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  • Writer's pictureNikita Chand

Fall Protocol – In-Home Setting

Caregiver Fall Protocol – In-Home Setting

Falls are one of the leading causes of prolonged hospitalization in the older adult population. Falls are prevalent in the older population for a variety of reasons, some of which include: Bone frailty, muscle wasting and weakness, side effects from polypharmacy, acute infections leading to changes in levels of consciousness, electrolyte imbalances, decreased mobility, cardiac disease ,autoimmune conditions, progressive degenerative disease, sensory deficits, inability to follow instructions, and lastly, poor indoor and outdoor environmental factors.

In many instances, falls can leave an individual feeling vulnerable and afraid to walk or transfer alone in their house. The good news is that falls in the household can be managed effectively with a fall protocol. Our care staff are trained to know how to respond when a individual suffers a fall at home.

See below for 3 Step Protocol:

Step 1 – Assess for any pain and changes in level of consciousness. If any areas of pain, identify where the pain is coming from. Check for any bleeding. If any lacerations or open wounds, apply pressure. If there is minimal bleeding, cleanse with saline and apply bandages.

Step 2 – Check to see if individual meets criteria to get up off the ground with minimal standby assistance. In an ideal situation, you would be able to take a complete set of vitals and neurovitals while the client is still on the ground. If you have the resources to do so, do that before the next step.

You would be able to assist them get up off the ground if all the following criteria are met:

 A) Individual is not complaining of any pain
 B)  The fall was witnessed
 C) The individual did not hit their head or neck
 D) The individual can get up with minimal standby assistance 

While the individual is on the ground you could preform a set of “neuro vitals” while they are still on the floor if you have the appropriate equipment. This would include a full set if vital signs (blood pressure, heart rate, respiration rate, oxygen saturation and temperature). The neuro aspect of neuro-vitals is bit more advanced training and includes checking for equal motor strength in upper and lower extremities, level of consciousness, and pupil response.

Other areas for assessment that you can check for while the individual is still on the ground include: Any areas of pain/ discomfort. Any bleeding or lacerations on head or body. Any nausea or vomit.

In additional, try to get an idea of what may have caused the fall, such as: Simple miss step of the feet, cluttered environment, person complain of weakness or lightheaded, poorly lit room, patient did not have glasses on, patient was confused, etc. This will give us a good idea of what caused the fall and ways to prevent future falls.

Use your training and previous experience to make a decision about whether your client is capable of getting up off the ground, and allow them to get up independently if they can. It is not recommended in the home environment for one caregiver to try to get the person off the ground by using pulling techniques as this could cause additional harm to the caregiver. If two caregivers are available, they could use a two person approach to get the patient up off from the ground, as long as the patient can follow instructions and bend their knees.

Step 3 – If individual is unable to get up from the ground. Call 911 ambulance service for assistance. They may just do an assessment and help get the individual off the ground, or they may decide to take them to hospital for further assessment and possible Xray. In addition, you must inform you supervisor immediately for further direction as a fall is considered an incident. Documentation regarding the fall incident will be completed along side your supervisor.

Disclaimer: This information is not intended for everyone. Information provided in this article is to be utilized by trained and certified care givers only. The information is to be used in conjunction with previous education and training provided to caregivers with a formal educational background.

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