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Fall Prevention and Management




What is a fall, and why are they dangerous?


A fall is when a person drops to a lower position. This often happens accidentally, from tripping and stumbling. In some cases, a fall can result in serious injury or even death. Falls can be especially dangerous for older adults because they may have weaker bones and muscles, making them more susceptible to fractures and other injuries. Older adults may have mobility issues that make it difficult for them to get up after a fall, which can increase the risk of further injury.


What percentage of hospitalizations of seniors are due to falls?

  • Falls cause 45% of seniors' injury-related hospitalizations

  • Falls cause 65% of seniors' injury-related hospitalizations

  • Falls cause 85% of seniors' injury-related hospitalizations

*correct answer is located in the infographic below


Falls can be more difficult for older adults to recover from, both physically and emotionally. Injuries from falls often lead to a loss of mobility or independence, as older adults may need assistance with daily activities or may need to use assistive devices, such as a walker or cane. Falls can cause psychological effects, such as fear, anxiety, or loss of confidence. This can lead to a reduced quality of life and may even cause social isolation.




How common are falls?


Falls are very common, and they can happen to people of all ages. According to the Centers for Disease Control and Prevention (CDC), falls are the leading cause of injury-related deaths among adults aged 65 and older in the United States. Additionally, falls are the most common cause of nonfatal injuries among older adults, and they account for more than 2.8 million hospital visits each year. According to the Government of Canada, 20-30% of seniors experience one or more fall each year and more than 1/3 of seniors are admitted to long-term care following hospitalization for a fall.


Government of Canada Fall Statistics Infographic
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Check out the following infographic provided by the Government of Canada. These statistics highlight the importance of preventing falls and seeking help if a fall does occur. By taking steps to improve strength and balance, remove potential hazards from home, and seek support from healthcare providers, older adults can reduce their risk of falling and maintain their quality of life.


Fall are the leading cause of injury among older Canadians - Government of Canada

What are some common risk factors for falls?

  • Age: The risk of falling increases with age, and older adults are more likely to fall and experience a fall-related injury.

  • Weakness: Weakness in the muscles, particularly in the legs, can increase the risk of falling. This can be due to arthritis, nerve damage, or muscle loss.

  • Balance problems: Poor balance can make it more likely that a person will fall. This can be due to conditions such as inner ear disorders, vision problems, or neurological conditions.

  • Medications: Certain medications, such as sedatives, tranquillizers, and antidepressants, can increase the risk of falling by causing drowsiness or dizziness.

  • Footwear: Wearing shoes that do not fit properly or that do not provide good support can increase the risk of falling. This is especially important for older adults, who may be more likely to have foot problems.

  • Environmental hazards: Hazards in the home, such as loose rugs, cluttered floors, or poor lighting, can increase the risk of falling. It is important to remove these hazards and to make the home as safe as possible.



  • Chronic conditions: Certain chronic conditions, such as diabetes, heart disease, or stroke, can increase the risk of falling by causing weakness, dizziness, or changes in blood pressure.

  • Poor vision: Vision problems, such as cataracts, glaucoma, or macular degeneration, can make it more difficult to see obstacles and can increase the risk of falling.

  • Substance abuse: Using alcohol or drugs can impair judgment and coordination, increasing the risk of falling.

  • Lack of physical activity: A sedentary lifestyle can lead to weak muscles, poor balance, and reduced flexibility, all of which can increase the risk of falling.

  • Poor nutrition: A diet that is low in nutrients and vitamins can cause weakness, dizziness, and fatigue, which can increase the risk of falling.


50% of all falls causing hospitalization happen at home - Government of Canada

How can you reduce your risk of having a fall?


  • Exercising regularly: Regular exercise can improve strength, balance, and coordination, reducing the risk of falling. This can include activities such as walking, cycling, swimming, or dancing.

  • Eating a healthy diet: A diet that is rich in nutrients and vitamins can help to maintain strength, energy, and overall health, which can reduce the risk of falling. This can include fruits, vegetables, whole grains, and lean protein.

  • Getting enough sleep: Adequate sleep can help to improve alertness, concentration, and coordination, which can reduce the risk of falling. Getting seven to eight hours of sleep per night is generally recommended.

