Do disruptive behaviors signal unmet physiologic or psychosocial needs?
Fall prevention. Brain damage from any source-dementia, stroke, or Parkinson’s disease, for instance-may predispose older adults to injury because they may not recognize their limitations. Depending on the setting, staff may judge certain behaviors to be unsafe and consider restraints-despite the risk of deconditioning from immobility, which can increase the risk of falls and the danger of injury if the patient struggles to get free of the restraints. The focus should be on preventing injurious falls, not on preventing falls at any cost.The nurse should develop an individualized plan of care, and all staff should be aware of its implementation; nursing assistants are especially critical to its success. Helping patients maintain gait, balance, and muscle strength is also crucial. Involving occupational and physical therapists in the hospital and in a restorative-care program in the nursing home will help forestall decline. Judicious use of adaptive aids, such as properly fitted walking
