Fall Prevention Strategies for Older Adults

This assignment delves into the crucial topic of fall prevention for older adults. It analyzes various studies and research papers that shed light on factors contributing to falls in this age group, such as medication use, cognitive decline, and physical limitations. The assignment also investigates effective fall prevention programs and interventions, highlighting evidence-based practices recommended by healthcare professionals. Furthermore, it considers the impact of falls on the health and well-being of older adults, emphasizing the importance of proactive measures to reduce fall risk.

Assessment

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................3
1. Justification of the chosen concept analysis method..........................................................4
2. Analysing the concept by using Walker and Avant ..........................................................5
3. Critical evaluation of how well theoretical and research literature address the concept....8
4. Critical evaluation of actual or potential implications for nursing in relation to the concept.9
CONCLUSION .............................................................................................................................10
REFERENCES..............................................................................................................................11

INTRODUCTION
Concept can be described as the mental representation, ideational objects that are
generated from specific instances which makes up the fundamental structural blocks of idea,
thoughts and beliefs (Alghamdi, 2016). The present report is about a concept that relates to “risk
of fall among elder people”. The concept is chosen because it will be helpful in the further
theoretical development of the nursing practise. Also, it will add to the existing knowledge of the
nursing practitioner whose stream is aged care nursing home. The concept is relatable to the
exiting practise of the nurse as it deals with the older people who are more prone to the risk of
falling frequently which could injure them severely.
In the concept paper of risk of fall among elder people”, a concept analysis will be done
for assessing the risk of fall among the older people.
The aim of the concept analysis is to determine and assess the high risk of fall amongst
the elders. The fall among the elder is one of the major cause of injuries amongst them and could
be an indication of undetected or undiagnosed disease in the aged people. As per the report of
World Health Organisation (WHO),
 Falls are second most cause of unintentional injuries around the world.
 646,000 individuals approximately dies every year from falls in the world. About 80%
deaths from falls are in low income countries.
 People over the age of 65 years are the at the peak of risk of fall.
 About 37.3 million falls are considered as serious falls that requires instant medical
attention (Falls, 2018).
Fall is also an indication of immobility, frailty and chronic impairment of health in the
older people. The issues in this concept paper will be discussed are the factors that causes fall,
the injuries that is caused to people due to falling and how can it be prevented. The concept
paper will also include an analysis of concept, justification of the concept chosen and evaluation
of actual or potential implications for nursing relating to this concept.
MAIN BODY

1. Justification of the chosen concept analysis method
Concept is an abstraction of ideas that builds up a strong base for thoughts and beliefs. A
concept is chosen mainly for the following reasons:
 interest in the concept
 which serves the needs of the researcher
 which is easily manageable if it is a first concept analysis
 which adds to the existing knowledge
 which leads to the further theoretical development in the work area (Flott & Linden,
2016).
The nursing practitioner has chosen the risk of fall among the elder because it is related to
its work area and an assessment of this concept will help it in widening its existing knowledge
and it will help the nurse in bettering its services in the aged care nursing home.
Studying the risk of fall in elders is important because falls are resulting into large
number of deaths every year across the globe. Another reason is that financial costs that are
associated with fall injuries significant. For people who are of 65 years or above, the average
cost of heath care facilities amounts for $1049 in Australia. Forming and implementing strategies
for preventing the falls could help in making net savings of US $ 120 millions every year (Falls,
2018).
Concept analysis is referred to as an exercise which is designed for making the researcher
or a student familiar with the concept chosen. In simpler language, it means cutting or breaking
down of a concept into simpler components for promoting clarity while rendering the mutual
understanding within nursing. An analysis of concept is basically the assessment of the
underlying facts and aspects of the concept chosen in the nursing which helps researcher in
understanding every possible of the concept that could be easily communicated and could be
easily understood by others as well (Flott & Linden, 2016).
Method of concept analysis:
There are different methods of concept analysis through which the nursing practitioner
can analyse its concept which is risk of fall amongst the elder people. They are :

