fall prevention
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Haley GladfelterUniversity of Findlay
DPT May 2012gladfelterh@findlay.edu
Cindy Nagel MA, BSN, RNBCTrauma Program Manager
St. Rita’s Medical Centercdnagel@health-partners.org
What is considered a fall Staggering statics about falling in older
adults Dangers of falling What to do if you fall How to prevent and protect yourself from
falling Balance exercises
A fall, as defined by The Technical Assistance Program (TAP) of the Ohio Department of Health includes:◦ An intercepted fall is still a fall.
An episode where and individual lose his or her balance but catches themselves before they fall.
◦ A fall without an injury is still a fall. If you fall but do not acquire an injury it is still
considered to be a fall. ◦ A fall to the ground where the individual is found
on the ground and or acquired an injury.
The Ohio Department of Health (ODH) and The Ohio Prevention Partnership reports:◦ Falls in older adults 65 and older have reached
epidemic proportions◦ Falls and fall-related injury seriously affect older
adults’ quality of life and present a substantial burden to the Ohio health-care system.
◦ They surpass all other mechanisms of injury as a cause of ER visits, hospitalization and death and are higher than rates for all other injuries combined.
Fall-related ER visit and hospitalization rates increased 61% and 51% respectively from 2002 to 2009.
In 2009, there were 4 fall-related ER visits for every 100 Ohio older adults and 10 fall-related hospitalizations for every 1,000 Ohio older adults
From 2000 to 2009, Ohioans aged 65 and older experienced a 125% increase in the number of fatal falls and 112% increase in the fall death rate.
On average, 2.3 older Ohioans suffered fatal falls each day in 2009.
Ohioans 65 and older accounted for approximately 82% of fatal falls in 2009; while they represent only 14% of the population.
Risk for suffering serious injury after a fall increases dramatically with advancing age. Females 85 years and older account for half of fatal falls, while they account for only 3% of the female population
http://www.odh.ohio.gov/sitecore/content/HealthyOhio/default/vipp/~/link.aspx?_id=6A91950F498E4D048648B21DA985BEE7&_z=z
Falls among older adults cost Ohio and its residents $4.2 billion in 2003, more than two-thirds (68 percent), of the total annual costs of nonfatal, hospital-admitted falls. Direct medical costs represent only a fraction (8%) of the total cost.
Medical $ 327,366,900
Work-Loss $ 116,513,800
Quality-of-Life $ 3,728,623,600
Total Costs $ 4.2 billion
Costs Associated with Falls Among Older Adults, Ages 65+, Ohio, 2003
In older adults◦ Falls are the leading cause of injury- related
deaths◦ The most common cause of nonfatal injuries and
hospital admissions for trauma◦ The most common fractures are
Spine Hip, pelvis, and leg Forearm, upper arm, hand Ankle
The psychological consequences of any fall, whether injury-causing or not, can be severe, resulting in◦ Fear ◦ Decreased quality of life from self‐imposed
restriction of activities, ◦ Social isolation and depressive symptoms. ◦ These “near-miss” falls can put someone at risk
for future falls as well if they are not adequately assessed and managed by a health care professional.
Biological changes secondary to age◦ Decreased balance and coordination◦ Slowed reaction time◦ Overall decline in strength and conditioning◦ Sensation issues
Peripheral Neuropathy Decreased skin sensation
FALLS ARE NOT A NORMAL PART OF AGING!◦ Simple steps discussed later can significantly
decrease your risk of falling
If an upper extremity injury◦ Use elbow to push up to side sitting position◦ Then use good arm to push to kneeling position◦ Last use legs to help move to standing position
Stationary object can be used to help stand
If a lower extremity injury ◦ If lateral fall on side of hip
Try to roll onto your back Sit up to your bottom Then scoot backwards across the floor using good
leg Keep affected leg still if possible
◦ If you fall on your bottom Try to scoot along the floor on the opposite side of
the hip◦ Do not try to stand◦ Always have a phone at that can be reached at
floor level such as an end table.
