Risk of Falls in Older Adults in a Mental Health Unit

This article discusses the risk of falls in older adults in a mental health unit and explores strategies to address this issue. It highlights the impact of falls on older adults' independence and the healthcare system. The case study is based on Albert Road Clinic, a specialist private psychiatric facility.

Topic - The risk that was
identified in my workplace is
fall in older Adults (over
65years) in an Older Adult
Mental Health Unit in a
hospital setting.

INTRODUCTION
When a person become older adults they experienced numbers of issues in their day to
day life because after 65 they not much capable to do each and every thing in best manner as
well as at this time they also faced number of health issues which impact on their productivity.
The older adults who are more than 65 years experienced numbers of issues or risk at their
workplace as they are not much productive as well as they also take time to adopt new things due
to which productivity of workplace get impacted (Arkkukangas and et.al., 2020). Organization
selected for the respective report is Albert Road Clinic which is a part of Ramsay Health Care.
The respective firm offer outpatient, inpatient as well as community that based mental health
care through comprehensive range of assessment and treatments. A Respective firm treatment
services involves senior service for more than 65 year people, addiction service, day programs
and many more. The respective report is based on the Gibbs model related to the risk that was
identified in respective workplace is falls in older Adults. In addition to this, it will also include
strategies through which a person may resolve issues or risk experienced by the older adults at
the respective workplace.
MAIN BODY
Organization in which I am working is Albert Road Clinic which is a leading specialist
private psychiatric facility that located close to the Melbourne CBD at 31 Albert Road
Melbourne. The respective clinic provide community, outpatient and inpatient based mental
health care services through a broad range of the assessment as well as treatment modalities and
services (Arkkukangas and et.al., 2020). The Albert Road Clinic was specialist in providing
treatment services that include adult inpatient services for the acute psychiatric intervention,
senior services who are more than 65 years, addiction service or rehabilitation or relapse
prevention, community programs related to mental health, young person mental health unit
which include 15 to 30 years age group people, ECT and TMS treatments available, day
programs such as managing mood and dialectical behaviour therapy, outreach and many more.
The respective clinic is home to the Ramsay Health Care Chair of Psychiatry of
Melbourne as well as Professorial Psychiatry Unit. According to the respective firm clinic is a

teaching as well as research active facility which involve in a range of studies in order to
evaluate new treatments as well as it also assess standard of care and its improvement (Baker and
et.al., 2020). Care services or facilities provided by Albert Road Clinic is secure, supportive as
well as comfortable by their own multidisciplinary teams of consultant psychiatrists, consulting
medical practitioners, registered nursing as well as Allied health staff. Respective firm also
provide collaborative care according to need and requirement of individual as well as they also
believe that personalized care of a person also contributes to effective recovery. Moreover,
while conducting working at the Albert Road Clinic I analyze that among the old adults there is
one major risk which is situated with the falls of older people because that may cause savior
injuries. While conducting work at the respective place I analyze that there are several aspects
which leads to the fall situations among the older people. It can be better understand through the
Gibbs model which is mentioned below as through it situation, cause as well as treatment all
factors can be determined in effective manner:-
Gibbs reflective cycle – It is introduced by Graham Gibbs in year 1988 in order to give structure
to learning from the person’s experiences. Through this a person can effectively evaluate its
experience in order to determine the aspects which they faced in past so that they can develop
strategies or plans accordingly as well as effectively (Dillon, Clemson and Keay, 2020). Through
this an individual also able to conclude their own experience in properly according to which they
may develop action plan which help in overcoming risk successfully. It is consist of different
stages that include description, feeling, evaluation, analysis, and conclusion and action plan. I
used this method in order to conduct evaluation of risks that are experienced by older people
related to falls at the Albert Road Clinic. Assessment of respective situation or risk is given
below:-
 Description – The respective part of the Gibbs reflection model include information
related to what happen in a specific situation or with a person. At respective phase no
conclusion is developing in this the main focus will be on the information which is
relevant to the topic. In this some major questions will be answered such as what
happened? When? Where? How did it happen? How they reacted? Did someone react?
Why you are there? and many more (Mathew and et.al., 2020). In respect of my situation
I am working in at the Albert Road Clinic in which when I need to analyze the risk which