  • Wearing appropriate footwear: Shoes that fit properly and provide good support can help to improve balance and reduce the risk of falling. It is important to avoid shoes with high heels, loose laces, or slippery soles.

  • Removing potential hazards: It is important to remove potential hazards from home, such as loose rugs, clutter, or poor lighting. This can help to reduce the risk of falls and improve overall safety.

Home Modifications That Reduce the Risk of Falling


Installing grab bars: Grab bars can provide support and stability when getting in and out of the shower, bathtub, or toilet. They can be installed near the shower, bathtub, toilet, and bed.

Adding non-slip mats: Non-slip mats can help to prevent falls in the bathroom, kitchen, and other areas of the home where the floor may be wet or slippery.

Improving lighting: Poor lighting can make it difficult to see obstacles and can increase the risk of falling. It is important to have adequate lighting in all areas of the home, including hallways, stairs, and bathrooms.

Removing tripping hazards: It is important to remove potential tripping hazards from the home, such as loose rugs, clutter, or electrical cords. This can help to reduce the risk of falls and improve overall safety.

Making stairs safer: Stairs can be a particular hazard for falls. To make stairs safer, it is important to keep them clear of clutter, to use non-slip mats or treads, and to install handrails on both sides of the stairs.



Role of Occupational Therapy and Fall Prevention

Occupational therapy plays an important role in fall prevention. Occupational therapists are healthcare professionals who help people to achieve independence and participate in activities that are important to them. In the context of fall prevention, an occupational therapist can assess a person's home environment, physical abilities, and daily activities to identify factors that may increase the risk of falling. Based on this assessment, the occupational therapist can provide advice and recommendations on how to reduce the risk of falling, such as by making home modifications, exercising to improve strength and balance, or using assistive devices. The occupational therapist can also provide education and support to the person and their family to help them understand and manage the risks of falling. Overall, the role of occupational therapy in fall prevention is to help people maintain their safety, independence, and quality of life.



Falls cause 95% of all hip fractures and cost $2 billion a year in direct healthcare costs - Government of Canada

Exercises To Improve Strength and Balance


There are several exercises that can help to improve balance and prevent falls. These include:

  1. Stand on one leg: This exercise can help to improve balance and leg strength. To do this exercise, stand on one leg and hold the other leg off the ground. Hold this position for 10 to 30 seconds, and then switch legs.

  2. Heel-to-toe walk: This exercise can help to improve balance and coordination. To do this exercise, place the heel of one foot in front of the toes of the other foot, and then take a step forward. Repeat this pattern, walking in a straight line.

  3. March in place: This exercise can help to improve balance and leg strength. To do this exercise, stand with your feet shoulder-width apart and your arms by your sides. Lift one knee up towards your chest, and then bring it back down. Repeat this movement with the other leg.

  4. Side leg raises: This exercise can help to improve balance and leg strength. To do this exercise, stand with your feet shoulder-width apart and your arms by your sides. Lift one leg out to the side, and then lower it back down. Repeat this movement with the other leg.

It is important to consult with a healthcare provider or occupational therapist before starting any new exercise. Always consider holding onto a solid object before trying any of the above exercises.

Assistive Devices That Can Help To Prevent Falls

  • Canes: A cane can provide support and stability when walking, which can reduce the risk of falling. Canes come in a variety of styles and sizes, and it is important to choose the right one for an individual's needs and preferences.

  • Walkers: A walker can provide more support and stability than a cane, and it can be used by people who have difficulty with balance or mobility. Walkers come in different styles and sizes and can be fitted with wheels or glides for added convenience.

  • Wheelchairs: A wheelchair can provide support and mobility for people who are unable to walk or have difficulty with balance. Wheelchairs come in different styles and sizes and can be manual or powered.






The good news is that fall are preventable. Take action now!

References:

“Falls and Fractures in Older Adults: Causes and Prevention.” National Institute on Aging, https://www.nia.nih.gov/health/falls-and-fractures-older-adults-causes-and-prevention. Accessed 14 Dec. 2022.

Seniors' Falls in Canada - Infographic - Government of Canada, https://bit.ly/3PuVqbt

Sterczyk, A. (2020). Balance Exercises for Fall Prevention: A Seniors' Home-based Exercise Plan. (n.p.): Amazon Digital Services LLC - Kdp.

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