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1.  Safety is a major concern when working with or providing care to older adults.  Falls, burns, poisoning, and automobile accidents are the most common safety problems among older adults  Exposure to temperature extremes also places older adults at risk for injury or death Introduction

2. Physiologic changes  Diminis h e d rang e o f peripher a l vision a n d changes in depth perception  Changes in visual acuity make it more difficult to read labels with small print  Decreased auditory acuity  Altered balance  Decreased mobility

3. Physiologic changes cont’d  Decreased flexibility  Decreased muscle strength  Slowed reaction time  Gait changes  Difficulty lifting the feet  Altered sense of balance  Postural changes

4.  Conditi o ns a f f ectin g t he ca r diov a scular, nervous, and musculoskeletal systems  Medications  Cognitive changes or emotional disturbance  Depression

5. Falls  Fall s a r e th e m o st com m o n safe t y p ro b l e ms in older adults.  One - thi r d t o o n e - half o f peopl e olde r th a n age 65 are prone to falling.  Any fall is the best predictor of future falls.  Th e olde r a pe r son becomes , th e more lik e ly he or she is to suffer serious consequences  Fall s a r e a leadi n g deat h cau s e d b y injur y in people older than age 65

6.  Prepare safe surroundings  Allow a d eq u at e tim e t o c omplet e a n acti v ity or task.  Wear proper-fitting footwear  Use assistive devices if needed  Ask for help when necessary.

7. Fire hazards  Institutions require safety doors, fire extinguishers, exit windows, oxygen precautions etc  Fire safety plan should be present  Quick not i fication system t o th e loca l fi r e department  Pr o tocol s for fire c onta i nmen t , a n d an evacuation plan also needed

8.  Fire hazards  Home security  Vehicular accidents  Thermal hazards

9.  Thin k a nd pl a n ahea d t o reduc e ri s k s to personal safety.  Identify ways an unknown person could enter the home  Maintain regular contact with friends and family  Use the telephone safely  Answer the door safely  Bank safety  Prepare for emergencies

10.  Maintain electric safety  Decrease any other hazards  Provide adequate lighting  Provide grip assistance wherever appropriate  Pla c e fr e q u ent l y used item s a t shoulder h ei g ht or lower where they can be reached easily  Take measures to prevent burns.

11. Plan ahead to know where you are going Add extra time so that you do not feel rushed Li m i t you r dri v in g to plac e s clos e to home an d e a sy to get to radio , Avoid distractions such as talking, playing the or using a cell phone Wear your seat belt at all times Wear appropriate eyeglasses and hearing aids Pace trips to allow for frequent rest breaks Drive at a safe distance behind other cars

12. Exposure to excessively cold or hot environments Limited financial resources to pay for heat or clothing that is suitable for environmental temperature Neurologic, endocrine, or cardiovascular disease Any metabolic disorders Infection or other illness Dehydration or electrolyte imbalances Inactivity or excessive activity

13. Assessment/Data Collection History of falls or other injuries? Types of injuries Person’s level of vision? Hearing? Temperature perception? Impairment in gait or balance? Use any assistive devices such as a cane, walker, etc?

14. Assessment/Data Collection cont’d Kind of footwear does the person wear most often? Any cognitive impairment? Forgetfulness Living alone Medications Dizziness or fainting?

15. Nursing Diagnoses Risk for falls, risk for injury, risk for trauma, risk for poisoning

16. Nursing Interventions Evaluate the person for the risk for fall Instruct to move slowly and to remain seated until the dizziness passes Evaluate laboratory values for the presence of anemia, which can increase the risk for falls. E nco u r a ged t o move at a com f o rta b l e p a ce and not to hurry Enco u r a ge t o w ea r c omfor t a b l e foo t we a r th a t helps with support and balance

17. Nursing Interventions cont’d Be sure to lock all devices with wheels such as beds and wheelchairs Use low beds or keep beds in low position unless the caregiver is at the bedside Medications should never be left at the bedside

18.  Nurses can play an important role by helping older adults recognize their risk factors, by planning coping strategies to promote safety, and by modifying their environment to minimize the likelihood of injury.

19. Wold, G. (2011). Basic geriatric nursing (3 rd ed.). St Louis: Mosby. Subhojit Dey, Devaki Nambiar, J. K. Lakshmi, Kabir Sheikh, and K. Srinath Reddy. Health of the Elderly in India: Challenges of Access and Affordability