Management of Falls and Fall Prevention Policy for Elderly Population

This report analyzes the current policy and legislation on elderly fall prevention, summarizes the incidents of falls among the elderly population, and identifies the effectiveness of the current legislation and policy. It also recommends actions and consultation activities for improving the policy for public wellness and benefit.

Running head: MANAGEMENT
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Introduction
Falls are very much prominent within the external reasons for unintentional injuries.
These lead to consequent injuries and are a major concern regarding the public health which
require medical attention. According to (), approximately more than 28-36% of the people
belonging to the aged population who are more than 65 of age fall each year while those with the
age range of 70 years and above falls 32 to 42%. The frequency of the rate of the falls increases
with the level of the frailty and age. As per the analysis and the research by (Preventing Falls and
Harm From Falls in Older People Best Practice Guidelines for Australian Hospitals, 2019) older
people who lives in the nursing home falls more than the those who resides in the community.
World Health Organization estimated more than 40% of the fall accounts to injury deaths among
the elderly population with the age range more than 65 years. The aim of the report is to analyze
the current policy and the legislation on elderly fall prevention (Falls prevention :: SA Health,
2019). The report furthermore targets to summarize the incidents of the falls among the elderly
population and how these are affecting the health and the wellbeing status of the elderly
population of the globe. The statement of purpose of tis report is to identify the effectiveness of
the current legislation and the policy regarding the fall prevention among the elderly population
and the recommended actions and the consultation activities that is required for the improvement
of the policy for the public wellness and benefit.
Overview of current policy
Fall and fall injury prevention policy is the current legislative measure by the government
of the country of Australia. The guidelines of the policy targets to improve the safety and the
quality of the care for the older people residing in the country. This policy has been designed for

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the professionals of the health care in Australian health care institution settings with the
opportunity to offer a nationally consistent approach and action for the prevention of the falls on
the basis of the best recommended practice (Bergen, 2016). Funded and managed by commission
on safety and quality in the Health Care, the fall and the fall injury policy advocates the
independence, the autonomy, the safety and the quality of the care in the acceptable risk
regarding the failure.
The overview of the fall prevention policy of the Australia incudes the scope, the
terminology, the development and the consultation of policy. The policy targets the older
Australians in the motive that fall though can occur at all the ages , but the rate and the frequency
or the severity of the injuries that are related to the falls increases with the age. Developed for
the hospitals and the health care unit of Australia, this policy is furthermore applicable to
emergency departments, the acute and the sub acute setting of care and the specialized units
where the elderly population resides (Carande-Kulis et al., 2015). The policy furthermore has
separate guidelines and structures for the residential settings and the community care settings. By
adhering to the National Health and Medical Research Council and the guidance from the
specialist groups, this policy was constructed in the conjunction with the inter jurisdictional,
primary care committees and the private hospital sector.
Consultation activities
One of the biggest triumph of the humanity is population ageing but it also possess as a
challenge to the society. The injuries related to the hospitalization increases with the age and the
fall related injury tops the list of the leading causes of the mortality and the morbidity among the
older Australians. Though the current policy and the standards as implemented by the

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government of Australia aims for the protection of the elderly people, little attention has been
focused over the causes and the factors leading to fall and injury among the elderly population
(McPhee et al., 2016). The current policy lacks to focus on the impact of the population aging on
the injury related to fall, the risk factors of the fall and the cost of the falls causing injury , harm
and even death among the elderly population in Australia.
Figure - Rate of fata falls by the age and the sex groups
Source - (WHO Global Report on Falls Prevention in Older Age, 2019)
The figure above shows the rate of the accidents and the harm due to the fall among the
elderly population even after the development and the implementation of the policy within the
country. This calls for the suspect and the challenges raising in the context of the effective
implementation of the policy.
Some of the activities and the actions that needs to be done for the improvement of the
current policy structure and its implementation programs are the following.

