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January 2012, Volume 42 Number 1 , p 65 - 66


  • MaryAnn Edelman MS, RN, CNS
  • Carmel T. Ficorelli MSN, RN, FNP


ABOUT 20% of the population in the United States will be age 65 or older by 2030.1 We can expect health problems to increase as our society ages. This article focuses on assessing older adults and intervening to improve safety in the home. It addresses fall prevention and medication safety.About one of every three older adults who lives in the community falls once every year.2 Falls are the primary cause of injury-related deaths in this population, and many of these deaths occur after months of medical care and treatment.3Many older adults have sensory impairments, including impaired hearing and vision, that contribute to fall risk. Their ability to adjust to night vision is decreased, and they need up to three times the amount of light that younger adults need to see well.Older adults may experience altered depth perception that can put them at risk for falls. Functional limitations that impede their mobility and ability to engage in activities of daily living also increase the risk of falls and may ultimately contribute to placement in a long-term-care facility.3Optimal nursing care can help keep older adults on their feet and in their own homes. A comprehensive nursing assessment can minimize their risks for injury, hospitalization, or long-term-care placement. (See Assessing older adults for fall risk.)Conducting a focused geriatric assessment as part of the standard assessment can also improve older adults' quality of life and keep them as independent as possible for as long as possible.4Best practices for fall risk assessment include the Hendrich II fall risk model (which includes the "get up and go" test), the Katz Index of Independence in Activities of Daily Living, and the Housing Enabler (in home settings). These assessment tools involve obtaining a thorough health history (including chronic diseases, elimination patterns, and medications) and physical assessment, including mental status and gait.5 The Hendrich II fall risk model considers being male an independent

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