are related to the fall in older people. As per the perspective of Laurence Z. Rubenstein,
2019, a fall is determine as an individual coming to rest on ground or any other lower
level, in this sometime parts of body strikes against an object which leads to break the fall
(Falls in Older People, 2020). Generally this panned due to acute disorders such as
stroke, seizure and many more or it may also arise due to overwhelming surrounding
hazards. Yearly, 30 to 40% of more established individuals living in the network fall; half
of nursing home inhabitants fall. In the United States, falls are the main source of
incidental demise and the seventh driving reason for death in individual’s ≥ 65. In 2017,
there were 31,190 falls passing in individuals ≥ 65 versus 5,148 in those more youthful;
along these lines 85% of passing brought about by falls happen in 13% of the populace
who are ≥ 65. Falls situation is generally threaten for the independence of older people as
well as it may also cause savoir injuries to individual. This is I analyze through
evaluating about the risk related to the fall of the older people at the respective place.
Moreover, I also analyze there is that falls is threaten the self - determination of elder
people as well as it cause a cascade of person and socioeconomic circumstances. In
addition to this, doctors are frequently uninformed of falls in patients who don't present
with a physical issue on the grounds that a normal history and physical assessment
commonly do exclude a particular assessment for falls (Mormer and et.al., 2020).
Numerous more established individuals are hesitant to report a fall since they ascribe
tumbling to the maturing cycle or in light of the fact that they dread being thusly confined
in their exercises or systematized.
 Feeling – At this stage emotion of a person will evaluated during a specific incident
which is discussed above. In this different questions will be answered such as what a
person feel before incident? During it? After that incident get over? How other person
will felt? What a person feel about the specific incident currently? How others feel about
it? and many more (Taheri-Kharameh and et.al., 2020). According to my experience at
the Albert Road Clinic there are several risks which are associated with the falls of older
adults who are generally more than 65 years. According to article given on American
family physician, 2020, there are several aspects due to which a person may fall such as
normally change of aging like poor hearing, poor eyesight leads to more fall of a person
who are more than 65 years old (What Causes Falls in the Elderly? How Can I Prevent a

Fall?, 2020). Moreover I also analyze that a person may also fall due to illnesses as well
as physical conditions which may affect their strength as well as balance. Fall of an older
adult also may due to poor light and throw rugs as they not able to walk properly on it
which may lead to trip or slip. In addition to this, while conducting work at the respective
firm I analyze that there are several side effects of some medicines which may also lead
to upset of a person’s balance and make them fall. Generally this will happen when elder
people take medicines for the depression, high blood pressure and sleep issues as well as
sometime it may also arise due to medicines for heart conditions and diabetes as it make
unsteady on person’s feet (Valipoor and et.al., 2020). There are neurosurgery, neurology,
and medicine units which experience highest fall rates within hospitals. On the other
hand, patients in intensive care units are less likely than patients in other units to be
ambulatory, contributing in part to the lower fall rates observed In addition to this, an
individual generally take two or more medicines at a time then there is chance that they
fall so it is essential for every person not only older one to take medicines in the gap of
10 minutes minimum. So by this I analyze that a person or older people experience risks
related to the fall due to several reason so it is essential at the Albert Road Clinic to take
proper care of it. This is so because through it respective metal unit able to take care of
older adults in more effective manner.
 Evaluation – In this evaluation of situation will be done on the basis of objective. In this a
person who is evaluating their experience need to answer several different questions such
as what went well? What did not? How did a person and other one contribute in it
(Negatively or positively) what are the positive and negative aspects of situation? and
many more. At this stage a person able to evaluate the risk related to experiences
accordingly which they will develop proper action plan or strategies so that it can be
resolve it effectively or successfully. At this stage according to my situation I will
evaluate the factors which are generally considered by doctors or nursing of Albert Road
Clinic. In this stage I will determine aspects which respective mental unit professional
evaluated during the time of evaluating when an older person experience fall. Health
condition of adults is not good and thus, it is essential for the hospital management to
focus upon their condition. This will help in reducing number of falls. According to the
view point of Leslie Kernisan, 2020, there are several aspects which medical professional

examine when they get case of fall of older person such as they conduct assessment for
underlying new illness, it is most common practice which is conducted by a medical
professional or doctor when they get case of fall of older person as it may generally occur
due to weakness, delirium or any other sign of feeling unwell (8 Things to Have the
Doctor Check After an Aging Person Falls, 2020). There are some of the common health
problem due to which older person may fall such as urinary tract infection, heart problem
like atrial fibrillation, anemia, dehydration, strokes, pneumonia and many more. There is
need for hospital authorities to focus on helping adults duroing these problems. In
addition to this while the analysis I analyze that respective mental firm doctors conduct
evaluation of blood pressure as well as pulse reading of a older person when they are
sitting and when they are standing. I determine that generally doctors do this because
through it they determine the situation of person according to which they provide them
facility or medication for improvement. Moreover, in respect of medical professional
they also conduct blood test of older person in order to determine the problems in body
such as they determine rate of blood sodium (Varshneya and Sonawane, 2020).
According to me it is generally done by doctors to their older patients as that will help
them in conducting proper as well as appropriate medication.
 Analysis – At this situation a person will able to determine hidden aspects in their
experienced situation. In this the questions which will answer are what challenges a
person experienced? An evaluation of details and why a specific judgment is taken? What
sense specific situation is making? and many more. In respect of my situation while
working at the Albert Road Clinic I determine that there are numbers of risk which are
associated with the fall of elder person so it is essential for a person to understand the
situation properly and provide them medication in proper manner. As per the view point
of Robin Lee, 2019, fall of a person leads to cause of the fatal as well as non fatal injuries
among the older adults who are more than 65 years at the United State. These people
generally related for the more than 3 million of visiting to emergency department as well
as 900000 people get hospitalized whereas nearby 30000 faced death each year due to
fall. Fall of an individual generally leads to the cause of traumatic brain injury as well as
more than 95 percent experienced hip fractures due to falling. In addition to this, I also
analyze that respective types of injuries make hard for an individual to get around and do

