Fall Prevention Tips
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Fall Prevention Tips
Having a knowledge of the risks of falling is important in helping to prevent them from happening.
Falls can occur anywhere, whether it is in a person’s own home, while out in the community or in nursing homes, they can happen anywhere. Older adults can be especially vulnerable and there are risk assessment tools available online that are helpful to people who may be at risk, such as the elderly, or anyone who is keen to be proactive in helping to prevent falls. A 2009/10 Community Health Survey completed by Statistics Canada, revealed that 45% of injuries that were self reported were fall related injuries caused just by walking.
Self-Assessing Older Adults Who Are Living Independently
Staying on Your Feet is a helpful website which is available for older adults who are living on their own. It provides a questionnaire called Prevent Falls Check Up which is a self assessment form. On completion, a check-up report is generated consisting of tips and suggestions. Many falls that happen are preventable and by fall prevention tips given, the risk can be greatly reduced.
No matter what measures are taken to reduce risk and how they may look or be perceived, safety is much more important.
Worries about getting in and out of the bathtub?
If you have concerns regarding falling while getting in and out of the bathtub then grab bars can be installed to hold on to. The most effective place for the installation of these bars can be found on the guidelines issued by The Canadian Mortgage and Housing Corporation. The idea that these kind of helpful aids may make us look old and frail should be ignored because it is far more important to be safe.
Are you on medication?
If you are experiencing feelings of dizziness or feel light-headed in any way and are taking three or more medications, then it is recommended that regular reviews are carried out. Adjustment of these meds may be needed in order to reduce any side effects that could be potentially harmful and may increase the risk of falling.
Home Environment - Could This Be Safer?
After living somewhere for many years, any risk reducing measures to improve safety tend to be overlooked. By taking a proactive look around, a relative can make improvements in many ways. Perhaps by placing chairs to sit on if the person is becoming more tired as they walk around and by ensuring their pathway is clear. If they have a pet, it is a good idea to put a bell on it’s collar so that it doesn’t get under their feet. In rooms like the kitchen, place all the frequently used items within easy to reach areas and if an item is in a difficult place to reach DO NOT use a chair, you must use a step stool or small step ladder, ideally one that has a top handle to keep you supported and stable.
Footwear - Is It Safe?
Many falls can be caused by ill-fitting footwear that is unsafe such as slip on shoes and slippers with no back for support or worn out slippery soles with no tread. Ensure a suitable, well fitting pair of shoes or slippers are being worn, styles without laces are best as these laces can sometimes cause people to trip over them. Wearing supportive footwear around the home is beneficial in preventing falls. Here are some examples of footwear with slip resistant soles, a closed heel and support with no laces:
Do you have problems with blood pressure?
In over 65 year old’s, postural hypotension or sudden low blood pressure after sudden movement of head elevation is common. Upon awakening, it is a good idea to develop a routine of remaining sat on the side of the bed for a minute before you stand up as this enables the blood pressure to adjust itself, therefore reducing the risk of dizziness and falls.
Do you suffer with an overactive bladder?
If you have problems with incontinence or often need to rush with urgency to the bathroom, falls can be a potential high risk. This risk is increased at night-time, in the dark, and where the bathroom is a distance from the bedroom. A bedside commode can reduce this risk considerably. Gone are the days of the very obvious, old fashioned style commodes, embarrassment should not be a factor, as today they are much more practical and attractive. If it is an issue, a screen can be used.
The Use of Stairs
The Community Health Survey, Statistics Canada also revealed that stair falls is reported to be the third most reported cause of falls, (behind walking and slips on the ice/snow.) The most effective apparatus in preventing this kind of fall is the installation of handrails on both sides of the stairway which should be used at all times for the safe ascending and descending of stairs. 12 Steps to Stair Safety at Home is a simple checklist of hazards and a way to tackle any issues effectively.
An important poster called What to Do After a Fall is available to print and position in visible places around the home. It is highly recommended for those people who live alone and who may have had a previous fall. For other tips on how to help some up safely after a fall click here.