http://www.familyhandyman.com/DIY-Projects/Home-Safety/http://www.mitrecontracting.com/railings/
Hand rails◦ Into and out of home◦ Going up and down
steps between levels in the home
◦ Hand rails on both sides is best, yet one side will still increase your safety significantly
Do not leave clutter on the floor◦ News papers and
magazines can increase risk of falls
http://www.boomer-livingplus.com/article/an_ounce_of_prevention
Remove all throw rugs◦ Throw rugs are a HUGE
cause of falls in older adults◦ The rug can slip under your
feet or a toe can get caught◦ One small ruffle in the rug
can cause you to lose your balance and fall
Furniture arrangement◦ Critical during nighttime
hours When arising from bed you
could be slightly dizzy and disoriented
Arrange furniture to ensure that there is always a clear pathway to enter and exit a room.
http://info.aia.org/aiarchitect/thisweek08/0801/0801p_lighting.cfm
Increase lighting in the home◦ Dull lighting can affect
how your view your surroundings leading to falls
◦ Can be a simple as increasing the bulb watt
Be mindful of small dogs and cats◦ Small dogs and cats can
end up under your feet causing you to lose your balance
http://acmedical.com/blog/?Tag=Adaptive%20home%20remodeling
http://www.seabridgewalkinbathau.com/avalon-walkin-shower.html
Bathroom Features◦ Grab bars
Should be installed in the shower and beside the toilet
◦ “Walk in showers” with a seat Removes the risk of falling
while stepping into a tub shower
The seat allows for you to shower without the risk of slipping and falling
◦ Elevated toilet seat Decreases the risk of falling
while getting up and down from the toilet
1. Increase Physical Activity◦ 15 minutes of daily activities can increase muscle
strength, and balance. Walking Biking Swimming Tia Chi
2. Yearly Eye Examinations ◦ Age related disease can increase risk of falling
Cataracts Macular degeneration Diabetic retinopathy
◦ Early detection is the key!!
3. Review Your Medications◦ Ask your doctor if the medicine your are taking can
cause dizziness or drowsiness.◦ Discuss if your are taking your medicine safely
Decrease risk of mixing medicine or taking too much medication.
4. Remove Environmental Hazards ◦ Increase lighting ◦ Remove all throw rugs◦ Watch for slippery floor
Linoleum Wood floors Tile
◦ Eliminate unsteady furniture
5. Think, Plan, Slow Down◦ Many falls are caused by rushing
Slow down and think though task you are performing before completing the task
Be mindful of all safety concerns/fall risks and plan your tasks accordingly
6. Always Have Emergency Phone◦ It is very important that you always have a cell phone or
life alert device for emergency situations◦ Always have a phone that can be reached from the floor
level (end table) ◦ BE PREPARED!
4 way hip Calf raises (going up on toes) Single leg standing
◦ All the above should be done by standing at a stationary table or counter top for support.
Side-walking Mini squats against a wall Toe taps at household objects
Fall risks are a serious danger for older adults. The following precaution may significantly decrease you risk of falling. ◦ Remove environmental hazards and add
additional safety features to your home.◦ Have annual eye examinations and asking your
doctors about your medications.◦ Think, plan, and slow down before implementing
and completing a task.◦ Always be prepared by having an emergency
phone ready.◦ Stay active with at least 15 minutes of exercise
daily
http://www.nsc.org/nsc_events/Nat_Safe_Month/Documents/2012_Falls_Preventionpublic.pdf
http://www.odh.ohio.gov/sitecore/content/HealthyOhio/default/vipp/~/link.aspx?_id=6A91950F498E4D048648B21DA985BEE7&_z=z
St. Rita’s Medical Center◦ Trauma Services and Injury Prevention
Program Cindy Nagel MA, BSN, RNBC 419-226-9150 cdnagel@health-partners.org
University of Findlay◦ DPT Class of 2013
Haley Gladfelter 419-204-7342 gladfelterh@findlay.edu
Ohio Injury Prevention Partnership. Falls Among Older Adults. Revised April 19, 2012. Available at:http://www.odh.ohio.gov/sitecore/content/HealthyOhio/default/vipp/~/link.aspx?_id=6A91950F498E4D048648B21DA985BEE7&_z=z.Accessed May 16, 2012.
National Safety Council. Preventing Slips, Trips and Falls. Revised 2012. Available at:http://www.nsc.org/nsc_events/Nat_Safe_Month/Documents/2012_Falls_Preventionpublic.pdf. Accessed May 16, 2012.
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