Public health nurse seeks local seniors for fall prevention study

By Mary Ann Price

Terri Khoury’s clientele ranges in age from 3 to 103 years old. In her role as the town of Canton’s public health nurse, Khoury, MSN, RN, believes that while her job is multi-faceted, her prime responsibility is singular. “The health of the community,” she said.

Khoury has visited commercial day care centers in Canton, the library, and the Rodman Early Childhood Center to work with 3- and 4-year-old children for two reasons. The first is to implement a hand-washing campaign using a Glo Germ hand-washing kit. “They all know how to properly wash their hands,” Khoury said.

The second is to let them know that the public health nurse can be a resource for them as they grow up. “I develop a relationship with them; I’m available to them,” she said.

Khoury has also worked with Canton’s senior citizens at the Senior Center, providing clinics on blood pressure and teaching about the importance of using sunscreen and staying hydrated. She visits seniors in their homes, checking to see that they are safe and that there are no major changes in their physical state. This fall, Khoury is planning to focus on one of her primary concerns about older adults.

“One of the biggest problems is falls,” she said.

Khoury said that there are more than 300 causes of falls taken by older adults. She mentioned vision problems and side effects from medication as two of the more obvious causes. A number of seniors take medication to lower their high blood pressure. At times this can lead to hypotension, or lower blood pressure, which can cause falls. When some seniors fall, they may not be able to explain what happened, saying that they went straight down. “It’s usually hypotension,” Khoury said.

She added that 35 percent of adults over the age of 65 develop a fear of falling. That fear leads many of them to limit the number of activities they do on a regular basis, believing that limited activity will limit the likelihood of falling. Khoury said that the opposite is true.

“They start losing muscle mass,” she said. “That causes issues with balance and heightens the risks of falls.”

A student at Regis College, Khoury is working on a doctoral degree in nursing. For her research project, she will attempt to determine whether a fall assessment intervention program would prove helpful to older adults by using the STEADI (Stopping Elderly Accidents, Deaths and Injuries) toolkit from the Centers for Disease Control and Prevention. She is seeking 80 participants for the research.

“For me, it was really important to address a problem that my community faces,” she said. “A number of fire department referrals are post falls. That really changes the lifestyle of the older adult. They want to stay home and maintain their independence.”

Khoury’s study will commence in September, which is Fall Prevention Month. Participants need to be Canton residents who are at least 65 years old and are living independently; read, write and speak English; and have a history of a fall or have concerns about falling.

“Those who qualify will be randomly selected to participate in the fall assessment intervention program,” Khoury said.

The Lions Club will administer a vision test to each participant; a physical therapist will assess balance; and a podiatrist will do a foot examination. A licensed pharmacist will review each participant’s medications, and blood pressure will be monitored.

“All participants will receive an automatic telephone question each day for 90 days,” Khoury said. “They don’t have to be home to answer it.”

Khoury is hopeful about the project. “I’m really excited about this,” she said. “If I can prevent one older adult from falling and losing their independence, it will be all be worth it.”

The deadline for those who would like to sign up for the study is September 8. Interested participants should contact Khoury at 781-821-2942.

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