 Walker and Avant Method
 Wilson Method
 Roger and Knafl Method
 Norris's Method
For the purpose of the analysis of the concept, the practitioner has selected the Walker
and Avant model which lays down eight steps for the complete assessment and analysis of the
chosen concept.
The rationale for selecting Walker and Avant's method of concept analysis is that it is the
most widely used model in the nursing science. The process of the Walker and Avant is very
influential and provides an opportunity to the researcher to evaluate and analyse every bit of the
concept (Ffleiszer, Semenic, Ritchie, Richer & Denis, 2015). It starts with the selection of the
concept and ends with defining of the empirical referents. The creator of the model said that the
concept should be selected in which the interest of the researcher lies, for e.g. the concept is
related to their work.
2. Analysing the concept by using Walker and Avant
The Walker and Avant method of concept analysis involves 8 steps for evaluating and
assessing the current concept Risk of fall among the elder people. These steps are discussed in
brief below:
 Selection of concept : Fall in nursing terms means coming falling on the ground
unintentionally. This is serious matter of concern in public heath care as large number of
people especially older people are experiencing severe injuries. The particular concept of
risk of fall in aged people is taken because it is associated with the work area of the
nursing practitioner and research and analysis of this concept will help it in understanding
the reason and control measures for preventing such fall in the senior citizen. This is
necessary because majority of the injury in the senior citizen segment of the population is
caused due to sudden falling accidents of the aged people. Also, it is a sign of undetected
illness in the people which needs to be diagnosed and treated (Schaefer & Welton, 2018).
 Determining the aims of the analysis: This step of in the analysis procedure is
concerned with the question which is “why the researcher is undertaking this research on

this particular concept”? In this step , it is found out that how the researcher is exactly
going to use the results of this analysis (Barnes, 2015). The aim of analysis is to clarify
the defining attributes of risk of fall in elders and determine the antecedents that impacts
the perception related to the concept and the potential consequences of falls amongst the
elders.
Nursing practitioner has undertaken the analysis on this topic as it is going to help it in
better performing at the work area, it would help it taking preventive measures for mitigating the
risk of falling in old age people.
 Identification of uses of concept : This the third stage in the concept analysis model of
Walker and Avant. This includes the thesauruses, colleagues, dictionaries literature etc.
The medical practitioner shall identify the areas where the concept can be used and it
shall not limit it to a particular field. The practitioner could use the concept in
sociological approach. The risk of fall in elders is gendered into two categories. Males
perceives that they are responsible who can reduce their own risk of falling while females
have the tendency to blame others for their falls.
 Determination of defining attributes : This stage is the centre f the model. This stage
shows the bunch of attributes that are often related with the concept chosen. This allows
the medical practitioner broad-brimmed insight of the concept. While examining the
instances related to the concept which appears again and again, a list could be prepared
by the concept analyst that would be called as characteristics of the concept. Such a list
filled with characteristics, is known as defining attributes (Kvelde, Lord, Close,
Reppermund, Kochan, Sachdev & Delbaere, 2015). For examining the taken concept of risk
of fall in older people, causes for the fall are mainly common. Definition of the attributes
regarding the concept could be understood by defining the term fall. It is unintentional
falling on the surface of land due to loss of unconsciousness or any other reason.
On the basis of this principle, main attributes of the concept of risk of falls include : a) an
individualistic human experience, b) state of feeling in relation feeling and sensation, c) warning
signs of chronic health diseases, d) falls are experienced because of balance, medical conditions,

inattention, outside environment, slip trip stumble, e) bodily responses to the stimulation related
to fall injury.
 Identifying model case : Model case refers to the illustration of use of the concept that
exhibits all the defining attributes that were ascertained in the fourth stage of model. This
in general terms means that case shall be the pure and exact example of the selected
concept. These model cases can be drawn out of real life experience, from the available
literature, or it may be a hypothetical case created by the analyst itself.
A model case for the concept of risk of falling in elder is :
“An old man fell in the ground unexpectedly and suffered serious injury in his head. It
caused internal bleeding in the head of old man. During the treatment it was observed that old
man fell because of the undiagnosed chronic illness which was circulatory disease.”
This is a model case for the concept because it contains all the attributes such as the cause
of the fall in elder which was one of the characteristic of the concept that is commonly found in
this specific age group. Identification of additional cases : In Australia, people of /over 65 years experiences at
least one fall every year. The incidence rate of cost of falls in elders is going to rise
around $1.4 billion by 2051 (The problem and prevalence of falls, 2019).
Finding and examination of different cases is another essentiality stated by the profounder of the
Walker and Avant concept analysis. These cases are not exactly same or contrary as the chosen
concept but studying such additional cases helps the analyst to better form its judgement about
the concept. One of the additional cases are categorised as Border line cases which consists of
majority of the defined attributes but not all of them. Another categories are related case,
contrary case, illegitimate case.
 Identification of Antecedents and Consequences : Antecedent can be described as
those incidents or instances that shall occur prior to occurrence and construction of the
concept (Allen‐Duck, Robinson & Stewart, 2017). Consequences are those instances or
events that happen as a result of construction of the concept or occurrence of the chosen
concept.

