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Stay on Your Feet-Tips to Improve Mobility for Fall Prevention

According to the CDC (Centers for Disease Control and Prevention), one in every three adults over the age of 65 falls every year, causing moderate to severe injuries such as hip fractures and head/brain injuries that increase the risk of early death. This is an alarming fact. But here’s the real scary news. According to recent research, fatal falls are on the increase among elders (by 112 percent since 1999)! With plenty of available education aimed at fall prevention (including my monthly blog), one has to wonder why the dramatic increase in falls. There are several reasons:
  • Our country's senior population is rapidly growing in numbers. Everyday more and more baby boomers reach their ‘golden years’. Unfortunately, for more than some, chronic illness, pain or disability can affect balance/walking ability.
  • Staying active is one of the best thing someone can do to prevent falls. However, many elders (especially those who have fallen in the past), have a fear of falling and tend to restrict their everyday activities. This can negatively affect muscle strength, balance and produce a spiraling effect and increase the risk of falling.
  • Too many drugs. Many of the most commonly prescribed medications (such as painkillers, antidepressants, sleeping pills, sedatives, etc.) are associated with a greater likelihood of falling and/or being injured in a fall.
  • But most importantly, many ‘at-risk ‘elders simply deny the risk of falling. Although elders consider falls to be an important, preventable health issue and understand the significance of risk factors in the context of aging, they minimized their personal susceptibility. Simply put, elders often support fall-prevention advice for others, but not for themselves personally.
Steps for Staying on Your Feet

There are a number of ways to prevent deadly falls. Taking just a few simple steps can make all the difference. With September being Fall Prevention Awareness month in many States across the country, this is good time to find out how to avoid falling and improve your mobility/quality of life.

Visit your doctor

Seeing your doctor and getting a fall risk assessment is crucial if you’re experiencing poor balance, dizziness and/or several falls. It's important to rule out any conditions that may be causing problems. Remember that falling is often a symptom of an underlying health problem.

Check your vision

Keep vision sharp. If you’re having difficulty seeing, visit your eye doctor. Poor eyesight can make it more difficult to see obstacles and judge distances, increasing the chance of falling. Elders should have their eyes checked every year and wear glasses or contact lenses with the right prescription strength to ensure they're seeing clearly and safely.

Medications

Be attentive of medications: Some medicines or combinations of medicines can have side effects such as dizziness or drowsiness, increasing the risk of falling. Having a doctor or pharmacist review all medications can help reduce the chance of risky side effects and drug interactions.

Eliminate hazards in your home

Most falls occur at home. Being aware of certain hazards that interfere with everyday tasks and creating a safe and navigable environment can ensure one’s safety. A home safety check can help identify potential conditions that need to be removed or changed (such as slip/trip hazards, clutter, poor lighting, etc.). 

Get fit

Get some exercise: Lack of exercise can lead to weak legs and poor balance. Exercises that focus on balance, such as tai chi and yoga, can be effective in keeping you on their feet.  The benefits of exercise include better cognitive function, faster reaction time and enhanced coordination, all of which can contribute to lowering the risk of falls. A recent study reported that balance exercises could reduce the chance of suffering a fall-related injury by 37%, and lower the risk of a fall resulting in a broken bone by 61%.

As in most cases, knowledge is power. However, there’s a huge difference between knowing something (available fall prevention strategies) and doing it. In general, we don’t lack for information. What we lack for is the ‘how to’ of behavior change, the day-to-day strategies that we can implement to help us stop old behavior (such as being too sedentary) and implement new ones (such as engaging in daily exercise). So how do you effect real change in behavior?

Encouraging Safe Behaviors

Fall prevention strategies call for elders to change their behaviors by doing prescribed exercises, changing their home environment, etc. But we know that behavior change is difficult. Advice and education often only has small effects on an individual’s behavior (especially in the face of strong habits).
To get elders to change their thinking about the changes they have to make, we need to determine their ‘readiness for change’. Individuals are always in one of four ‘stages of change’.

Pre-contemplation
    •    Does not consider themselves at risk
    •    Does not think about change.

Contemplation
    •    Thinking about risk
    •    Weighs benefits of proposed behavior change

Action
    •    Understands their risk factors
    •    Takes definitive action to change

Maintenance
    •    Maintains new behavior over time

Let’s take exercise as an example. Many elders may experience loss of strength, coordination, balance, etc. as they age. To avoid this, elders should be encouraged to maintain physical fitness.

But what if the elder resists exercise (pre-contemplation) or is thinking about it (contemplation)? Aside from the benefits of preventing falls, tell them about the benefits gained by exercise (don’t assume they know about the benefits): psychological well-being; decreased stress and anxiety; reduced symptoms of depression; improved ability to think, learn and make decisions; improved sleep; decreased arthritic pain; decreased blood pressure; lowered risk of heart disease, stroke, diabetes; improved strength and balance, etc.

Once buy-in is achieved, the elder may be able to figure out how to get more physical activity on their own, or they may need a bit of encouragement from family. Look at the types of activities they have enjoyed their entire life. Which activities involve exercise? Getting activity may be easier to do with others than on their own. The YMCA offers membership discounts for elders and a variety of exercise programs and activities.

Lastly, the best approach to changing any habit is to:
    •    Ease into it
    •    Start with small steps

Trying to make drastic changes in behavior is too difficult for the vast majority of people and often leads to failure.

Guest blog post by  Rein Tideiksaar Ph.D., PA-C (or Dr Rein as he is commonly referred to) is the president of FallPrevent, LLC, Blackwood, NJ, a consulting company that provides educational, legal and marketing services related to fall prevention in the elderly. Dr Tideiksaar is a gerontologist (health care professional who specializes in working with elderly patients) and a geriatric physician's assistant. He has been active in the area of fall prevention for over 30 years, and has directed numerous research projects on falls and has developed fall prevention programs in the community, assisted living, home care, acute care hospital, and nursing facility setting.

Dr. Rein has authored many fall prevention continuing education courses and inservices for certified nurse assistants and caregivers. Click on each course title to view the course description, contact hours, objectives and curriculum:

Caring for People with Fall Risks
Managing Falls In the Nursing Home: Who, Why and What Next?
Facts About Falls
Preventing Falls
The Fall Prevention Care Process

You may also find Dr. Reins Fall Prevention printable resources.  These printable posters guide in the fall risk assessment, bed safety checklist, fall prevention program guidelines and fall risk level tools and the high fall risk room set up.  Click here to view these resources and print them for yourself and facility.


Posted: 9/26/2014 9:38:55 AM
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