day to day activities or live by their own properly (Identifying Risk Factors for Falls
can Help Older Adults Live Their Fullest Live, 2020). As per the research mentioned
by the writer in between 2007 and 2016 the more troubling as well as death rate due to
fall get enhanced by 30 percent i.e. from the 47 to the 62 per 100000 individual. I also
analyze that several people who fall if they not get any injury but they get afraid of
falling as well as this fear impact on a person and they get cut down on day to day
activities. Moreover due to this a person get weaker as well as it also increase their
chance of falling when they do something. The financial effect of fall wounds and
passings is considerable, representing about $50 billion in direct clinical costs every year.
Fall wounds are among the 20 most costly ailments, and government-subsidized projects,
for example, Medicare and Medicaid, fund about 75% of these expenses.
 Conclusion – It is determined as the second last stage of the Gibbs reflective cycle in
which a person need to determine the experience related to situation that discussed above.
In this an individual will answer questions like what else can a person do? What have an
individual learned? What a person may change in future by developing strategies and
plans? and many more (Varshneya and Sonawane, 2020). According to my situation I
will conduct evaluation of the whole experienced related to the risk of fall among the
elder adults. I learned that older people fall because of many reasons, like there could be
an imbalance or they might have problem with their eyesight. Due to this, they are not
able to work see clearly and fall on the floor. This can also be due to weaknesses in the
muscles and a relatively low blood pressure. Therefore, in order to avoid such situations,
we should take appropriate measures. I will promote using shoes that have soles that are
no-skid. Also, the place of residence should be well lit so that they don’t face any kind of
trouble in seeing. This is because these are some risks that I have identified at my
workplace and believe that they should be addressed effectively. Working in a health care
institution, I should always be very conscious as well as aware that there are no electrical
wires in the pathways. I will share a suggestion that nights lights should be installed in
the rooms where the older people live, the staircase as well as the hallways (Arnautovska
and et. al., 2019). Moreover, I will continue to suggest them, that they should seek
regular health check-ups. Also, I will ensure that the environment is safe and the floors
within the health care institution are not slippery. I will keep a record of the medications

that the older person has been taking recently. This will help the doctor in examining
their condition much more effectively. I have also learned that with older people, it is
extremely important to keep the walkways clear and free of any kind of boxes or loose
boards on the floor. These techniques can help in reducing the falls among older people.
 Action plan – If in the future, I ever come across such a situation wherein an old person
falls on the floor, I will immediately provide them support. I will speak to them regarding
that they can contact any of the health care staff to assist them with anything they might
need. I will tell the family members of the patient to accompany them when they take a
walk, in order to understand if they are stable enough to walk alone (Forlenza, Argento
and Laffel, 2017). I will suggest them some light exercises that they can practice in order
to maintain their muscles flexible and moving. I would also suggest the family members
of the older people to keep the floors at the home well lit as well as clean so that the older
person can see clearly. This can help in reducing the number of falls among people
belonging to older age groups. Whenever any family member of an older person will
speak to be about the problem of falling, I will recommend them to use door mats that are
non-slippery. I will also tell them to keep the floors dry and clean so that the older person
does not face any difficulty with walking. There are some strategies which can be used by
hospitals for reducing falls among adults. I think, first of all they must focus upon
identifying high risk patients above age of 65 years. They must be provided safety
companions. Patients must be provided extra care for keeping them safe. Alarm beds are
set so that nurses will regularly check these adults. As per the view point of Leslie
Kernisan, the doctors should check for any underlying illness among the older people if
they fall (8 Things to Have the Doctor Check After an Aging Person Falls, 2020). Albert
Road Clinic has adopted various strategies in order to help the older people in walking
easily and eliminating any falls. The clinic has installed night lights in the hallways as
well as the staircase in order to help the older people with walking easily and not facing
any difficulty with their vision at night time. Also, there is always a staff member
available to help them with walking. If any older person reports of dizziness and not
feeling well, the doctors do a checkup in order to cure the condition effectively.

REFERENCES
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adults living in residential aged care. Information Processing & Management. 57(3).
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Dillon, L. L., Clemson, L. and Keay, L. J., 2020. Stakeholder perspectives of fall prevention for
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%20considered%20falls.>.

Identifying Risk Factors for Falls can Help Older Adults Live Their Fullest Live . 2020.
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