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“We do the best we can with what we know, and when we know better, we do better.” – Maya Angelou
Many of our staff discussions are wrapped around the question, “What can we do to make a more homelike environment for our residents?” In deciding what areas to target, we decided to focus on areas that impact quality of life. Environmental noise came to mind, and the discussion of personal alarms came up. Our interdisciplinary team has come up with a goal to eliminate all resident alarms.
About 20% of Episcopal Church Home’s residents have a personal alarm. This is for various reasons, but primarily due to the resident being a “high fall risk.” When doing research, we’ve learned that by having alarms, the actual number of falls does not decrease. An alarm simply notifies someone when someone could have fallen, or is simply moving or leaning forward. Listed below are some reasons that we are choosing to go “alarm free.”
- Alarms create noise, fear and confusion for the person and those around them. For example, one man would duck down when he heard the alarms as he was interpreting the sound to mean incoming missiles, from his World War II experience. In another case a woman tried to get up to answer the door bell every time the alarms sounded putting her at higher risk to fall.
- If staff tell the resident to sit down when the alarm goes off, the underlying need causing them to want to move is not addressed.
- Many residents dislike them and go to great lengths to hide or remove them often causing falls, bruises or skin tears.
- As the alarm use increases it decreases the resident’s overall mobility, he/she gets weaker, has balance disturbances and a decrease in endurance.
- Alarms can be embarrassing and an infringement of freedom, dignity and privacy.
- Sleep may be interrupted or even impossible as every movement set off the alarm. This often causes agitation, weight loss and weakness.
- Statistics show that alarms do not reduce the number of falls!
Episcopal Church Home is very excited to move forward with this goal, and will be working hard over this first quarter to accomplish this. Our interdisciplinary team will be working with each resident and looking at the reasons their alarm is going off. We will identify ways to prevent falls – making more rounds, involving the therapy team more, trying to find out why the alarm goes off. Maybe the resident is in bed, and isn’t ready for bed yet. There are a lot of reasons alarms go off, and that is why we are looking at each individual.
For more information, please call Episcopal Church Home at 651-646-4061. Ask for Andrea Krebs (Administrator), or Mary Leber (Director of Nursing).
I agree that personal alarms are counter-productive as they make residents afraid to move. Without all the minute adjustments that we make to our bodies every minute, we lose muscle tone, leading to weakening and wasting of muscles. Residents should be encouraged to move and make those minor readjustments. Not only can it help with toning of muscles, it also helps prevent pressure sores. If a person is afraid to move because they might set off their alarm, they may be creating an environment conducive to this bane of residential care life.
-Patt Dolan
I look forward to hearing more about what ideas you come up with. My mother, who passed away in December, spent the last 2 years of her life in a nursing home where alarms were always going off–usually residents leaning forward out of their wheelchairs or trying to stand up. It was constant noise and “You need to sit down, XXX!”
Good luck!
–author, “Inside the Dementia Epidemic: A Daughter’s Memoir”
-Martha Stettinius
Great use of analytic “out of the box” thinking!
-Jason M.
Good for you, Episcopal Church Home. Keep us posted on your progress!
-Cathy Lieblich
I hope you continue to post progress and insights into meeting your fantastic goal! Thanks for the inspiration!
-Alisa