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The World Health Organization defines a fall as ‘an event that results in a person coming to rest inadvertently on the ground, floor, or other lower level’.
Understandably, falls throughout aged care are a major concern worldwide, with an estimated one in two older people suffering a fall within the first 12 months of transferring to a residential care setting, and as many as 30 percent of these sustaining a significant physical injury, such as a fracture as a result.
Such alarming statistics have resulted in the development of several guidelines and evidence-based recommendations used as a supplementary resource for aged care homes to intervene and take action. At a strategic level, a falls prevention program requires meticulous planning, implementation and evaluation.
In Australia, The Australian Dietary Guidelines (ADG), are commonly used as a standardised framework; this states that the recommended Adequate Intake (AI) for total water (both fluids and food moisture) and total fluid intake (including food moisture) for adults is 3.4 L for males, 2.8 L for females and 1.4–2.2 L for children/adolescents depending on age and gender. The AIs for total fluids are set at 2.6 L for adult males, 2.1 L for adult females, and 1.0–1.9 L for children/adolescents.
Amongst these evidence-based recommendations, promoting good hydration and nutrition in older adults has been statistically proven to increase resident well-being and improve overall quality of life. Indeed, older adults, through no fault of their own, often have a tendency to forget to drink, meaning more than half of aged care home residents do not have a safe swallowing mechanism, making them susceptible to decreased fluid intake.
These factors increase the risk of dehydration and UTIs, which can, in turn, lead to confusion, falls, acute kidney injury and hospital admission.
Until recently, practically all fall prevention strategies in aged care homes relied heavily on human intervention; watching and assisting the vulnerable when they need to be mobile. Whether it’s a resident going to the toilet, entering the lounge area, or going outside for fresh air, aged care staff need to be vigilant and on guard at all times, which can be difficult, especially in large-scale environments and on 24/7 schedules.
However, as with most of today’s professions and necessities, technology has played a fundamental role in supporting people, alleviating pressures, and improving time management while also providing an extra layer of protection to residents’ health, safety and wellbeing.
Thankfully, there is now a vast array of technology at the fingertips of aged care providers throughout Australia, such as mobile clinical care systems, that can help reduce falls and UTIs amongst the elderly by up to 50 per cent – a revolutionary feat simply unachievable on such a scale before.
In fact, recent research by a team at Adelaide’s Flinders University discovered that mobile digital technology can significantly reduce the likelihood of falls and pressure injuries by half – reducing the overall number of subsequent admissions to hospital. In addition, with digital care plans in the palm of their hands, carers and nurses can immediately see whether residents have had sufficient nutrients or fluids and take appropriate action.
On top of this, reminders to offer drinks or specific food groups to alleviate the risk of UTIs can also be set up as part of a planned person-centred routine. Meanwhile, other digital software solutions are able to simplify the process even further by utilising a traffic light system to alert staff to when a care task is due, or to a resident falling below the recommended nutrition/hydration threshold for the rolling 24-hour period and flagging the need for intervention.
So, when the risk increases, so too does the caregiver’s ability to be alerted and take appropriate action to avoid that person becoming dehydrated, which, in turn, reduces the risk of developing UTIs. For example, through the utilisation of technology, caregivers now have access to tools to monitor and share sore or swallowing issues that contribute to how well someone can eat and drink.
Again, it’s all about being able to review someone’s needs by measuring all risk factors such as height, weight, age, allergies, medical conditions, etc. Following this, all data is then pulled through the clinical care system, allowing caregivers to provide the appropriate level of person-centred care.
Overall, digital care technology grants aged care providers a clearer understanding of an individual’s nutrition and hydration plan, which can be monitored in real-time – a scenario that just wasn’t possible in a paper-based care setting.
Ultimately, if aged care homes throughout Australia are to continue to thrive, then digital care plans must become the benchmark for providing a holistic approach to care that ensures the people at the heart of the action have the tools at their disposal to significantly reduce the chance of a fall, or conversely, developing a UTI.
Tammy Sherwood is chief executive of Person Centred Software Australia.
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We had a policy in the Nursing Home that the end of every time a resident received care the Carer would hand the resident a drink of water, cordial etc before they left the room.
Even if the Resident only took a few sips it moistened their mouth which is beneficial. increasing appetite, improving skin, reducing falls, helping with orientation, orientation lessens confusion, pain.
The resident soon gets into the habit to have a drink.
This also created a habit with the staff so they are aware that the resident needs extra fluid and why. (Unless there is a medical reason not to offer a fluids)
As long as it is not contraindicated, there are other ways of helping a resident with hydration such as chopped watermelon, ice blocks and jelly
It’s also all about finding out what a resident likes to drink. Facilities cannot provide every juice/cordial but on admission, if staff find out from family/carer/resident themselves what they like, then maybe family members can provide a particular drink for the individual resident