamination concerns associated with pads placed on top of the mattress. The pad adjusts to accommodate patients or residents of different weights and features a stand-by mode that will deactivate the monitor when moving a patient or resident from the bed. The bed and chair pads, like the cord and clip device, also have the nurse call capability and adjustable alarm tone settings, ensuring the alarm is noticed. The chair pads function in the same manner but are sized to fit wheelchair seats and other small furniture. The “elite” model pad plugs into a standard wall outlet, if maintaining a stock of batteries is a concern.
       With the exception of the most basic model, the Tabs® monitors utilize dual or selective monitoring technology. Dual or selective monitoring technology means a single monitor can be activated with either a cord and clip and/or pressure pad. Dual monitoring capability saves expense by eliminating the need to purchase one cord and clip activated monitor and a second pressure pad activated monitor. When used on a bed, chair, or wheelchair, the cord and clip can be used simultaneously with the pressure pad for added protection.[5]
       Fall assessment forms and materials are used to evaluate what type of fall prevention monitor is best suited to your facility’s needs. A training video is included with each new monitor, and additional videos are available upon request.
       For more information, visit http://www.seniortech.com/tabs/index-2.html.