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A newsletter
for caregivers
from the
Iowa Health
Care Association



among the elderly, according to the IGEC. This
includes head injuries, fractures and soft tissue
damage, such as internal bleeding, sprains and
lacerations. Although this is a negative statistic, it’s
important to remember that falling is not a normal part
of aging, and caregivers can minimize the risk.

What You Can Do

Stay educated on fall prevention


alls are a common medical problem among
the elderly. Every 18 seconds, an older adult
is treated for a fall, according to the Iowa
Geriatric Education Center (IGEC). Caregivers play
an important role in preventing falls and lowering this

What Causes Falls?
Understanding the cause of falls helps caregivers
be proactive in preventing them. Finding the cause
is more effective than merely treating the symptoms
of problems, studies show. Caregivers will not only
achieve the goal of fall reduction, but significantly
improve the quality of life for residents. Risk factors
that contribute to falls include:
• Fall history
• Muscle weakness or foot pain
• Poor balance, strength and/or endurance
• Vision and hearing problems
• Improper footwear or clothing
• Diagnoses and medications
• Personal items and/or assistive devices not seen or
within reach
• Clutter
• Unsecured carpet or wet floors
• Improper toilet, bed or chair height
• Poor lighting
• Cognitive impairment or depression
• Noise levels—residents in noisy areas fall down
more often than those in quieter areas; the noisiest
time of day is during shift change and mealtime
• Busy activity—the busiest month is frequently
About 25 percent of falls result in serious injury

First, caregivers must identify those at risk for falls.
Special codes or signs of a certain color, such as a
star or ribbon, can be placed on residents’ doors.
Having this information accessible helps with the
safety of both employees and residents. Once
those at risk have been identified, here are some
suggestions to assist in fall prevention:
• Place the call light within reach and answer it
• Take residents to the bathroom on a regular basis or
when restless
• Stay with confused residents while they are in the
• Stay in close vicinity of alert residents who need
assistance transferring on and off the toilet
• Make sure residents wear proper footwear at all
• Have residents sit on the side of the bed until they
get their balance before standing
• Keep residents awake during the day, if possible,
so they will sleep at night instead of wandering—if
napping occurs, it should be in early afternoon
• Walk with residents one-on-one when possible
rather than restricting their mobility
• Allow residents time to sit to receive their
• Keep frequently used items near residents
• Make sure clothing doesn’t hang below the ankles
• Ensure residents receive enough fluids throughout
the day—usually six to eight glasses
• Report to the next shift those residents who have
the risk of falling
• Keep bed in a proper position
• Elevate toilet seats and other chairs if needed
• Provide good lighting and leave a night light on in
• Maintain firmly attached carpet and non-skid strips
Continued on page 4

Working Effectively

Five foods

to avoid before your shift
A solid supply of energy and stamina before a caregivers shift is
important. Avoid the following foods to ensure a smooth, energetic

1. Candy, cake and cookies.
Everyone loves a sugary treat, but it doesn’t provide the best
nutritional value—especially if you are about to start a shift.
Immediately after eating these types of food, blood sugar spikes and
our bodies begin to produce high amounts of insulin. In other words,
we get a short term energy boost, but shortly after digesting we begin
to feel sluggish—which will prevent you from being at your best.

Keep your health
this winter

Tip: Save a cookie for after your shift as a reward or something to look
forward to.

During the winter season, it’s all
too easy to get sick. Use these five
easy tips to keep your health this

2. Foods with no protein.

1. Stay hydrated.

Since protein is great at keeping us feeling full, eating foods with
little to no protein can leave you feeling hungry again after only a few
hours. This isn’t good since caregivers often work long shifts.

Staying hydrated with proper fluids
will ward off common germs and

Tip: Eat foods high in protein, such as meat, nuts, eggs, yogurt or

2. Eat healthy.

Tip: Avoid foods such as ground beef, fried meat, food high in fat,
broccoli, cauliflower, beans and carbonated beverages.

