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Stay Independent – Reducing Fall Risk

 By Samantha Jordan, DPT, OCS, CSCS & Julie Tashner, MPT – Physical Therapists at The Orthopedic Institute at Southwest Health

Falls are the main reason older adults lose their independence. Each year one-third of
the population over 65 years old experience a fall. As fall-related injuries result in 30 billion dollars of direct and indirect medical costs annually, reducing falls is a priority for both clinicians and older adults.

The main concern with a fall is not the act of falling itself, but the subsequent injury and the effect that those injuries have on the individual’s ability to be independent and safe in their environment. One fall can result in a serious injury such as a hip fracture causing the patient to need surgery and nursing home placement for rehabilitation. Our goal as a medical community and as therapists, in particular, is to help older adults reduce their risk of falls to keep them in their own homes and doing the things that they love to do.

There are several risk factors for falls but sensations of dizziness or imbalance, a history of falls and being on multiple medications are the largest risk factors. Complete the questionnaire below to determine if you might be at risk.

Please choose “Yes” or “No” for each statement below

Why it matters

Yes (2) No (0) I have fallen in the past year. People who have fallen once are more likely to fall again
Yes (2) No (0) I use or have been advised to use a cane or walker to get around safely. People who have been advised to use a cane or walker may already be more likely to fall.
Yes (1) No (0) Sometimes I feel unsteady when I am walking. Unsteadiness or needing support while walking are signs of poor balance.
Yes (1) No (0) I steady myself by holding onto furniture when walking at home. This is also a sign of poor balance.
Yes (1) No (0) I am worried about falling. People who are worried about falling are more likely to fall.
Yes (1) No (0) I need to push with my hands to stand up from a chair. This is a sign of weak leg muscles, a major reason for falling.
Yes (1) No (0) I have some trouble stepping up onto a curb. This is also a sign of weak leg muscles.
Yes (1) No (0) I often have to rush to the toilet. Rushing to the bathroom, especially at night, increases your chance of falling.
Yes (1) No (0) I have lost some feeling in my feet. Numbness in your feet can cause stumbles and lead to falls.
Yes (1) No (0) I take medicine that sometimes makes me feel light-headed or more tired than usual. Side effects from medicines can sometimes increase your chance of falling.
Yes (1) No (0) I take medicine to help me sleep or improve my mood. These medicines can sometimes increase your chance of falling
Yes (1) No (0) I often feel sad or depressed. Symptoms of depression, such as not feeling well or feeling slowed down, are linked to falls.
Total______ Add up the number of points for each “yes” answer.  If you scored 4 points or more, you may be at risk for falling. Discuss these results with your doctor.

This checklist was developed by the Greater Los Angeles VA Geriatric Research Education Clinical Center and affiliates and is a validated fall risk self-assessment tool (Rubenstein et al. J Safety Res; 2011: 42(6) 493-499.  Taken from “Stay Independent” hand out from the Centers for Disease Control Website.

Here are several simple ways to lower your fall risk:

  • using nightlights at night or in poor lighting especially at stairs
  • removing throw rugs, keeping pathways clear of obstacles/ electric cords or clutter
  • avoiding bedding touching the floor around the bed
  • installing railings at all stairs and adding grab bars in bathroom

If you or a family member are consistently touching walls and furniture during walking, please consider the benefit of an assistive device fit and instructed for you by a physical therapist. A physical therapist is trained to address the reduction of falls and improve balance through an evaluation and treatment for patients of any age. Please discuss these ideas with your physician or primary caregiver who can order physical therapy.

Samantha Jordan has her Clinical Doctor of Physical Therapy from Clarke University in Dubuque, IA. She is an Orthopedic Clinical Specialist, a Certified Strength & Conditioning Specialist, certified and trained in CPR, Graston Technique, Evaluation and prescription of custom shoe orthotics, WorkWell Functional Capacity Evaluations and also teaches a running clinic.

Julie Tashner has her Master of Physical Therapy from Mayo School of Health Related Sciences in Rochester, MN. She is trained and certified in Vestibular Rehabilitation, CPR, and the Graston Technique.

For more information on fall prevention or for a free balance assessment please feel free to contact your local physical therapy staff at the Orthopedic Institute at Southwest Health at 608.342.4748.

For more information on fall prevention, please visit:

www.cdc.gov/steadi or www.stopfalls.org

 

References:

  1. Avin KG, Hamke T, Kirk-Sanchez N, McDonough CM, Shubert TE, Hardage J, Hartley G. Management of Falls in Community-Dwelling Older Adults: Clinical Guidance Statement From the Academy of Geriatric Physical Therapy of the American Physical Therapy Association. Phys Ther. 2015; 95: 815-834.
  2. Robinson B, Gordon J, Wallentine S, Visio M. Effectiveness of Physical Therapy Intervention in Decreasing the Risk for Falls in a Community-Dwelling Aging Population. Orthoped Nurs. 2002; 21(1): 55-69.

 

 

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