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Fall Prevention and Management


What is a fall, and why are they dangerous?


A fall occurs when a person falls to a lower level. This is frequently caused by tripping and stumbling. A fall can cause serious injury or even death in some cases. Falls are especially dangerous for older people because their bones and muscles may be weaker, making them more prone to fractures and other injuries. Older adults may have mobility issues that make getting up after a fall difficult, increasing 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 to recover from for older adults, both physically and emotionally. Falls injuries frequently result in a loss of mobility or independence, as older adults may require assistance with daily activities or may require the use of assistive devices such as a walker or cane. Falls can have psychological consequences such as fear, anxiety, or a loss of confidence. This can lead to a lower quality of life and even social isolation.




How common are falls?


Falls are extremely common and can affect people of all ages. Falls are the leading cause of injury-related deaths among adults 65 and older in the United States, according to the Centers for Disease Control and Prevention (CDC). Furthermore, falls are the leading cause of nonfatal injuries in older adults, accounting for more than 2.8 million hospital visits each year. According to the Government of Canada, 20-30% of seniors fall each year, and more than one-third of seniors are admitted to long-term care after being hospitalized for a fall.


Government of Canada Fall Statistics Infographic
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Check out the infographic above from the Government of Canada. These statistics emphasize the importance of avoiding falls and seeking assistance if one does occur. Older adults can reduce their risk of falling and maintain their quality of life by improving their strength and balance, removing potential hazards from their homes, and seeking help from healthcare providers.


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

What are some common risk factors for falls?


  • Age increases the risk of falling, and older adults are more likely to fall and sustain a fall-related injury.

  • Weakness: Muscle weakness, especially in the legs, can increase the risk of falling. This could be a result of arthritis, nerve damage, or muscle loss.

  • Problems with balance: Poor balance can increase the likelihood of a person falling. This can be caused by conditions such as inner ear disorders, vision issues, or neurological disorders.

  • Medications: Sedatives, tranquillizers, and antidepressants, among others, can increase the risk of falling by causing drowsiness or dizziness.

  • Footwear: Wearing shoes that do not fit properly or provide adequate support increases the risk of falling. This is especially important for older people, who are more prone to foot problems.

  • Hazards in the home, such as loose rugs, cluttered floors, or inadequate lighting, can increase the risk of falling. It is critical to eliminate these hazards and make the home as safe as possible.




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

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

  • Alcohol and drug abuse can impair judgement and coordination, increasing the risk of falling.

  • A sedentary lifestyle can result in weak muscles, poor balance, and reduced flexibility, all of which can increase the risk of falling.

  • Poor nutrition: A diet deficient in nutrients and vitamins can lead to weakness, dizziness, and fatigue, increasing 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?


  1. Regular exercise can improve strength, balance, and coordination, lowering the risk of falling. Walking, cycling, swimming, and dancing are examples of such activities.

  2. A healthy diet rich in nutrients and vitamins can help to maintain strength, energy, and overall health, lowering the risk of falling. Fruits, vegetables, whole grains, and lean protein can all be included.

  3. Getting enough sleep: Getting enough sleep can help improve alertness, concentration, and coordination, lowering the risk of falling. It is generally recommended that you get seven to eight hours of sleep per night.

  4. Wearing proper footwear: Shoes that fit properly and provide adequate support can aid in improving balance and lowering the risk of falling. Shoes with high heels, loose laces, or slick soles should be avoided.

  5. Taking care of potential hazards: It is critical to take care of potential hazards in the home, such as loose rugs, clutter, and poor lighting. This can help to reduce the risk of falls while also improving overall safety.

Home Modifications That Reduce the Risk of Falling


Installing grab bars: Grab bars can help you get in and out of the shower, bathtub, or toilet by providing support and stability. They can be installed in close proximity to the shower, bathtub, toilet, and bed.


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


Improving lighting: Poor lighting makes obstacles difficult to see and increases the risk of falling. Lighting is essential in all areas of the home, including hallways, stairs, and bathrooms.


Tripping hazards must be removed: It is critical to remove potential tripping hazards from home, such as loose rugs, clutter, or electrical cords. This can help to reduce the risk of falls while also improving overall safety.


Making stairs safer: Stairs can be a particular source of injury. It is critical to keep stairs clear of clutter, use non-slip mats or treads, and install handrails on both sides of the stairs to make them safer.



Role of Occupational Therapy and Fall Prevention

Occupational therapy is very important in fall prevention. Occupational therapists are healthcare professionals who assist people in achieving independence and engaging in activities that are meaningful to them. An occupational therapist can assess a person's home environment, physical abilities, and daily activities in the context of fall prevention to identify factors that may increase the risk of falling. Based on this assessment, the occupational therapist can advise and recommend ways to reduce the risk of falling, such as making home modifications, exercising to improve strength and balance, or using assistive devices. The occupational therapist can also educate and support the individual and their family in order to help them understand and manage the risks of falling. Overall, occupational therapy's role in fall prevention is to assist people in maintaining 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. Standing on one leg can help to improve balance and leg strength. To perform this exercise, stand on one leg while lifting the other leg off the ground. Hold this pose for 10 to 30 seconds before switching legs.

  2. Balance and coordination can be improved with a heel-to-toe walk. To perform this exercise, step forward with one foot's heel in front of the toes of the other foot. Walking in a straight line, repeat this pattern.

  3. Marching: This exercise can help with leg strength and balance. Stand with your feet shoulder-width apart and your arms by your sides for this exercise. Lift one knee up towards your chest and then lower it. Repeat this movement with the opposite leg.

  4. Side leg raises: This exercise can help with leg strength and balance. Stand with your feet shoulder-width apart and your arms by your sides for this exercise. Raise one leg to the side, then lower it back down. Repeat this movement with the opposite leg.


Before beginning any new exercise programme, it is critical to consult with a healthcare provider or occupational therapist. Before attempting any of the above exercises, consider holding onto a solid object.


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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