Environmental surrounding, personal attributes and social values are the
antecedent of concept of risk of fall in elders. Personal attributes such as lack of care while
walking could lead to fall etc., gender of the elder also affects the risk of fall.
Falls reaction are more in physical nature. The consequences of the falls could be serious
hip fractures, internal bleeding, bruising, neck fractures and even death. About 1.5 % person
suffers from hip fractures, 2-6% suffers fractures (The problem and prevalence of falls, 2019).
 Defining of empirical referents : These referents are the categories of actual
phenomenon which is based on their beingness or presence demonstrated the happening
of concept. These empirical referents are in development of instrument or concept. It very
significantly contributes to the content and assists in constructing validity of the new
concept.
3. Critical evaluation of how well theoretical and research literature address the concept
The concept taken was risk of fall in elders. The medical practitioner applied the method
of Walker and Avant for analysing the concept. From the research undertaken, it was found out
that there are different risk factors that gives rise to the risk of fall in aged people. Some of which
are chronic heath diseases which are not diagnosed yet, ageing, weaknesses, etc. There is a wide
categorisation regarding the risk factors such as living alone, ethnicity, medicines, medical
conditions, sedentary behaviour, psychological status etc. For example, if an old man is on
medication for more than 4 medicine, the risk of fall increases very significantly (Li, Harmer,
Eckstrom, Fitzgerald, Akers, Chou & Winters-Stone, 2019)
The literature available has supported and addressed the concept up-to a satisfactory
level. The use of Walker and Avant model has helped in the analysing the concept taken. As per
the available literature, the antecedents and consequences, older people after the age of 65 years,
falls very frequently and about 30 – 40 % of the community falls each year. This rate is greater in
residents of nursing homes and patients who are hospitalised. The risk increases even more at the
age of 80 years. By looking the information available, the practitioner is able to examine and
analyse the concept.
However, the literature available mainly focused on selected category such as cause of
fall, impact of fall, prevention of fall and its related social context. The literature is about the
impact of fall such as fall can cause anxiety in the family of older people, but not in depth

literature is there about the impact of falls on the people who are closely related to the affected
older person. It is yet unknown that the fear of fall will pass on to relatives or the care providers
in the nursing homes. Identification of this aspect is necessary, because higher number of falls
directly questions the care providers in the nursing home (Von Colln-Appling & Giuliano, 2017).
4. Critical evaluation of actual or potential implications for nursing in relation to the concept
The risk of fall in the elders can be prevented by determining the health history and
physical examination. These two components could help the nursing sector in establishing
strategies for the fall prevention. A thorough diagnosis of an elder person for ascertaining the
various elements such as neurological functions, cognitive functioning, visual and hearing
capabilities of old people, degree of musculoskeleton strength along with cardiopulmonary
stamina would assist the nursing institutions in forming effective preventive measures for
deterring the risk of falls amongst the older people. This is also necessary because a fall can lead
to life taking injuries in the people (Törnvall, Marcusson & Wressle, 2016).
There are fall prevention strategies that could be used by the nursing homes such as
regular exercise for keeping the aged people fit, providing them high dose of Vitamin D. There is
a well established relationship between regular exercising and reduction in the number of fall in
the old age group of population. The disability in the old people can be decreased by engaging
them in specifically designed exercises for them. This would reduce the risk of fall in the elder
population. Tai Chi , a tool for prevention has reduced the rate of fall in elder people by 37 %.
Vitamin D is the supplement that could be provided to senior citizens for the deficiency they are
suffering, is an effective and easy strategy for preventing fall and fractures amongst this segment
of the community. This strategy might result in the reduction in the rate of fall in a year to a
significant level. Reducing the benzodiazepine or psychoactive medicines terribly increase the
risk of fall amongst the older people. If the prescription regarding the same can be reduced, it can
critically result into the deterring in the rate of risk of fall(Green,Reifler,Bayliss, Weffald &
Boyd,2019).
However, formulating prevention strategies is imposed with various challenges that have
arisen due to different factors which intervene and interact. Another challenge is application of
available evidence in practice consistently. Merely assessing the risk of fall will not be
translated into the reduction in the harm unless such assessment is connected with an

