Why No Risk Assessment is Complete Without a Plan for Post-Fall Intervention

With the aid of cutting-edge technologies, the world of risk assessment in senior housing has made great strides in recent years. Remote sensing tied to artificial intelligence software has made it possible to observe seniors passively, to build a baseline picture of their regular movement patterns, and to send automated warnings when a fall may be imminent.

Still, a fall risk assessment system – however sophisticated it may be – is only the beginning, when it comes to safeguarding senior wellness. Given the frequency and severity of falls, any risk assessment must be tied to a plan for post-fall interventions.

Timely response

Falls require a quick response. The longer an injury goes on diagnosed, the more time goes by before treatment is initiated, the more likely it will be that the severity of the incident is increased. This means that a falls risk program needs to have a time component: Not just goals (“respond within two minutes”) but mechanisms: Who will respond? How will they know about the falls? Will the resident need to pull a cord, or will there be some timely form of automated alert?

Emotional impact

As physically traumatic as a fall may be, many will overlook the potential emotional impact of an event. A fall may cause a senior to feel unsure of herself, to feel anxious about future mobility. A senior who falls may be embarrassed, or may feel worried about potentially losing their present living situation. Any falls plan therefore needs to take this emotional factor into account. Staff should be trained in how to respond to the senior’s emotional needs. Counseling should be made available if needed to help the senior overcome any negative emotional impact.

Changes needed? 

Any falls program should include plans for a rigorous post-fall analysis. Caregivers should confer about processes and procedures. Could something have been organized differently in terms of the physical space, perhaps different lighting or alternative flooring materials? In some instances experts might be consulted to look at specific structural issues that have contributed to the incident, particularly if staff members see a pattern of incidents emerging in a particular setting.

For those seeking a way to build a falls remediation program that goes beyond assessment, the U.S. Department of Veterans Affairs offers extensive guidelines. It recommends, among other thing, the early and intensive involvement of staff in the wake of a fall.

VA calls this the post-fall huddle, a way to bring together key players quickly and efficiently. The interdisciplinary huddle should happen within 15 minutes of the event. The top clinician present leads the team. The huddle brings in the patient at the point of fall, and participants seek consensus in determining the immediate cause of the incident. All this leads to preventative action.

The VA’s version is just one model. The greater point is to have a plan in place. The more one prepares in advance, the better off one will be if and when the time comes to respond to an actual negative event.

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