Community Health Promotion: Falls Prevention for Older Adults in PEI

This report addresses the critical issue of falls prevention in older adults within the context of community health. It begins by outlining the multifactorial determinants of falls in the elderly, including intrinsic factors like age-related physical conditions and sensory impairments, as well as environmental and pharmacological risks. The report then delves into community health concepts, emphasizing the importance of exercise and physical activity in improving balance and strength. It highlights the role of education in raising awareness of fall risks and the significance of social policies in supporting seniors' well-being, such as financial assistance programs and home modifications. Furthermore, the report details the key responsibilities of community nurses in assessing fall risks and implementing interventions. The paper concludes by underscoring the need for collaborative efforts from all community stakeholders to enhance the quality of life and minimize fall-related injuries among older adults, referencing relevant literature to support its findings.

Running head: COMMUNITY HEALTH PROMOTION
Falls Prevention and health Promotion in Older Adults
Nisha Varghese
Athabasca University
Author Note

COMMUNITY HEALTH PROMOTION
Falls Prevention and Health Promotion in Older Adults
The nursing community plays a critical role in developing a care plan and ensuring
interventions for the promotion of health and safety of the community. In the geriatric
community, that is, the patient population comprising of the elderly, falls are considered to be
one of the most common phenomena. The incidence of falls leads to severe psychological
and physical impact on the patient, resulting in reduced quality of life, increased dependence
on others, chronic pain, disability, and even death (Canadian Patient Safety Institute, 2014).
To prevent the subsequent injuries and risks associated with falls, a greater understanding of
the risk factors and implementation of effective strategies is required. The following sections
of the paper will discuss the determinants of falls in the geriatric ward and aim at reviewing
the preventive and follow-up measures to reduce fall-related injuries that can be employed
within the community for the same set of patients.
Determinants of Falls in Elderly
The cause behind the incidences of falls in geriatric wards are multifactorial and are
resulted from the convergence of several factors, which are mostly behavioral, daily-activity
related, environmental, pharmacologic, and intrinsic (Berg, 1992). The most important
determinants of risk factors associated with falls in the elderly population are usually either
environmental or situational. The intrinsic risk factors are predominant and include age-
related physical conditions such as arthritis, impaired reflexes, gait & balance issues, sensory
impairment, or impaired vision. In the pharmacological risk factors, medication errors, or
other medications with side-effects, such as anti-hypertensive, anti-Parkinson, or
psychotropic drugs that affect the patients by depressing psychomotor function, causing
fatigue and postural hypotension.
The environmental hazards are one of the most prominent factors influencing the
incidence of falls and includes infrastructural faults such as inadequate lighting, clutter,

COMMUNITY HEALTH PROMOTION
stairway design, unsecured mats, skid surfaces in bathtubs, and slippery floors. According to
Plaksin (2014), at least on environmental risk factors are reported to be in 50-80 per cent of
total falls recorded.
Health Concepts
Falls are highly preventable; however, with the presence of multifactorial nature
behind falls, it is evident that it is one of the fastest-growing health concern and requires to be
addressed with shared responsibility from the community stakeholders. Multisectoral
collaboration is required to achieve dramatic progress in the prevention of falls, which
include the participation of the non-government organizations, health care providers,
government of different levels, and, most importantly, the population itself (Public Health
Agency of Canada, 2014).
Exercise and Physical Activity
Increasing endurance and strengthening muscles with the help of exercises and
physical activities are one of the crucial strategies to improve the postural reflexes, joint
motion, improving alertness, and cardiorespiratory function. A meta-analysis of 7
randomized trials found that planned exercise programs reduce the incidence of falls in an at-
risk population (Hanley, 2011). In addition, a randomized controlled study found a 54%
reduction in falls among women aged above 65 years receiving the exercise program
(Hanley, 2011).
Exercise, especially practices that aims quality, stride, and parity, has been found to
diminish fall hazard and falls, despite the fact that the impact varies by length, power, type,
time for development, and different components (Dellinger, 2017). The best exercise
mediations distinguished were community-based projects that included at least two exercise
parts, separately custom fitted projects conveyed in the home, and network based Tai Chi

