AELTCC Forum Highlights Mobility as Key to Managing Fall Risks

Staff education, interdisciplinary teams, assessment tools, and interventions are among the many strategies commonly deployed by senior living providers to prevent and reduce falls among residents. Such efforts are helpful in keeping elders from taking a spill, but could shifting the focus to mobility be the answer to the perennial conundrum of falls? This was the center of discussion among clinicians, attorneys, risk managers, and others during a recent forum presented by the Advancing Excellence in Long-Term Care Collaborative in Washington, D.C.

Titled “Unintended Consequences of Good Intentions,” program panelists and participants engaged in dialogue about balancing residents’ rights, quality of life, preventing falls, and managing risks. Facilitator Anna Ortigara, organizational change consultant at PHI, prompted attendees to consider the benefits of creating a culture of mobility within care communities. “What does your mobility mean to you?” she challenged attendees at the outset of the forum.

The question evoked nods of recognition and agreement and resulted in a discussion about the actions and policies within a care community that create a “culture of immobility.” Among the culprits: counting falls, family members who implore staff to insist that loved ones stay in a wheelchair, and staff who feel compelled to push residents to the dining hall for quicker and more efficient turn around.

The discussion produced a list of ideas about better methods for monitoring falls, how to communicate with family members about their role in preventing falls and fostering mobility over immobility, and examining staff competencies and education around “surplus safety”—a term used to describe how providers’ good intentions often inadvertently prevent good things from happening when they focus too much on what can go wrong.

Maggie Calkins, PhD, EDAC, executive director of the Myer-Rothschild Foundation, led a discussion about what providers, staff, family, and residents can do to prevent surplus safety. She reviewed a toolkit created by a diverse group of aging services stakeholders that helps providers manage risk while also honoring resident choices. The Care Planning for Choice toolkit helps care partners find the balance between providing good care and keeping elders safe, on the one hand, and enabling choice, which may involve risk but enhances quality of life, on the other.

Participants of the forum shared perspectives and challenges, offered insights, and walked away with a new or renewed appreciation of the importance of mobility, resident choice, quality of life...and safety.