Safety Starts with Prevention
by Felicia Juntunen, MA, CMC, ECM Director of Care Management
As care managers and Aging Life Care professionals, one of our goals is to help clients maintain their maximum functional potential. We address safety and security concerns as we monitor and encourage their overall well-being. Last month we shared about the importance of mobility and its relationship to safety and independence. This month we are maintaining the focus on safety, specifically addressing avoiding physical accidents that can create a cascade of events leading to unwanted change and increased dependency. While a care manager will take a holistic approach to monitoring a client’s safety and well-being, there are three categories of safety specifically related to physical accidents to which a care manager will pay close attention, including home or environmental safety, assistive devices, and medication management.
Over time, we all become accustomed to our home environments and often overlook the simplest of things that might contribute to accidents. Aging Life Care Managers will assess a client’s environment starting with accessibility and determine if the client can safely enter and exit their home, and navigate steps, thresholds, narrow doorways, or other obstacles. We evaluate whether there is adequate lighting, during the day and at night. Bathroom safety is assessed including shower accessibility, the presence of safety bars, shower seats, handheld shower heads, raised toilet seats, and handrails. Often, the addition of any of these safety features helps prevent an accident, improves functioning, and leads to improved well-being. Another environmental safety issue to which care managers are alert is clutter. The accumulation of items in areas of the home that impedes or prevents necessary activity or lead to poor hygiene is cause for concern. Care managers aren’t looking for pristine, clutter-free environments but will encourage and assist clients in making their environments functional and safe.
Many care management clients use a variety of assistive devices to enhance their functioning. A care manager takes great interest in assessing the appropriateness and performance of this equipment. A walker that is properly sized, in good condition (for example, do the brakes work?), and used regularly will best serve the safety of the client. Hearing aids and glasses enhance awareness of one’s surroundings which is vital for accident prevention. For clients who wear hearing aids, we ask how the devices are charged, if they are worn regularly during waking hours, and help secure technical support as needed. Likewise, for those who need glasses, we regularly check that the glasses are worn, the prescription is current, and promote regular exams to monitor eye issues like cataracts or glaucoma. Aging Life Care professionals promote the value of a personal alert device, especially for those clients who live alone. While wearing a call button can’t prevent accidents, accessibility to call for help can often prevent a minor event from becoming a major emergency.
Medication mismanagement can lead to adverse health outcomes which directly impact safety, including increased falls. Medications are often prescribed with specific instructions for timing, avoidance of other medications or certain foods, and caution with side effects. Medication that is taken improperly, or not taken, can cause worsening of symptoms or side effects that can impair a patient’s functioning. Care managers assess for an understanding of medication instructions as well as the client’s system for administering their medication. Is a pill box utilized and does the client or someone else fill it? Are medications being taken on time? Are side effects being monitored and reported to the physician? Is required lab work being completed? Identifying and addressing gaps in medication management can help avoid over or underdosing and the risk of accidents that may result. Medication management is a critical part of safety and accident prevention for older adults and an area regularly evaluated by a care manager.