Personal Response System for Safety and Reassurance
A very popular option for people who are at high risk is to use a personal response system. This provides reassurance in the knowledge that if a fall does occur, it will alert others and help can automatically be summoned to assist the individual. One such system is The Philips Lifeline AutoAlert Service. Along with lots of other services available, such as ADT, Alert1, Bay Alarm, Care Innovations, LifeAlert, LifeFone, LifeStation, Medical Guardian, Mobilehelp and RescueAlert .However, some of these services may be unavailable in Canada, therefore, looking for the most suitable system for a person’s individual circumstances is recommended. Not everybody likes the idea of wearing such a device but in today’s world these devices can be disguised in attractive, fashionable jewellery such as a necklace or bracelet. Canadian Costco stores sell two devices like this, Direct Alert and Medical Alert.
According to Statistics Canada, there are only a fifth as many falls in residential care homes as there are in private homes, however, the awareness of risks and prevention methods in these places are still important.
In some senior residence facilities, there are safety check procedures or there is a buddy system. Examples include, hangers on door handles or an item placed outside at night time then the person brings the item back inside in the morning to signal they are ok. Or even better, a telephone call to check they are fine as this engages the person in social interaction.
Long Term Care and Residential Facilities - The Prevalence of Falls
Complex medical needs and the increased risk of falls often result in people who live alone moving into long term care. Nursing Home residents(NH), who experience a fall are at risk of breaking bones such as a hip fracture and sadly, sometimes a bad fall could lead to death.
34 Nursing Home resident falls were identified as occurring over a 3 month period from Oct 1st 2013 to Dec 31st 2013 by The Winnipeg Regional Health Authority listing of Critical Incidents Reported to Manitoba Health. One of these reported falls resulted in death, 7 were witnessed by a member of staff and 27 of them were not witnessed. 16 of the unwitnessed falls resulted in a fracture of the hip with the need to attend hospital for surgery and repair.
In one year,18,868 falls were reported in nursing homes according to The Personal Care Home View,(a Winnipeg Regional Health Authority publication in 2008). Most of these falls happened in the resident’s room during the evening and weekends.
Long Term Care Facilities - Falls Risk Assessment Tool (FRAT)
The Johns Hopkins Falls Risk Assessment Tool helps in the identification of the risk level in Nursing Home residents. It is based on the following criteria:
- Recent falls
- Psychological factors
- Cognitive status
The risk of a repeated occurrence is increased if a person has recently experienced a fall/falls. Particular types of medications can also increase risk, including antidepressants, anti-Parkinson’s, antihypertensive, antipsychotics, diuretics, hypnotics and sedatives. Dementia, along with other psychological factors, such as anxiety and depression can increase the risk of falls as do other factors such as decreased cooperation, and the impairment of judgement, especially regarding mobility. The final criteria of cognitive status recognise that a higher cognitive impairment results in a higher risk of a potential incident happening.
The FRAT has an overall score out of 20, whereby the higher the score, the higher the risk. A fall risk status can be identified as low, medium or high and shown in the person’s care plan. Where risks have been identified, intervention strategies can be devised and referrals made where needed, such as a review of medication by a pharmacist or a referral to a geriatric psychiatrist. An occupational therapist can carry out a mobility assessment which will highlight areas to reduce risk and to provide any mobility aids.
Identifying, Preventing and Reducing Risk
Education is paramount as most falls can be prevented.
Regularly exercising will help in strengthening muscles and can help to keep the body more balanced and mobile. A professionally qualified physiotherapist can devise individual exercise programmes to suit. Stronger bones and muscles can also help to be maintained by eating a diet that is healthy and balanced, together with as much outside sunshine as possible to increase Vitamin D.
It doesn’t matter if the older adult is living alone, independently or is living in long term care, education and assessment can be used to help identify, prevent and reduce any risk of falls. You may even consider getting involved in organising activities and events such as The Fall Prevention Awareness Month that is promoted in British Columbia. Being proactive in this subject can significantly help in the prevention of falls.
Silverts and Fall Prevention Clothing
- Heel: A slightly raised heel that is on Silvert’s shoes and slippers allow for stability and support. A raised heels helps to propel the foot and body forward instead of rocking back.
- Grip socks are perfect for nighttime trips to the washroom to ensure no slipping.
- Grip socks come in two different fabrics to ensure that you can either be kept warm or a more breathable option.
- Slip resistance helps to not let feet slide off of wheelchair feet.
- Open back pants allow person to not have to stand while putting them on, making them less at risk of a fall.
- Open back attire allows less time in the lift, another hazard of falling out of.
- Slip resistance helps to not let feet slide off of wheelchair feet.
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