With multiple holidays in the winter,
it’s easy to over eat or choose
unhealthy food options. While it’s
okay to indulge on the holidays,
try to eat healthy every other day.
A healthy diet keeps you feeling
energized and ready to take on the
cold weather.

4. Foods with offensive odor.

3. Moisturize your skin.

Avoid any foods that may give you bad breath during your shift, such
as foods containing large amounts of garlic or onion. If you must eat
these foods, be sure to brush your teeth afterwards.

High winds and frigid weather
can dry out and crack your skin.
Regularly moisturizing will help
prevent skin breakage and drying.

3. Foods that cause indigestion or gas.
When you have a busy job on your feet, that last thing you want to
deal with is indigestion or gas. Avoid foods that may cause cramping,
gas, heartburn or any other uncomfortable symptoms.

Tip: Invest in minty gum!

5. Heavily caffeinated beverages.

4. Wear sunglasses.

Caffeine may be an excellent pick-me-up, however drinking too much
can make you feel jittery. Caffeine also works as a diuretic, meaning
it encourages urination. Drinking too much caffeine before work may
lead to an entire day spent running to the bathroom.

The bright sun can damage your
eyes if not protected. The sun can
also reflect off snow and shine even

Tip: Stick to water or tea.

5. Dress for the weather.
Always bundle up if you plan on
being outside, even just for a tiny
bit of time. You want your body as
warm and comfortable as possible
to ensure you stay healthy.

Winter 2017

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Techniques for Caregivers
Stay sanitized this season!

Infections are the leading cause of death among
nursing home residents, however good handwashing
by caregivers, residents and visitors can protect
against the spread of infectious diseases! Infections
such as the common cold, influenza and diarrhea can
quickly spread through hand-to-hand contact. These
conditions can be very serious in older adults, as a
cold or the flu can turn into pneumonia.

Handwashing is the most effective way to avoid
spreading diseases. Wearing gloves is not enough, as
they can still transmit infections if not changed after
working with a patient, or if a glove is cut, torn or has a
small hole.
The best cleansing option is to use soap and water.
Be sure to follow the proper hand washing technique:
1. Turn on water and keep it running while you wash
your hands—do not touch the sink after this.
2. Hold hands under a water stream until they are
wet up to the wrist.
3. Apply a generous amount of soap in your palm
and rub hands together.
4. Wash hands for at least 15 seconds—make sure
to wash the front and back of the hands, between
fingers, around and under the finger nails and up
your arm about eight inches above your wrist.
5. Dry hands with a paper towel.
6. Use paper towel to turn the water off and

Although sanitizer does not take the place of hand
soap, use an alcohol-based sanitizer, such as
Purell, if that is your best option. To effectively use
sanitizers, rub about half a teaspoon into your hands
until they are dry, ensuring you cover all surfaces.
Caregivers should be cleansing or sanitizing their
• As soon as they get to work
• Before entering a patient’s room
• When they are leaving a patients room
• Before and after each task performed
• Before and after touching a person
• Before and after putting on gloves
• Before leaving the restroom
• Before and after taking a break or handling food
• After coughing, sneezing or blowing their nose
• After handling garbage or trash
• Before leaving work
Good handwashing by caregivers, residents and
visitors will help minimize the transmission of viruses
and bacteria.

Responding to resident repetition
Residents with Alzheimer’s may
repeat words, questions, activities
or undo something that was
just finished. He/she is probably
looking for comfort, security
and familiarity, according to the
Alzheimer’s Association. Here are
eight tips on how to respond to
repetitive behavior:

Look for a reason behind the
Does the repetition occur around
certain people, surroundings or
at a certain time of day? Is the
resident trying to communicate
Winter 2017

Focus on the emotion, not the
Rather than reacting to what the
resident is doing, think about how
he/she is feeling.
Turn the action or behavior
into an activity.
If the resident is rubbing his/her
hand across the table, provide a
cloth and ask for help with dusting.
Use memory aids.
If the resident asks the same
questions over and over, offer
meaningful reminders by using
notes, clocks, calendars or photos.

