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ST. CLOUD - The answer to reducing falls in nursing homes may rest in part with the electrodes stuck to Rita Hammerel's legs.
In St. Benedict's Senior Community nursing home to recover from her second knee-replacement surgery, Hammerel slowly stretched her leg up and down, forward and back, pointing the toes of her white sneakers to and fro.
Normally, the physical therapy would have been painful. But with electrical impulses tickling through her knee, stimulating nerves to release natural pain-relieving endorphins, it's much easier and faster to build up her strength -- a key to avoiding falls.
"It just tingles, then it stops," said Hammerel, 77. "The pain goes down."
It's part of an arsenal of approaches St. Benedict's turned to after falls at the 222-bed facility increased last year. Administrators re-evaluated fall prevention and saw vast improvement, with falls reduced from 60 to 34 a month.
Tonight, they are to receive an award from Care Providers of Minnesota.
"There's a lot of reasons why people come to nursing homes, but one is to be safe. And that safety is typically from falling," care center administrator Christine Bakke said.
At St. Benedict's, administrators decided they should examine what caused any individual resident to fall, Bakke said. It's an approach some other nursing homes, including St. Therese Home in New Hope, are also trying.
"We went floor-by-floor and resident-by-resident and rebuilt plans for every resident to reduce our falls," Bakke said.
St. Benedict's often used equipment it already had. The electrode stimulation machine that Hammerel used sits near Nautilus gym equipment, also used to make residents stronger. A bladder scanner, a $16,000 ultrasound-like machine, shows how full a resident's bladder gets at various times to better estimate when bathroom trips are needed.
"One big reason why people fall is trying to go to the bathroom," Bakke said.
The nursing home's call-light and alarm system is wirelessly linked to pagers that nurses and nurses aides carry. The system is tracked so administrators can see how long it takes to answer. Staffing was changed so that the same aides worked with the same residents more often, and more staffers were assigned to residents with memory issues late in the day.
Bakke said St. Benedict's, which recently added a new wing for short-stay residents, has been able to afford improvements because it has generous donors and its ratio of Medicare-paid residents is higher than most. The home also received about $64,000 from the state Department of Human Services to reduce pain, reduce the length of stay for short-stay residents and improve residents' abilities to move and function daily. That has also helped reduce falls, Bakke said.
"There are so many studies out there that reinforce the benefits of keeping people mobile," she said.
At St. Therese, the staff uses high-tech balance machines to pinpoint problems in a resident's ability to move and balance, from eyesight to muscle weakness. The machines analyze how people walk or get up from a chair. They can also track whether interventions work for a particular resident over time. The nursing home raised about $117,000 in donations to buy the equipment.
Along with sending nursing assistants to fall-prevention training, St. Therese's administrators have staff members draw a picture after finding a fallen resident. The drawings can be revealing, they said, showing a phone cord on the floor or something else that staff might accidentally overlook. They look for patterns in events leading up to a resident's fall.
"Our whole approach ... is more holistic," St. Therese administrator Denise Barnett said. "You can't look at falls and only look at falls. There's a lot of reasons why people fall," such as medication, disease, strength or even inner-ear issues, she said. St. Therese's staff is working to pinpoint why a resident fell to prevent it from happening again.
Administrators at both homes say keeping seniors independent and mobile is important. They caution that not all falls can be prevented.
Studies show a range of outcomes from such efforts in facilities around the world. Some experts say fall-prevention efforts don't work as well in nursing homes compared to community-wide efforts. One 2008 review in Canada found some studies showed effective fall reduction in residential care facilities. But, the review cautioned, more research is needed.
Nursing homes offer more supervision and safety equipment than people can get at home, Bakke said.
So while no place can be made completely safe, nursing homes are safer, Bakke said. "The key word is safer."
Pam Louwagie • 612-673-7102 Glenn Howatt • 612-673-7192