Fall Prevention

Hannah Speckhart
Director of Rehabilitation
Southern Hills Skilled Nursing & Rehab Center

More than 1 out of every 4 older people (over the age of 65) experiences a fall every year (CDC). Out of those falls, 1 in every 5 result in a serious injury; ie. Fracture to a bone or injury to the head (CDC). Falls are unfortunately common, but can be avoided if given the time to educate oneself. There are steps that those of the older generations can incorporate into their lives in order to decrease their risk of falls. Preventative measures can include the assessment of the person as well as their environment.

A way to assess the abilities of a person can be to address their level of strength, coordination, balance, and endurance as well as their overall health. Lower impact activities such as Tai Chi or swimming can be the most helpful for older adults to maintain their levels of strength and endurance. Tai Chi also involves a component that focuses on balance; balance being the main component affected with those experiencing falls. If an older adult is able to strengthen their “righting reactions” they may be able to decrease their risk of experiencing a fall while improving their balance. A righting reaction is the ability to return your body to midline alignment after experience a change in position/posture. Righting reactions are developed during infancy and strengthen overtime as we age. Initially righting reactions develop as a baby learns to control their musculature against the effects of gravity in order to maintain an upright position/posture. The adverse effect happens as people reach the ages of 65+; reaction time and strength tend to slow due to muscle weakness and often joint related pain or discomfort as well as medical comorbidities. Just as much as impaired balance can influence a fall, so can vision. Completing regular scheduled vision checkups with the appropriate physician can also help to decrease ones risk of a fall. The Greater Los Angeles VA Geriatric Research Education Clinical Center provides a helpful handout that includes an assessment that an individual can complete to determine their level of risk for experiencing a fall.

Prevention

Risk for FallingFall prevention is just that; prevention. Becoming more proactive instead of reactive will help to decrease ones risk to maintain their highest level of independence and safety while continuing to live in their environment. Being more proactive would include maintaining a regular communication line with your family doctor to review medication and potential side effects can also influence a person’s risk for falls. The use of adaptive devices can also help to decrease the risk of falls. Some elderly adults unfortunately are unable to maintain their prior level of independence throughout functional mobility from when they were younger. If a task cannot be rehabilitated to return to prior level, then it must be adapted and modified for the patient’s current functional level. Adaptations/modifications include adaptive devices: ie. Cane, walker, rollator, wheelchair, etc. If it is recommended by a healthcare professional to utilize a device, it is strongly encouraged to use it throughout all aspects of life- meaning mobility in the home and outside of the home. Some older adults find increased safety with mobility by using a combination of adaptive devices. Each person is different and requires tailored recommendations based on their past medical history and current functional status.

A way to assess the environment of older adults to prevent falls can be by way of a home assessment. Recommendations to the layout of a home can help to decrease the risk of a fall. For example: making sure all areas of the home (that are most frequented) are well lit and clear of any clutter that may create an obstacle, remove throw rugs, and add additional handrails where needed. The CDC provides a check list that encompasses the different rooms of a home and what to look for specifically in each room to adapt/assess.

Check for Safety

Home health therapists are the most well versed when completing home assessments or recommendations for a person’s environment to decrease their risk of injury and promote safe independence.

References

 

CDC: https://www.cdc.gov/falls/facts.html

 

The Greater Los Angeles VA Geriatric Research Education Clinical Center: https://www.va.gov/GRECC/pages/Greater_Los_Angeles_GRECC.asp