1. Fall Prevention Programs for Older Adults
Preventing Falls:
Fall Prevention Programs for Older Adults

2. Falls at Home
Each year, thousands of older Americans fall at home. Many of them are seriously injured, and some are disabled.
In 2002, more than 12,800 people over age 65 died and 1.6 million were treated in emergency departments because of falls.
Falls are often due to hazards that are easy to overlook but easy to fix.

3. Who is at risk? People who have: Fallen Before Balance Problems
Chronic diseases , such as, arthritis
Depression
Hazards in the home
A lot of medications
Memory Problems
Muscle Weakness
Problems Walking
Vision Problems

4. Risk Factors—Environmental: Where Do People Fall?
60% fall in the home
30% fall in public areas
10% fall in healthcare facilities

5. Four Things you can do to Prevent Falls
Begin a regular exercise program
Have your healthcare provider review your medications
Have your vision checked
Make your home safer…

6. Begin an exercise program
Exercise is one of the most important ways to lower your chances of falling. It makes you stronger and helps you feel better. Exercises that improve balance and coordination are the most helpful. Lack of exercise leads to weakness and increases your chances of falling.

7. Why is Exercise Important?
Balance
When you were very young, you had to learn to balance yourself, and unless you continue to use your balance under safe conditions, this vital skill diminishes. Balance also helps you to keep the mass of your body over your feet, which helps you maintain your stability when moving your weight from one position to another.
Gait
Regain some of the spring in your step, and practice walking (either alone, or with a cane or walker) with a stronger, safer and more fluid gait.
Reflexes
Exercise can make you more responsive and help you react more safely to obstacles in your path and other potential dangers.

8. Intervention & Prevention— Age-Related Risk Factors
Assessment & management of chronic conditions, vision, & hearing
Encourage health with exercise & nutrition
Osteoporosis screening
Medication review (reduce if possible)
Referrals for at-risk seniors
Physical Therapist for balance & gait, vestibular rehabilitation
Occupation Therapist for assistive devices
Medical risk factor reduction would include assessment and monitoring of chronic conditions, vision, and hearing.
Osteoporosis screening is important.
Medical providers should ask about dizziness, and reduce or change medications if appropriate.
Of course, all health care providers should encourage optimal health through appropriate exercise and nutrition.
The other thing a health care provider can do is make referrals to physical and occupational therapists for balance and gait training, strength training, home safety assessments, and use of assistive devices.
Note to Trainer: The DOEA has Osteoporosis screening and an education program that is coordinated by each Area Agency on Aging’s health promotional program.

9. Make Your Home Safer:
Remove things you can trip over (like papers, books, clothes, and shoes) from stairs and places where you walk.
Remove small throw rugs or use double- sided tape to keep the rugs from slipping.
Keep items you use often in cabinets you can reach easily without using a step stool.
Have grab bars put in next to your toilet and in the tub or shower. Use non-slip mats in the bathtub and on shower floors.
Improve the lighting in your home. As you get older, you need brighter lights to see well.

10. Safer Home Continued…
Hang light-weight curtains or shades to reduce glare.
Wear shoes both inside and outside the house. Avoid going barefoot or wearing slippers.
Freedom Senior Service can help to make your home safer! A senior Services caregiver can help to de-clutter your home to diminish fall risk. They can also help with activities that may be difficult for those at risk for falling.
If you have trouble with Meal preparation, Bathing, or maintaining your home’s cleanliness Freedom Senior Services can help you!

11. Intervention & Prevention—Environment: Home
Kitchen—keep items within easy reach
Bathroom—grab bars for toilet and bathtub
Bedroom
nightlights
bed and nightstand at proper height
Seniors and their helpers should take into account the lifestyle and limitations of the particular senior.
Items that are used on a daily basis should be stored in an easy to reach place.
Handrails in the bathroom and stairways are helpful.
They have to be installed by someone who knows how to do it – since the support of the underlying studs in the walls is important.

12. Intervention & Prevention—Environment: Home & Yard
Living room
remove clutter, cords, throw rugs
Porch
railings
clear pathways
Throughout
clear paths
good lighting
Throughout the house, good lighting is important.
Make sure that the wattage on the bulb is appropriate for the socket.
Wattage over 75 watts can be a fire hazard.
Outside, keep hoses out of the way, and keep porch steps safe by mopping up rain water.
Again, properly installed handrails are important.

13. Intervention & Prevention—Lifestyle & Behavioral Risk Factors
Mental activity & focus training
Exercise—Tai Chi classes, strength training
Education to improve home environment
Some risk factors are best addressed by the senior and with some helpful education from professionals.
A cognitive psychologist can provide exercises to improve mental focus.
Seniors can do some things on their own, such as games and activities that challenge the memory.
Exercise classes are good ways to encourage regular exercise.
Tai Chi is one exercise that is gaining in popularity, and has been shown to increase balance.
It helps to increase your coordination, body awareness, strength and flexibility.
Also, aerobic exercise, such as power walking is very good for you.
Note to Trainer – You can do an exercise or Tai Chi demonstration. (see activities)

14. Intervention & Prevention—Assistive Devices
Walkers:
improve balance
relieve or reduce weight bearing
provide 4-way stability
Canes:
provide support for one side of the body

15. Intervention & Prevention—Assistive Devices cont’d…
Reachers
Portable seat lift
Special step stools
There are a variety of tools which can help seniors do activities of daily living in a safer manner, so they will be less likely to fall.
If you need to get something down from a high place, or a hard to reach place, you can use a reacher to grab on to the object.
Step stools should have a sturdy support and a hand rail.
The seat lift shown here helps you get in and out of chairs.
An occupational therapist can help seniors learn which tools are best for their situation, and how to use them to the best advantage.

16. Benefits of Assistive Devices:
Provide increased support
Improve balance while walking
Reduce pain
Increase confidence
Make walking safer

17. Assistive Devices Continued…
Although it may seem easiest to go to the local store and pick up a cane or a walker, it is important that the product is fitted to the individual and his or her needs. Talk with your doctor, an occupational therapist, or a physical therapist about what kind of support you need to make sure that you get the best fit for you. If they don’t fit or are not used properly, they can be uncomfortable and also unsafe. If they do fit and are used as directed, these devices can give you support to help you stay active.

18. Have your medications checked:
Have your doctor, pharmacist, or Home Health caregiver review all the medicines you take, even over-the-counter medicines. As you get older, the way medicines work in your body can change. Some medicines, or combinations of medicines, can make you sleepy or dizzy and can cause you to fall.
Home Health will manage Medications to help you live a more balance life.
Their physical therapists can help with in home exercises to improve your strength and balance till the required strength level is reached then you can graduate to the HealthCrest program.

19. Do You Know What to do if you Fall?
What to do if you fall at home.
What to do if you fall and CANNOT get up.

20. Conclusion Importance of fall prevention education
Fall risk assessment
Identification of risk factors
Interventions & prevention
Healthcare providers, communities, and seniors work together
In summary, there are many different risk factors for falls, so awareness of the issues are important.
Also, a complete fall risk assessment would include medical conditions, behavioral factors such as exercise, nutrition, and mental activity, as well as environmental safety.
Once the risk factors for an individual are identified, the appropriate intervention can be implemented.
Some of the interventions can be done by the senior alone, and many would benefit from the help of a referral to a PT, OT or other professional.
Note to Trainer: Handout with intervention table would be good to use here. Also, could give the home environment checklist.