of 2019 to make approved existing facilities barrier-free.
Other factors can also present hazards for the elderly. For example,
according to the findings of Commission 2, the hoses of a central
vacuum cleaner in a retirement and nursing home in Salzburg
represent a major risk for falls. In other Laender, there have also been
observations regarding avoidable tripping hazards with regard to
slippery floor coverings, insufficient lighting in hallways, stairway steps
and ramps that are too steep, missing handrails, etc.
Tripping hazards
The NPM regularly emphasises the importance of structural measures
to prevent falls to support the autonomy and quality of life of residents.
At the same time, such measures would also relieve staff, because in
a barrier-free environment the likelihood of injuries or necessary
assistance when entering or leaving rooms can be reduced. Fewer
falls also protect the health care system from follow-up costs in
connection with necessary medical treatments. It is therefore an
important quality characteristic of an institution if it minimises falls and
their consequences, e.g. increased dependence, permanent disability
or the fear of falling, for the well-being of residents by way of suitable
measures.
In nursing homes, the reaction to the danger of falls is sometimes not
additional support or appropriate actions, but measures that restrict
freedom, which are sometimes demanded by relatives, who do not
have any specialised care experience, once falls have occurred. Study
results indicate that residents are not kept safe from falling by means
of measures that restrict freedom; rather this initiates an insidious
cycle. Due to the forced immobilisation, the body loses more and more
muscle strength and balance, which ultimately increases the danger
of falling even further.
Restriction of freedom
increases the danger of
falling
Regarding the question of how falls can effectively be prevented,
relevant studies and evidence-based guidelines from Germany, which
the commissions repeatedly refer to in their reports to the AOB,
provide a relatively uniform picture.
Guidelines regarding
prevention of falls
According to them, effective prevention of falls presumes that each
resident’s risk of falling is comprehensively and systematically
ascertained and that personal risk factors, such as external or
environment-related factors, are taken into consideration. As the risk
of falling can change during the resident’s stay, it must be ascertained
on a regular basis, at least whenever the state of a person’s health or
their medication changes. Based on the collected data, individual
measures for the prevention of falls should be planned – with the
involvement of the persons concerned – and their suitability should be
examined on an ongoing basis.
Systematic identification
of risks
Many studies have examined the effectiveness of interventions with
regard to the prevention of falls. One can roughly differentiate
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