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Apart from taking steps and actions by the government of the country regarding proper
implementation of the fall and the fall prevention policy for the elderly population , it is
important for the health care agencies and the hospitals to take up trainings and to spread the
knowledge regarding the residential care settings for the elderly person living in their home
(Sherrington et al., 2017). Consultation activities furthermore includes the consideration of the
fact that the exponential rate or the tendency of the fall increase with the changes of the age
related biology. The actions furthermore needs to trigger the potential causes of the substantial
increase of the fall and the fall related injury at the alarming rate among the residence which is
higher as compared to the hospitals.
One of the most essential consultation activities that the government of the country needs
to update regarding their fall prevention settings for the old age is the monthly visit and
checkups for the residential aged population in the country by the hospital and the health care
tem. This new and improved actions needs to be added with the policy since this will help the
aged population from fall and the fall related chronic injury (Muir-Hunter & Wittwer, 2016). The
actions furthermore includes the need for the consideration of the biological risk factors that
embraces the characteristics of the each and every individuals which pertains to the human body.
Factors such as decline of the cognitive, physical and the affective capabilities with the co-
morbidity and the association with the chronic illness needs to be considered.
Literature Review
The rate of the admission in the hospital due to the fall and the fall related injury among
the people with the age of 60 and above in Australia ranges from 1.6 to 3.0 per 10000
population. According to Houry et al. (2016) falls leads to mild and severe injuries and these are

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some of the underlying causes behind the emergency departmental visits. The author in his
research paper highlighted the fact that more than 50% of the injury related to the hospital was
among the population over the age group of 65 years. Some of the major underlying causes for
the fall injured hospital admission are the traumatic brain injuries, the hip fracture and the upper
limb injuries.
As per the analysis of Verma et al. (2016) falls and the fall related to injury is the occurrence of
the complex interaction of the risk factors. Some of the main factors of the risk reflects the
multitude of the health determinants that possibly directly or indirectly affect the wellbeing of
the aged population.
Figure - Risk Factor model in the context of the fall among the older population
Source – (WHO Global Report on Falls Prevention in Older Age, 2019)

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The figure above highlights the major factors those are connected or related to the fall
among the older people. As per the analysis of Tricco et al. (2017) the interaction of the
biological factors with the environmental and the behavioral risks increases the risk regarding the
falling. The behavioral factors includes those that concerns the areas of the human, the daily
choice and the emotions. The environmental factors furthermore encapsulate the interplay of the
physical condition of the individuals together with the surrounding environment that includes the
hazards at home or the hazards at the public.
According to the analysis of Florence et al. (2018) the fall and the fall prevention policy
by the country lacks the recognition of the harm caused within the home. The hazards of the
home includes the narrow steps, the slippery surfaces, the loose rugs and the insufficient lighting
at the home. Furthermore factors such as the poor building, lack of safe and proper design,
cracked and uneven sidewalks and the poor lightening in the public areas are some of the major
hazard contributing to the fall among the elderly population which the policy does not recognize.
As per the explanation and the research by Uusi-Rasi et al. (2015) the economic effects of
the fall among the aged and the elderly population is critical for the family, the community and
the society. The health care impacts and the costs related to the falls among the older age has
been significantly increasing through out the world. As per the research evidences, the fall
incurred cost for the elderly population are of two of the major aspects (Grossman et al. 2018).
These are the direct costs like the rehabilitation and the consultations in the treatment and the
indirect costs like the lost income. In the perspective of the fall prevention policy among the
elderly group of population, the policy needs improvement and revision regarding certain areas
like residential care setting, cause of fall and the cost of fall and the fall related injury.

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Implementing the policy
The implementation of the new and the revise policy is essential for the benefit of the
older age population of the country. In this section some of the major key evaluation criteria will
be used and analyzed for the policy implementation plan. These are the mood scale which is
beneficial for the identification of the age centered care, the observational checklist for the health
care professionals and the nurses in the hospitals for the inpatient, the pain scale for
understanding the rate of injury and the interview with the family acre givers for identification of
the residential status of the fall among the elderly population.
The Mood Scale
Known also as the Brief Mood Introspection Scale (BMIS), it is an open-source model
that consists of 16 mood-adjectives. A person responds to these 16 mood-adjectives, for example
“are you sad?” “Are you jubilant?” The scale could yield measures of generally pleasant and
unpleasant mood, arousal and calm mood. The scale could also measure the positive-tired and
negative-calm mood. The scale is used especially in old care facilities for aged people who have
no one to look after and who need people and things to cheer them up.

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Image 1. The Mood Scale
Source: (Thedepressedduck.com, 2019)
The above image is an example of the mood scale that helps in analyzing the mood of the
aged people who are at risk of falls. The mood scale is a valuable tool for the new policy because
often the aged people suffer from anxiety and depression and do not take care of the way they
walk and fall down. Assessing the mood of the aged people would help in understanding the
need to look after them.
Pain scale
Pain scale refers to the tool used by doctors to assist in the assessment of an individual’s
pain. An individual generally self-reports her or his pain utilizing a specifically designed scale.