COMMUNITY HEALTH PROMOTION
programs (Rose, 2015). Exercise projects can be conveyed in the home by a prepared medical
nurse and have been demonstrated to be practical and cost-effective.
Education
One of the fundamental parts of fall anticipation is the patient's wellbeing training, as
wellbeing activity is upheld by the wellbeing hazard view of the patients. Instructing more
seasoned grown-ups to perceive potential dangers in the home and to recognize safe from
hazard taking conduct may have benefits as far as the impression of hazard and the selection
of wellbeing rehearses (RL Berg, 1992). Singular meetings can make a non-undermining
condition giving a more customer focused methodology, permitting the customer to pose
inquiries and the attendant to do an increasingly itemized appraisal (Ontario, 2005).
Gathering meetings can spare showing time and permit customers to profit by social
association and to gain from others' encounters (Ontario, 2005). When building up the
training materials, factors influencing the maturing procedure ought to be thought about. Falls
education topics include
1. Educating the patient and family regarding the risk of falling, activity
limitations and safety issues
2. Information on the outcome of a fall
3. Importance of being mobile and staying active
4. Educate regarding common risk factors of falls and the strategies to prevent it.
5. What to do when you had a fall.
Social Policies
Addressing the social determinants of health as they relate to fall prevention is a
shared responsibility that includes collaborative policies and programs and integration with
other relevant sectors such as health, community services, social development, non-
governmental organizations, care settings, and seniors themselves (Atlantic Collaborative on

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Injury Prevention, 2019). Social policy initiatives can reduce injuries by improving social and
economic conditions. Social policies which are successfully implemented for seniors in
Prince Edward Island are:
1. Seniors Property Tax Deferral Program: financial support for low-income
seniors provides cost-savings to contribute to other daily living needs
2. Caring for Older Adults in the Community and at Home (COACH) Program:
assistance for daily living needs in their home
3. Homecare Program: provide assistance for seniors to help with daily activities
4. Seniors Independent Initiative: financial assistance to help with housekeeping,
home, and property maintenance
5. Seniors Home Repair Program: helps to minimize the risk of falling by
ensuring home hazards can be repaired
6. Seniors Safe @ Home Program: financial support to assist in-home
modifications that make the home environment less hazardous
Role of Community Nurse
One of the key role that a nurse has to play in this regard is performing complete
documenting of the fall risk screening for the patient and assessing the data for determining
falls risk. Risk assessment is one of the most crucial falls prevention strategy and the
community nurses need to perform such assessments during the time of admission of the
patient and then on regular intervals. Moreover, community nurses can help in offering
assisted living to the patients and perform necessary environmental modifications to reduce
the risk of falls in the geriatric departments or during home nursing.
Conclusion
The increasing incidence of falls is a global public health issue and requires the
involvement of all major stakeholders from a community to ensure focused efforts into

COMMUNITY HEALTH PROMOTION
improving the quality of life of older patients and reduce the incidences of falls. The elderly
population is influenced by multifactorial aspects, which significantly increases their risk of
falls, and thus, health promotion strategies are crucial in inducing behavioral and
environmental changes for fall prevention.

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References
Atlantic Collaborative on Injury Prevention, (2019). Seniors' Fall Prevention and the Social
Determinants of Health: A Social Policy Lens. Retrieved from
www.acip.ca>component>easyfolderlistingpro
Canadian Patient Safety Institute (2014). Preventing Falls: From evidence to improvement in
Canadian Health Care. Canadian Patient Safety Institute. Retrieved from
https://www.patientsafetyinstitute.ca/en/toolsResources/Documents/Interventions/
Reducing%20Falls%20and%20Injury%20from%20Falls/
FallsJointReport_2014_EN.pdf
Dellinger, A. (2017). Older adult falls: effective approaches to prevention. Current trauma
reports, 3(2), 118-123. doi: 10.1007/s40719-017-0087-x
Hanley, A., Silke, C., & Murphy, J. (2011). Community-based health efforts for the
prevention of falls in the elderly. Clinical interventions in aging, 6, 19. doi:
10.2147/CIA.S9489
Ontario, R. N. (2005). Prevention of Falls and Fall Injuries in the older Adult. Toronto:
Registered Nurses Association of Ontario. Retrieved from www.rnao.ca>sites>rnao-
ca>files>prevention_of_falls_and_fall_injurie...
Plaksin, J. (2014, October 15). Clinical Correlations. Falls in Older Adults- Risk Factors and
Strategies for Prevention. Retrieved from
www.clinicalcorrelations.org>2014/10/15>falls-in-older-adults-risk...
Public Health Agency of Canada, (2014). Seniors' Falls in Canada: Second Report. Public
Health Agency of Canada. Retrieved from
www.canada.ca>services>publications>publications-general-public

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Pynoos, J., Steinman, B. A., & Nguyen, A. Q. (2010). Environmental assessment and
modification as fall-prevention strategies for older adults. Clinics in geriatric
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RL Berg, J. C. (1992). The Second Fifty Years: Promoting health and preventing disability.
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Health & Fitness Journal, 19(3), 23-29. DOI: 10.1249/FIT.0000000000000124