Falling is a common serious clinical problem and a leading cause of injury in seniors. The definition of a fall is an event that results in a person unintentionally coming to rest on the ground, floor, or other lower level with or without loss of consciousness or injury. In a recent study published in JAMDA, Orthostatic Hypotension (OH) measured at 30 seconds after standing was related to the risk of falls.
That said, OH should not be confused with functional balance, the way someone will teeter and appear to be unsteady when they initially rise from a seated or lying position. OH is different, it is a measure of blood pressure, not the resident’s true “balance”. We often evaluate a resident’s blood pressure when lying, sitting, and standing however, the study indicates that taking the blood pressure 30 seconds after the resident rises is the most reliable measure for OH.
Considering that the prevalence of OH is quite high and many residents are asymptomatic (until they fall), maybe it is time that we re-evaluate how we assess our residents and their risk for falls. A 30-second assessment of blood pressure may indeed identify OH and allow your caregivers to initiate interventions that may actually assist in preventing that next fall. Definitely worth a try! Take your fall log to the next QAPI committee meeting, talk about the study (link below) and identify if there are residents who may benefit from OH preventive interventions! Stay well, stay informed, and stay tuned!