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The person uses it sometimes with the doctor’s help, parent’s help of guardian’s help. It is
important in falls prevention because pain is one of the major reasons for fall in older patients.
Image 2. The pain scale
Source: (Wellness.allinahealth.org, 2019)
The above is an example of pain scale. The pain scale comes in different format but the
basic structure remains the same. The older patients are given these pain scale questionnaires to
fill up. The nurses and healthcare professionals than use the pain scale indicators to assess the
level of pain the patients have gone through.
Observation tick list

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The observation tick list has been provided to the nurses and other healthcare
professionals to assess the rate of falls among older patients within the healthcare facility. Apart
from that, the observation tick list also has been provided to find out the type of patients who are
most vulnerable to falls. The tick list also helps in assessing the rate of falls amongst the older
patients.
Image 3. The observation tick list
Source: (Martinforfreedom.com, 2019)
As evident from the image above, the observation tick list includes medication and
health, hazards of tripping, exercise and nutrition, assistive devices, bathroom and safety, stairs
and other hazards to help the nurses and healthcare professionals to assess the rate and reasons
for falls in residential care units in particular.
Interviewing family carers

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The family carers’ interview is important to conduct to understand the rate of falls
amongst older patients in in-house facilities. The carers are asked as to how many times do the
aged people fall and what is the rate of their pain. This allows better implementation of the
policy within the homes of the older patients.
For the above reasons, the existing policy has been revised as per the new action plan.
Action Plan: Implementing a policy
Task/ Activity Resources Timeframe Outcome measures of
success
Assessing falls in
residential care
Observation tick list
and interviewing
family carers
One month The nurses and
healthcare
professionals looking
after the older
patients in residential
care units will be
surveyed every one
month to measure the
outcome of the
activity
Assessing reasons
behind falls
Mood Scale Two months to four
months
The mood scale would
help in understanding
the mood of the older

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patients that cause
them to walk in haste
and cause in falls
Assessing the cost
of falls
Pain scale Two months to six
months
The pain scale would
help in assessing the
level of pain caused
due to falls. This
would then help in
measuring the cost of
falls in both
residential cares and
hospitals
Conclusion
Thus it can be concluded from the above report of the policy assessment that the targeted
policy aims to improve the safety and the quality of the care for the older people residing in the
country. The frequency of the rate of the falls increases with the level of the frailty and age. Falls
lead to consequent injuries and are a major concern regarding the public health which require
medical attention. Though the current policy and the standards as implemented by the
government of Australia aims for the protection of the elderly people, little attention has been
focused over the causes and the factors leading to fall and injury among the elderly population.
The current policy lacks to focus on the impact of the population aging on the injury related to

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fall, the risk factors of the fall and the cost of the falls causing injury, harm and even death
among the elderly population in Australia. The actions for the improvement and the revision of
the current policy includes the effective promotion and the propagation of the health care settings
for the old age care together with the development of new and improved approaches of monthly
check ups for the aged population residing in the residence who do not have any proper health
caregiver at home.

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Appendix A- Updated Policy
Policy Statement - Policy targets to improve the safety and the quality of the care for the older
people residing in the country. The statement of the policy includes the scope, the terminology,
the development and the consultation of policy. The policy targets the older Australians in the
motive that fall though can occur at all the ages , but the rate and the frequency or the severity of
the injuries that are related to the falls increases with the age.
AIMS – The aim of the policy is to focus over the causes and the factors leading to fall and
injury among the elderly population, focus on the impact of the population aging on the injury
related to fall, the risk factors of the fall. The new and the improved policy furthermore aims to
analyze the cost of the falls causing injury, harm and even death among the elderly population in
Australia.
Target Audience- The targeted audience of the new ad the improved policy is the professionals
of the health care in Australian health care institution settings with the opportunity to offer a
nationally consistent approach and action for the prevention of the falls on the basis of the best
recommended practice. This new and the improved policy targets the aged population residing in
the residence who do not have any proper health caregiver at home.
Responsibilities – The responsibilities of the policy includes the update regarding their fall
prevention settings, monthly visit and checkups for the residential aged population, consideration
of the social , behavioral and the economic factors causing fall among the elderly population and
the consideration of the cost of the fall and the fall related injury.