Provide an answer.
Give the resident the answer he/
she is looking for, even if you have
to repeat it several times.
Engage the resident in an
The resident may simply be bored
and need something to do. Provide
structure and engage him/her in an
Stay calm and be patient.
Reassure the resident with a calm
voice and gentle touch.

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Caregivers’ Corner
Continued from page 1

Stay educated on fall prevention

Health Care Assistants

near areas that might get wet or in areas near beds where residents may
step while wearing socks
• Place a rubber mat or non-skid strips in tubs or showers
• Maintain a regular program of exercise to improve strength, muscle tone
and mobility
• Encourage residents to attend your organization’s scheduled activities
(Add info in winter)
• Encourage wandering residents to sit in rocking chairs so they can use
up some of their energy
The greatest effect in preventing falls is seen with exercise that challenges
balance, according to a study by the Journal of the American Geriatrics
Society. Balance is a combination of posture, range of motion, strength,
reaction time, visual perception, somatosensory and pain, according to
Empira Director of Education Sue Guildermann. As we age, we lose our
balance because we become more sedentary, which is especially true in
health care facilities where staff tend to do things for residents. Caregivers
Caregivers’ Quarterly is a newsletter
can provide opportunities for residents to stand and reach more often,
incorporating balance into current activity programs and ADLs.
published by the Iowa Health Care

Association (IHCA) for the staff of its
members and is intended to help them
If caregivers come across a situation too late, studies show that when
stay informed on current techniques
responding to a resident who has fallen, the “Check, Call and Care”
and issues related to providing care in
technique is very effective. The technique consists of these steps:
nursing homes, assisted living, home
1. Immediately go to and stay with the resident
health, residential care and independent
2. Call for a nurse
living facilities. IHCA and their members
3. Encourage the resident not to move—Ask, “Are you okay?”
are dedicated to improving the quality
4. Ask, “What were you doing/trying to do just before you fell?”
of long term services and supports in
5. Begin getting answers to the “10 questions”
Iowa through educational programs
• Ask: Are you okay?
and proactive advocacy with the Iowa
• Ask: What were you trying to do?
and U.S. legislatures and administrative
• Ask or determine: What was different this time?
• What was the position of the resident? — Near a bed, toilet, chair, on agencies. The Iowa Health Care
Association (IHCA), Iowa Center for
their back, etc.
• What was the surrounding area like?—Noisy, cluttered, poor lighting, Assisted Living (ICAL) and Iowa Center
for Home Care (ICHA) are affiliated
• What the floor was like? – Wet, uneven, carpet, tile, etc.
respectively with the American Health
• What was the resident’s apparel? – Shoes, socks, slippers, bare feet, Care Association (AHCA), the National
Center for Assisted Living (NCAL) and
• WasQuality
the resident
an assistiveAwards
device? – Walker, cane,
the National Association for Home Care
wheelchair, etc.
and Hospice (NAHCH).

Call, Check and Care

• Did the resident have glasses and/or hearing aids on?
• Who was in the area when the resident fell?
These steps can be laminated and placed in work areas for reference
when needed. It’s easy to miss something you’re not looking for, so posting
the “Check, Call and Care” technique throughout the facility is a good idea.
By staying educated on the fall facility’s policies and procedures,
prevention techniques and appropriate reporting for when falls do happen,
caregivers will play a huge role in keeping elders safe.
Visit for
excellent fall prevention information. You can also print off the “Check, Call and Care” steps
at our website,

Winter 2017

Managing Editor: Nicole Mergen,
Communications Intern
Editor: Claire Seely, Director of
Iowa Health Care Association
1775 90th St.
West Des Moines, IA 50266-7726

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