Fall prevention in elderly

Falls are common in the geriatric population, and they have devastating consequences. Tin fact, falls are the leading cause of injury and death in adults over the age of 65 years. Over the age of 65%, up to 33% of people report having fallen, and that number increased to 50% in the population that’s 80 years and older. 1 in 4 of these elderly people who fall will sustain an injury, and the truly scary statistic is that the one-year mortality rate for the these elderly people who have experienced a fall (with an injury) has been shown to be up to 26%. After a fall with an injury, there is often a hospitalization, loss of strength and mobility and therefore a loss of independence. There is also the chance of infection and other complications as well. All of these have serious effects on a person’s physical and mental state and generally we often see a functional decline from this point.
There are even consequences for those who fall and do not injure themselves, because they become afraid of falling again. They therefore move less and continually lose function. As the saying goes, “if you don’t use it, you lose it”.
As people age, they may experience stiffened joints, decreased muscle strength, poor balance and impaired neurologic feedback. These changes, in combination with other risk factors, increase the likelihood of falls. How can you tell when someone is at risk for falling? The strongest independent risk factors for falls are previous falls, weakness, gait and balance impairments, and use of psychoactive medications. So, if you know someone is at risk, let’s talk about how to prevent falls from happening.

How to Prevent your Loved Ones from Falling:
In adults, use of multifactorial assessments and interventions has led to a decrease in fall rates by 25% to 40%. Depending on the results of this risk assessment, appropriate multifactorial interventions for preventing falls may include any or all the following:
• Engage in Daily Exercises: Exercises/physical therapy programs are aimed at improving balance, gait, and strength and thereby reducing the overall risk of fall. A daily exercise routine is important and should be implemented with professional help to target exercises that are both appropriate and safe.
• Consult your Doctor: For reviews of your medication or withdrawing or minimizing psycho-active medications. Ask your doctor about what other interventions may be necessary.
• Make the Home Safer: Get rid of things you can tip over. Remove any items from the floor (loose rugs, phone charging cords, etc.). Add grab bars inside and outside the tub or shower and next to the toilet. Put non-slip stickers or mats on the bathroom and shower floors. Put rails on both sides of the stairs and make sure home has a lot of lights by adding more or brighter light bulbs. There also may be a need for items like a shower chair, elevated toilet seat, bedside commode or bed rails.
• Have Their Eyes Checked: Have your eyes checked by an eye doctor at least once a year and be sure to update eyeglasses if needed. Poor vision can easily lead to tripping and falling, especially at night or in dim lighting.
• Address Incontinence Issues: Falls can occur when someone is rushing to get to the bathroom and not paying attention to hazards or risks. If the incontinence cannot be better managed, there may be a need for a bedside commode, a urinal next to the bed, or briefs/diapers.
• Ensure Proper Footwear: Shoes should be sturdy and supportive (no heels or slippers). They should also be non-slip material and grip the floor well. Grip socks or non-slip socks are also safe.
• Ensure any Prescribed Walking Aid is Used Appropriately: If a walker or cane has been prescribed, it should always be used for safety. We often see people leave their walker or cane across the room when they enter or propped up against a wall and then go to sit on the bed or chair. That is when they are most likely to fall, so always remind your loved ones to use their devices properly.

How to Tell When an Assistive Device is Needed:
The first thing to consider when assessing the need of an assistive devices includes.

  1. Difficulty with daily tasks (without help or equipment).
  2. Assistive devices should be considered when a person is walking with a wide stance, hunched over, taking small shuffling steps, or holding their arms out to their sides. It is also indicative of a balance problem with they start to hold on to furniture or walls when walking around the house to steady themselves.
  3. A person who experiences repeated falls also needs to consider assistive device use.
    Getting Help:
    Owing to the devastating effects falls have on the elderly and the increased burden on family members, screening and assessment for fall risk are paramount priorities. Screening may be easily performed in the outpatient and hospital settings, with simple interventions producing meaningful results. Who can help you manage your loved one’s risk of falls?
  4. Doctor: A doctor can help with adjustments in medication as needed, as well as addressing eyesight, incontinence, dizziness, or other factors that may contribute to risk.
  5. Physiotherapist / Occupational Therapist: A Therapist can do an assessment of the person to determine their risk of falls from multiple components. They will assess their strength, gait, balance reactions, mobility, functional movements, sensation, and others. They can also assess the home fully to make recommendations for all safety considerations as well as possible equipment needs. If you need a physiotherapy assessment for your loved one or a home assessment, a PCA physio or occupational therapist can assess and advise you as well as provide whatever equipment may be needed.
  6. Caregiver: In some cases, an in-home caregiver may be needed. It may be for something simple like assisting with daily tasks (dressing, bathing, cooking), or it may be that the person is not safe to be left alone (either for physical inability or diminished mental capacity).
    Whatever you or your family’s needs are, PCA can assist in making sure that falls are prevented, and that independence is maintained as much as possible, safely. Give us a call for physiotherapy or occupational therapy assessments, home assessments and equipment supply, or in-home caregivers.

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