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The new and the improved policy furthermore has the responsibility towards the
affordable health care settings for the elderly population and free check ups and visit to the
nearby health institutions for the elderly population. The responsibilities furthermore includes the
need for the consideration of the biological risk factors that embraces the characteristics of the
each and every individuals which pertains to the human body.
Definitions – The definition of the policy incudes the scope, the terminology, the development
and the consultation of policy. Falls are very much prominent within the external reasons for
unintentional injuries. These lead to consequent injuries and are a major concern regarding the
public health which require medical attention. The policy defines to analyze the consultation
activities and the improved health care settings for the benefit and the wellbeing of the elderly
population in Australia.
Documentation-
Preventing Falls and Harm From Falls in Older People Best Practice Guidelines for Australian
Hospitals. (2019). Retrieved from
https://www.safetyandquality.gov.au/wp-content/uploads/2009/01/Guidelines-HOSP.pdf
Falls prevention :: SA Health. (2019). Retrieved from
https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/
clinical+resources/clinical+topics/falls+prevention
The Falls Policy for Older Western Autralians. (2019). Retrieved from
https://www.health.wa.gov.au/publications/documents/Falls_Policy_document.pdf

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References
Bergen, G. (2016). Falls and fall injuries among adults aged≥ 65 years—United States,
2014. MMWR. Morbidity and mortality weekly report, 65.
Carande-Kulis, V., Stevens, J. A., Florence, C. S., Beattie, B. L., & Arias, I. (2015). A cost–
benefit analysis of three older adult fall prevention interventions. Journal of safety
research, 52, 65-70.
Falls prevention :: SA Health. (2019). Retrieved from
https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/
clinical+resources/clinical+topics/falls+prevention
Florence, C. S., Bergen, G., Atherly, A., Burns, E., Stevens, J., & Drake, C. (2018). Medical
costs of fatal and nonfatal falls in older adults. Journal of the American Geriatrics
Society, 66(4), 693-698.
Grossman, D. C., Curry, S. J., Owens, D. K., Barry, M. J., Caughey, A. B., Davidson, K. W., ...
& Kubik, M. (2018). Interventions to prevent falls in community-dwelling older adults:
US Preventive Services Task Force recommendation statement. Jama, 319(16), 1696-
1704.
Houry, D., Florence, C., Baldwin, G., Stevens, J., & McClure, R. (2016). The CDC injury
center’s response to the growing public health problem of falls among older
adults. American journal of lifestyle medicine, 10(1), 74-77.

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Martinforfreedom.com. (2019). Fall Prevention Checklist Spanish Minnesota For Nursing
Homes Home Older Adults | Martinforfreedom. Retrieved from
https://martinforfreedom.com/fall-prevention-checklist/falls-prevention-checklist-circle-
of-care/
McPhee, J. S., French, D. P., Jackson, D., Nazroo, J., Pendleton, N., & Degens, H. (2016).
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Muir-Hunter, S. W., & Wittwer, J. E. (2016). Dual-task testing to predict falls in community-
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Preventing Falls and Harm From Falls in Older People Best Practice Guidelines for Australian
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Sherrington, C., Michaleff, Z. A., Fairhall, N., Paul, S. S., Tiedemann, A., Whitney, J., ... &
Lord, S. R. (2017). Exercise to prevent falls in older adults: an updated systematic review
and meta-analysis. Br J Sports Med, 51(24), 1750-1758.
The Falls Policy for Older Western Autralians. (2019). Retrieved from
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Thedepressedduck.com. (2019). One Simple Tool to Help You Manage Your Moods. Retrieved
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moods/

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Tricco, A. C., Thomas, S. M., Veroniki, A. A., Hamid, J. S., Cogo, E., Strifler, L., ... & Riva, J. J.
(2017). Comparisons of interventions for preventing falls in older adults: a systematic
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Uusi-Rasi, K., Patil, R., Karinkanta, S., Kannus, P., Tokola, K., Lamberg-Allardt, C., &
Sievänen, H. (2015). Exercise and vitamin D in fall prevention among older women: a
randomized clinical trial. JAMA internal medicine, 175(5), 703-711.
Verma, S. K., Willetts, J. L., Corns, H. L., Marucci-Wellman, H. R., Lombardi, D. A., &
Courtney, T. K. (2016). Falls and fall-related injuries among community-dwelling adults
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https://www.who.int/ageing/publications/Falls_prevention7March.pdf

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