By: Margaret Espino

Introduction of Falls in Older people Statistics of falls amongst seniors Risk factors and reducing the risks Strategies to prevent falls:

◦ Exercises to improve physical functioning of seniors◦ Home modifications to prevent falls & injuries within

your home◦ Practicing Safe transfers

The role of the OTA and PTA in relevance to fall prevention

Conclusion References

Falls is a major issue for older adults. For seniors, falls in and around the

home are the most frequently occurring accident.

One out of three adults age 65 and older fall each year and these rates increase drastically with advancing age.

Many of these falls cause serious injuries such as hip, wrist, or vertebrae fracture and sometimes death.

It is falls that commonly results in seniors being hospitalized and moved to a nursing home.

According to the Public Health Agency of Canada in 2005 shows that falls are the 2nd leading cause (after MVA’s) of injury related hospitalizations for all ages

Falls are the 6th leading cause of death for those over the age of 75 years old.

50% of all people over age of 75 fall each year.

Older people who have suffered a fall are at increased risk of falling again.◦ Fear of falling leads to reduced activity and

results in higher risk of falling 25% of falls cause seniors to limit their

normal activities either because of an injury or the fear of falling again

Falls account for 84% of injury related hospital admissions and 40% of admissions to nursing homes and a 10% increase in home care services

Among older adults, falls are the number one cause of fractures, hospital admissions for trauma, loss of independence, and injury deaths.

After an older adult falls:◦ 40% become less active◦ 40-70% report fear of falling

Fractures account for 80% of fall related deaths, one half of hospital admissions and two thirds of emergency department admissions.

Risk factors for falls are caused by health and age-related changes, such as:◦ Lower body weakness ◦ Poor postural stability◦ Vision changes◦ Problems with balance and gait

characteristics◦ Slow reflexes◦ Use of medication

Environmental factors in and around the home is a major cause of falls, such as:◦ Poor lighting◦ Slippery floors◦ Loose rugs◦ Cluttered floors◦ Stairs

Heart disease, stroke, Parkinson’s and low blood pressure can cause dizziness, balance problems and fatigue.

Loss of sensation Arthritis results in loss of flexibility, and

increased difficulty maintaining balance COPD and Heart Failure result in

breathing difficulties, weakness and fatigue increasing the risk of falls with exertion

Vision problems such as glaucoma and cataracts

Keeping active helps prevent falls! Staying physically active and exercising

regularly can help prevent or delay some diseases.

Increase lower body strength and improving balance through physical activity and balance exercises

Seeing a eye doctor for vision problems Learning how to fall-proof your home and

being aware of external conditions that can increase your chance of a fall

Major benefits of staying active:◦ Maintains muscle strength◦ Strengthen bones – slows down process of osteoporosis◦ Gain flexibility◦ Increases energy◦ Strengthens heart and lungs

Balance exercises and Gait training◦ Balance exercises:

One-leg balancing Weight shifting Leg lifts

◦ Improve ambulation with use of mobility aids

Resistance training and strengthening◦ To improve muscle weakness

and prevent inactivity that leads to atrophy and deteriorating condition

Endurance training◦ An activity like walking,

arm cardio and cycling that increases the heart rate and breathing for an extended period of time. Which builds endurance and stamina.

General exercise program To keep seniors healthy,

increase heart rate, promote physical activity and staying active!

Equipment used to prevent falls:◦ Low riser bed with

protective mats◦ Bed/Chair Alarms◦ Bed rails◦ Assistive Devices (long

handle reachers)◦ Gait Belts◦ Physical restraints are a

last resort only –

Special equipment is used to prevent falls and/or reduce risk of injury from a fall

After patient has been assessed for risk of falling, equipment can be provided for patients who require and would benefit from the equipment.

