Chapter 22Risk Reduction

Chapter 22Risk Reduction

Older Adults and Safety RisksOlder Adults and Safety Risks

• Older adults face similar risks to adults of any age.

– Age-related factors can:

• Reduce capacity for self-protection.

• Increase vulnerability to safety hazards.

• Assessment should include a review of safety risks.

– Preventive and corrective interventions should be planned.

Factors Contributing to High Elderly Susceptibility to InfectionsFactors Contributing to High Elderly Susceptibility to Infections

• Age-related changes

• Altered antigen–antibody response

• High prevalence of chronic disease

– Atypical symptomatology

• Often results in delayed diagnosis of infection.

Factors Leading to Safety Risks Involving Use of Drugs in ElderlyFactors Leading to Safety Risks Involving Use of Drugs in Elderly

• Altered pharmacokinetics

• Self-administration problems

• The high volume of drugs consumed by older individuals

EnvironmentEnvironment

• Microenvironment: immediate surroundings with which we closely interact.

• Furnishings, wall coverings, lighting, temperature

• Macroenvironment: the elements in the larger world that affect groups of people.

• Weather, pollution, traffic, natural resources

Factors Affecting EnvironmentFactors Affecting Environment

• Lighting

• Temperature

• Colors

• Scents

• Floor coverings

• Furniture

• Sensory stimulation

Factors Affecting Environment (cont.)Factors Affecting Environment (cont.)

• Noise control

• Bathroom hazards

• Psychosocial considerations

Factors Affected by LightingFactors Affected by Lighting

• Function

• Orientation

• Mood

• Behavior

Using Lighting to Promote SafetyUsing Lighting to Promote Safety

• Use several diffuse lighting sources.

• Do not use fluorescent lighting.

• Control bright lights and direct sunlight.

• Use nightlights to provide visibility and orientation.

• Use natural light to maintain body rhythms.

Effect of Temperature on Older AdultsEffect of Temperature on Older Adults

• Body temperature affects performance.

• The elderly are especially sensitive to lower temperatures.

– Environmental temperatures should not be lower than 75°F.

Effects of Color on Older AdultsEffects of Color on Older Adults

• Red, yellow, and white

– Can be stimulating and increase pulse, blood pressure, and appetite.

• Blue, brown, and earth tones

– Can be relaxing.

• Orange

– Can stimulate appetite.

Effects of Color on Older Adults (cont.)Effects of Color on Older Adults (cont.)

• Violet

– Can decrease appetite.

• Green

– Can give a sense of well-being.

• Black and gray

– Can be depressing.

Precautions for Use of Essential OilsPrecautions for Use of Essential Oils

• Do not ingest orally.

• Keep out of the eyes.

• Store away from sunlight, heat, and fire.

• Assess for allergies before using.

Precautions for Use of Essential Oils (cont.)Precautions for Use of Essential Oils (cont.)

• Seek advice of aromatherapist before using with chemotherapy.

• Be aware of sedative effect on certain medications.

• Use pure essential oils, not artificial scents.

Risks Associated with CarpetingRisks Associated with Carpeting

• Static electricity and cling

• Difficult wheelchair mobility

• Cleaning

• Odors

• Pests

• Falls

Use of FurnitureUse of Furniture

• Furnishings should be:

– Appealing

– Functional

– Comfortable

Components of a Pleasing EnvironmentComponents of a Pleasing Environment

• Textured wall surfaces

• Soft blankets

• Differently shaped and textured objects to hold

• Murals; pictures; sculptures

• Plants and flowers

• Coffee brewing; food cooking; perfumes

• Birds and animals

• Soft music

Bathroom SafetyBathroom Safety

• Lighting

– Keep a small light on at all times.

• Floor

– Do not leave items on the bathroom floor,

– Do not use throw rugs.

• Faucets

– Use color-coded, lever-shaped faucet handles.

Bathroom Safety (cont.)Bathroom Safety (cont.)

• Tubs and shower stalls

– Use nonslip surfaces, grab bars, safety rails, and tub seats.

• Toilets

– Use grab bars or support frames; raised seats.

• Electrical appliances

– Monitor the use of electrical devices.

Respecting Personal SpaceRespecting Personal Space

• Define an area that is specifically the individual’s.

• Ask permission before entering personal space.

• Allow maximum control over personal space.

Enhancing Institutional EnvironmentsEnhancing Institutional Environments

• Provide an attractive décor.

• Include the individual’s personal possessions.

• Respect privacy and personal territory.

• Recognize the individuality of the resident.

• Allow maximum control over activities and decision making.

• Make environmental modifications to compensate for deficits.

Considerations for Reducing Safety RisksConsiderations for Reducing Safety Risks

• Sufficient fluid intake

• Adequate nutrition

• Vision aids

• Hearing aids

• Stable body temperature

• Infection prevention

Considerations for Reducing Safety Risks (cont.)Considerations for Reducing Safety Risks (cont.)

• Sensible clothing

• Cautious use of drugs

• Crime avoidance

• Safe driving

Early Detection of IllnessEarly Detection of Illness

• Older adults can:

– Take their own temperature and pulse.

– Listen to their own lungs with a stethoscope.

– Observe changes in their own body fluids.

– Identify effects of their medications.

– Recognize symptoms that warrant evaluation.

Factors Contributing to High Risk of FallsFactors Contributing to High Risk of Falls

• Age-related changes

• Improper use of mobility aids

• Medications

• Unsafe clothing

• Disease-related symptoms

• Environmental hazards

• Caregiver-related factors

Interventions to Address Safety ProblemsInterventions to Address Safety Problems

• Refer the individual to specialists.

• Provide assistive devices and mobility aids.

• Help the person to prepare and label drugs.

• Arrange for community resources.

• Instructing and support family caregivers

• Modify the environment to reduce hazards.

Using Alternatives to RestraintsUsing Alternatives to Restraints

• Place patient in room near nursing station.

• Use supervision and companionship.

• Use electronic alert devices.

• Use comfort measures.

• Use frequent reality orientation and diversional activities.

SourceSource

• Eliopoulos, C. (2005).  Gerontological Nursing, (6th ed.).  Philadelphia: Lippincott, Williams & Wilkins (ISBN 0-7817-4428-8).