Think Before You Move
You have been lying in bed for several hours. What steps should you take before beginning to walk?
Sit up slowly, place feet securely on the floor, check for dizziness, use the recommended device, and request assistance if indicated.
You notice an electrical cord stretched across your walking path. What's the hazard?
It is a tripping hazard and should be moved before walking through the area.
Your glasses fall on the floor while you're sitting in your wheelchair. What is the safest response?
Ask for assistance rather than leaning excessively out of the chair.
Why should wheelchair brakes be locked before a transfer?
To prevent the wheelchair from moving when body weight shifts during the transfer.
Name three personal factors that can increase someone's fall risk.
Weakness, poor balance, dizziness, impaired vision, cognitive impairment, medications, pain, fatigue, or previous falls.
Why might standing immediately after lying down increase your risk for a fall?
A sudden position change can cause dizziness or a drop in blood pressure.
A resident is wearing loose slippers without backs. Identify the problem and a safer alternative.
Loose footwear can slip off or reduce stability; properly fitting, supportive nonskid footwear is safer.
You need the bathroom and have pressed the call light, but staff haven't arrived yet. What should you do?
Remain seated/in bed and use the call system again rather than attempting an unsafe transfer.
Why can carrying several objects while using a walker be unsafe?
It can interfere with proper use of the walker, balance, visual attention, and the ability to maintain adequate support.
Why can certain medications increase fall risk?
Some medications may cause dizziness, sedation, changes in blood pressure, confusion, or impaired balance.
You're walking with your walker and suddenly feel weak. Your chair is about 10 feet away. What should you do?
Stop rather than rushing toward the chair, maintain support with the walker, and call for assistance.
You're getting ready for bed. Your walker is across the room, the lights are off, and your call light fell on the floor. Identify three fall hazards.
Inaccessible walker, poor lighting, and inaccessible call light.
You normally use a walker but feel stronger today. Should you try walking without it? Explain your reasoning.
Not unless your mobility recommendations have been changed by the appropriate clinical staff; feeling stronger does not necessarily mean balance and mobility are safe without the device.
Your walker is adjusted too low. How might this affect your safety?
It can cause poor posture, improper weight bearing, reduced stability, and inefficient use of the device.
Why might someone who has already fallen be at greater risk for another fall?
The factors contributing to the first fall may still be present, and fear of falling can also change mobility patterns and activity levels.
You're transferring from your wheelchair to bed. Name four things you should consider before beginning the transfer.
Wheelchair position, locked brakes, footrest placement, appropriate footwear, transfer surface, mobility device, and required level of assistance.
A resident has to use the bathroom urgently. The floor is wet, their walker is behind a chair, and they say, “I'll just hurry.” Identify the hazards and the safest response.
Wet floor, inaccessible mobility device, urgency/rushing, and attempting mobility without appropriate assistance. The resident should remain in a safe position and call for help.
Your roommate starts to fall while walking. Should you try to catch them?
Call for staff assistance rather than putting yourself at risk of falling or being injured while attempting an unsafe rescue.
A resident forgets to use the wheelchair brakes even though they can explain what the brakes are for. What cognitive skill may be affecting safety?
Carryover, memory, executive functioning, attention, or safety awareness.
Explain how poor attention can contribute to falls even when someone's legs are physically strong.
The person may fail to notice obstacles, forget their mobility device, become distracted during transfers, or fail to follow safety precautions.
A resident says, “I've walked by myself my whole life. I don't need help now.” Give two reasons this reasoning may be unsafe during a SNF stay.
Illness, hospitalization, medications, weakness, impaired balance, pain, or deconditioning can temporarily change someone's mobility and fall risk.
A resident falls twice while trying to reach the bathroom at night. What environmental and behavioral changes could reduce the chance of another fall?
Examples include improving lighting, keeping the call light and mobility device accessible, removing clutter, wearing safe footwear, requesting assistance, scheduled toileting, and avoiding rushing.
You wake up confused during the night and aren't sure where you are. You think the bathroom is across the room. What should your first action be?
Stay in a safe position, orient yourself, turn on/use available lighting, and call for staff assistance rather than getting up independently.
A resident correctly uses their walker during therapy but repeatedly leaves it behind when going to the bathroom. Is knowing how to use the walker enough to demonstrate safe independence? Why?
No. Safe independence also requires consistent initiation, judgment, recall, and carryover of the strategy into functional situations.
A resident wakes at 2:00 a.m. needing the bathroom. They received a new medication earlier that evening. Their walker is beside the bed, but they feel slightly dizzy when sitting up. They say, “The bathroom is only a few steps away.”
Identify at least four factors you would consider before deciding whether it is safe to walk.
Dizziness, possible medication effects, recent change in position, nighttime/lighting, mobility recommendations, need for assistance, balance, footwear, urgency, and ability to safely use the walker.