All rooms well lit, and a lamp/light switch easily to reach without getting out of bedInstall hand rails on both sides of stairsRails on bed to avoid falling and assist in getting upAdd grab bars in shower, tub and toilet areasUse bath mats and appropriate AD’s in bathroom ( bench or stool in shower)Make certain carpets are firmly attached to stairsRemove or replace rugs that tend to slip

Keep telephone and electrical cords out of pathways

Consider using an elevated toilet seat

Make sure their is a non-slip backing to rug outside of shower

Purchase a step stool – place frequently used objects in places you can reach easily

Remove all clutter on floors in the house- organize room for space of mobility aids

A transfer is the movement of an individual from one surface to another or from one position to another

Patients and healthcare professionals should be educated and capable of performing safe transfers

When a patient is educated on how to transfer properly for example sit from wheelchair to toilet reduces risk of falls

Client must be able to bear weight through the legs

The Patient’s position:◦ Slide hips to the front of the chair-

slightly turned to position being moved to- anterior pelvic tilt

◦ Feet apart and flat on the floor- feet pointing to surface being transferred to

◦ Patient has one hand on the chair and one hand on the walking aid

◦ Bring shoulders forward The Caregiver Position:

◦ Standing at the side of the patient◦ Hand at the clients lower back or at

the scapular level to apply pressure in the stance

◦ Lead forward and stand up

The Patient’s Position:◦ Slide hips to front of chair- turn

client so hips are closer to surface being transferred to and pointing in that direction

◦ Feet apart and flat on floor- position feet in line with pelvis

◦ Client has both hands on chair/bed◦ Bring shoulder forward (Nose over

Toes) The Caregiver Position:

◦ Standing in front of the patient◦ Hands at lower back or at scapular

area (dependent on patient)◦ On count of 3 lean forward and turn

to sit on chair/wheelchair...

The Patient’s Position:◦ Slide hips to front of chair- turn client so

hips are closer to surface being transferred to and pointing in that direction

◦ Feet apart and flat on floor- position feet in line with pelvis

◦ Patient has both hands on chair/bed◦ Bring shoulders forward – (Nose over Toes)

The Caregiver’s Position:◦ One standing in front of patient and the

other behind◦ Front- Hands at lower back◦ Back- Hands on patients hips◦ On count of 3 lean forward and turn to sit

on bed/chair....

Falls amongst older people is a current and ongoing issue related to rehabilitation.

With falls and fall related injuries the role of an OTA/PTA is very significant for recovery and prevention of falls.

Both OTA’s and PTA’s provide treatment and education to seniors to prevent falls.

An OTA’s role can consist of: Home modifications Patient education on use

of mobility aids, assistive devices..

Practice safe transfers and energy conservation techniques

A PTA’s role can consist of: Ensuring physical fitness

of seniors, providing them with exercises

Increase/Improve patients balance and endurance

Gait training

Falls is a major concern in older adults and precautions should be taken to reduce risk of falls from occurring.

This includes staying active, exercising regularly to improve physical functioning such as balance, strength and endurance

For seniors living at home/in a nursing home certain home modifications should be made to make your living space a fall proof place.

An OT/OTA can help one prevent falls by doing home assessments and making sure your home is safe for a senior. They can also educate and provide assistive devices.

A PT can assess patients for risk of falling the PTA’s role is to deliver treatment as requested by PT which include exercises to improve physical fitness.

Both also practice safe transfers with patients so they can practice independently. As well as educating other caregivers to perform proper transfer on patient safely.

With cooperation from patients and other caregivers knowledge on fall prevention can help promote healthier and safe living of seniors

1996 Surgeon General’s Report on Physical Activity and Health . Early, M. (2006). Physical Dysfunction Practice Skills. Mosby Elsevier. Fredrikson, E. (2004). How to Avoid Falling: A guide for active aging and

independence. Firefly Books. Lord, S., Sherrington, C., Menz, H., & Close, J. (2007). Falls in Older People: Risk

Factors and Strategies for Prevention. Cambridge University Press. Seniors, D. o. (2002). The Safe Living Guide to Home Safety for Seniors. Health

Canada. Tinetti ME, Williams CS. Falls, injuries due to falls, and the risk of admission to a

nursing home. N Engl J Med. 1997;337:1279-1284 National Center of Injury Prevention and Control, Falls and hip fractures among

older adults, http://www.cdc.gov/ncipc/factsheets/falls.htm

Thank you for listening, I hope you enjoyed my presentation. Hope you find the folder package useful.

Sincerely, Margaret Espino