intervention because labelling the old people as high risk would not do the work of preventing
fall. If there is no consistency followed by the caregivers, family or nurses in the hospital ,
reducing the fall in senior citizen would be a challenge (PREVENTING FALLS IN OLDER
ADULTS, 2018).
CONCLUSION
From the above assessment, it can be summarised that a concept is something which is
conceived in the mind of a person or its an abstract idea. The concept taken was risk of fall in the
elders. A concept analysis was undertaken in the assessment report which was carried out by
using the model of Walker and Avant. The mentioned method of concept analysis was selected
because this method it is one of the widely applied method in the nursing science. It also helps
the analyst to analyse the every bit of the concept. The model starts with the selection of the
concept which would help in increasing the existing knowledge available on the subject matter,
It ends with finding of the empirical referents that makes the content of the concept more viable
and reliable. Moreover, it was concluded that reduction in the fall can be done by employing
effective prevention program such as implementing exercise culture in the nursing homes,
hospitals and even in home for the elder people.

REFERENCES
Books and Journals
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449-457.
Allen‐Duck, A., Robinson, J. C., & Stewart, M. W. (2017, October). Healthcare quality: A concept
analysis. In Nursing forum (Vol. 52, No. 4, pp. 377-386).
Barnes, H. (2015, July). Nurse practitioner role transition: a concept analysis. In Nursing Forum (Vol. 50,
No. 3, pp. 137-146).
Fleiszer, A. R., Semenic, S. E., Ritchie, J. A., Richer, M. C., & Denis, J. L. (2015). The sustainability of
healthcare innovations: a concept analysis. Journal of advanced nursing. 71(7). 1484-1498.
Flott, E. A., & Linden, L. (2016). The clinical learning environment in nursing education: a concept
analysis. Journal of advanced nursing. 72(3). 501-513.
Green, A. R., Reifler, L. M., Bayliss, E. A., Weffald, L. A., & Boyd, C. M. (2019). Drugs Contributing to
Anticholinergic Burden and Risk of Fall or Fall-Related Injury among Older Adults with Mild Cognitive
Impairment, Dementia and Multiple Chronic Conditions: A Retrospective Cohort Study. Drugs &
aging, 36(3), 289-297.
Kvelde, T., Lord, S. R., Close, J. C., Reppermund, S., Kochan, N. A., Sachdev, P., ... & Delbaere, K.
(2015). Depressive symptoms increase fall risk in older people, independent of antidepressant use, and
reduced executive and physical functioning. Archives of gerontology and geriatrics, 60(1), 190-195.
Li, F., Harmer, P., Eckstrom, E., Fitzgerald, K., Akers, L., Chou, L. S., ... & Winters-Stone, K. (2019).
Cost-effectiveness of a therapeutic Tai Ji Quan fall prevention intervention for older adults at high risk of
falling. The Journals of Gerontology: Series A.
Schaefer, J. D., & Welton, J. M. (2018). Evidence based practice readiness: A concept analysis. Journal of
nursing management, 26(6), 621-629.
Törnvall, E., Marcusson, J., & Wressle, E. (2016). Health-related quality of life in relation to mobility and
fall risk in 85-year-old people: A population study in Sweden. Ageing & Society. 36(9). 1982-1997.
Von Colln-Appling, C., & Giuliano, D. (2017). A concept analysis of critical thinking: a guide for nurse
educators. Nurse education today. 49. 106-109.
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