Introduction, Purpose, and Background
As a person grows older, he or she becomes vulnerable to many different health problems. Some of the health problems are opportunistic, that is they occur only when someone has weakened immune systems. Also, some of the health issues have been associated with the weakening of the muscles, hence inability to manufacture enough energy needed to support the body. This, therefore, makes the older people fall more often than, the younger and middle-aged persons. It has been discovered that the main cause of injuries in older persons is falling. In Canada, it is estimated that approximately 1 in every 3 elderly persons is likely to once at least. Elderly people are people of between ages 65 and above. Most cases of injury-related hospitalization among the elderly in Canadian hospitals has been associated with falls. For instance, in the year 2008- 2009, falls contributed to the hospitalization of over 73,000 elderly persons who had suffered serious injuries due to the falls ( Pearson, St-Arnaud & Geran, 2014) . Among those who suffers injuries due to falls, quite a number of them become disabled and hence, they are put in long-term care. That, therefore, makes falls to be classified as a serious health issue that must be attended to by the health professionals particularly the nurses. A registered nurse according to the Canadian Nurses Association, is a self- regulated individual professionally trained to willingly work with other people in order to allow families, communities, individuals, and populations to attain maximum levels of health. The nurses, therefore, offer healthcare services at all time in all stages of life including situations of health, injury, illness, and disability. They serve a critical role in assisting the clients to manage their health. Due to this, nurses are therefore important in helping older people in the Canadian society with necessary prevention measures that may help lower cases of falls among the elderly persons. In this study, therefore, we shall focus on the roles of the registered nurses in minimizing cases of falls among the elderly people.
Strategies to Promote/Protect Health
Falls according to Emily and Sharon, remains a major cause of injury in the older people with approximately 30% -40 % of the elderly people living in the community falling each year ( Kwan & Straus, 2014) . Some of the factors contributing to the occurrence of falls identified include home hazards, age, previous falls, visual and cognitive impairment, and balance impairment of gait balance. For nurses to be able to fully help in the prevention of the falls, they must ensure that they maintain a good relationship with their clients and observe the holistic nursing theories. Additionally, nurses are expected to act in the best interest of the public and therefore, they must engage in self-regulation so as to uphold professional and individual responsibilities.
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According to Bauman et al, falls are highly risky for individuals above the age of sixty-five. Given that falls may lead to death or permanent disability, Bauman et al, recommends that screening should be conducted at least once in a year on all persons above the age of sixty-five years ( Bauman et al, 2014) . That may allow nurses to be able to come up with good care plans that may help in the reduction in the number of falls.
Several interventions for the managing falls among the elderly have been identified. Given that the cause of falls is multiple, managing falls should be done to each patient based on the physical and historical examinations. Some of the interventions include multifactorial falls interventions where specific balance, gait, strengthening and coordination exercises are applicable with the guide and help of the physician. Otago exercise, for instance, has been identified to be useful in lowering rates of fall. This enables the patient gain strength and balance. Also, a patient can gain strength and balance through participating in the community-based exercise programs specifically meant for elderly people to assist in lowering the risk of falls ( Winter, Watt & Peel, 2013) . I am convinced that this intervention may help lower cases of falls among the elderly because based on the evidence, out the total number of participants, the number of falls recorded after the exercise were less than 0.5%. The source is credible because the article has been peer reviewed by many authors who have agreed with the findings and conclusions made in the study.
The influence of Tai chi interventions on preventing falls was studied by Saravanakumar et al. Participants were involved in a fourteen-week program with a half an hour class twice a week may also be used. In every session, participants begun with warm up exercises specific for different joints and then proceeded through eighteen individual qigong and tai chi movement patterns. Each pattern was repeated several times using posture control, imagery and breathing control and the session concluded with the lotus. In their findings, they found out that tai chi helped the participants gain control of their posture and hence reducing the case of falls ( Saravanakumar et al, 2014). The challenge with regard to tai chi is that it can be expensive especially for poor, elderly persons. As per the evidence provided, I am convinced that the intervention is helpful for reducing cases of falls as it helps in improving balance. This source is credible because many other researchers have also identified the usefulness of tai chi in reducing falls.
Home assessment and modification intervention is essential in reducing cases of falls among the elderly. It includes hazard reduction, footwear, vision assessment, home modifications, behavioral changes and home visits ( Kwan & Straus, 2014) . The intervention helps reduce chances of falls, by ensuring that all factors raising the risk of falls at home are eliminated. For example, a slippery floor can be modified so as to reduce the risk of an elderly person falling. Also, a Home Fast screening tool can be used which helps in predicting falls in older people and therefore preventing such falls in good time. Additionally, in the home assessment, the elderly people can also be trained on how to get up safely when they fall especially in cases when they fall, and no one is around and also offer training for the family members on how to safely transfer the elderly person when he has fallen without committing further injuries. The major challenge with this intervention is that it requires a combined effort from all family members which sometimes might fail to occur due to differences in opinions.
The use of the personal emergency response systems may help the patients raise the alarm when they are alone and are at a risk of falling. These systems, therefore, may be mainly useful for persons who are aging and are often living alone or are left alone during the daytime when others go to work. For instance, if an old person raises the alarm of being at risk of falling, the person can quickly receive help and therefore, lower cases injuries among the elderly people due to falls ( Bauman et al, 2014) . However, the only problem with the use of this system is that there might be delayed response and therefore, the system might not so much help in reducing cases of falls. I am, however, convinced that if the systems are applied well, cases of falls may reduce to fewer levels than the previous years. This source is credible because findings identified for this study are similar to those identified by other renowned researchers.
The Nurse’s Role in Health Promotion/protection
Nurses serve a critical role in preventing cases of falls among the elderly. According to the holistic nursing theories, nurses are expected to serve their patients well so as to attain normal health as soon as possible. Before a nurse is fully authorized to offer health care services to the public, he or she must prove that they are ready and willing to serve their clients without any form of discrimination. According to the Canadian Nurses Association, there are five different competency categories that are, ethical practice, self -regulation, service to the public, knowledge-based practice and professional responsibility and accountability (CNA 2015). A registered nurse is expected to apply and integrates many competencies at the same time so as to ensure effective, safe and ethical practice.
Registered nurse practice consist of clinical practice, education, research, policy, and administration (CNA 2015). All registered nurses no matter their section, are required to work towards ensuring that patients receive optimal healthcare services. They can, therefore, prevent cases of falls in elderly people in several ways. First, they can offer advice to family members on ways and measures that can be taken to reduce falls in the patient. That involvement of family members contributes to holistic healing.
The Nurses also, help in making health care plans for patients and thus can involve the family and the client in creating an efficient care plan to help minimize cases of falls. Additionally, nurses have the responsibility to ensure that their patients follow the instructions given by the physician regarding the application of a given intervention. In this case, they are supposed to ensure that the elderly people corporate fully by ensuring that their holistic needs are fully fulfilled. With this regard, the Canadian Nurses Association, recognize the positive effects of nurses as improving clinical, functional, safety and perceptional outcomes (CNA 2015).
Some of the challenges that may hinder the nurses from attaining their goal of reducing cases of falls among the elderly include resistance from family members and poor hospital facilities. For instance, if family members of a given patient fail to comply with the nurse, assisting such a patient may be difficult.
To conclude, nurses have a bigger role in preventing falls among the elderly. Some of the roles identified include offering efficient educational services to the patients and family members on how to minimize cases of falling. They also, offer assistance in deciding which best healthcare plan to be used so as to minimize fall cases. It is, therefore, important that nurses are motivated by the public and the government so that they can offer effective health care services.
References
Bauman, C. A., Milligan, J. D., Patel, T., Pritchard, S., Labreche, T., Dillon-Martin, S., ... & Riva, J. J. (2014). Community-based falls prevention: lessons from an Interprofessional Mobility Clinic. The Journal of the Canadian Chiropractic Association , 58 (3), 300.
Kwan, E., & Straus, S. E. (2014). Assessment and management of falls in older people. Canadian Medical Association Journal , 186 (16), E610-E621.
Pearson, C., St-Arnaud, J., & Geran, L. (2014). Understanding Seniors' Risk of Falling and Their Perception of Risk . Statistics Canada.
Saravanakumar, P., Johanna Higgins, I., Jane van der Riet, P., Marquez, J., & Sibbritt, D. (2014). The influence of tai chi and yoga on balance and falls in a residential care setting: a randomized controlled trial. Contemporary nurse , 48 (1), 76-87.
The CNA (2015). Framework for the Practice of Registered Nurses in Canada.
Winter, H., Watt, K., & Peel, N. M. (2013). Falls prevention interventions for community-dwelling older persons with cognitive impairment: a systematic review. International psychogeriatrics , 25 (02), 215-227.
Appendix
Search Strategy
In order to attain optimal results as per the roles of the nurses in preventing falls among the elderly, I used peer reviewed articles, scholarly journals and recently published books from various databases. To ensure that I used information that concurs with the current trends in the health sector I set limits and used articles and books that were no more than five years old. From the various databases, I managed to identify six sources that were most relevant with regard to the topic and used them in writing this paper.
