Wednesday, September 9, 2015

FALL EDUCATION AND PREVENTION (PART 2)



FALL EDUCATION AND PREVENTION (PART 2)

One of the subjects the Invisible Illness Awareness Week page asks us to blog about is "what advice would you give someone recently diagnosed." I am very passionate about fall education and prevention for all those living with an invisible illness due to the high percentage of falls and injuries that occur! I hope you are able to stay safe!

In my previous blog post,  FALL EDUCATION AND PREVENTION (PART 1)  I discussed research findings regarding falls and many physical factors that cause us to be  high risk for falls. I strongly believe that being aware of what can potentially lead to a fall and the injuries that can be sustained is very important! It is also necessary to be aware of what we can do regarding our physical conditions, as well as changes in our environment, to keep us as safe as possible and potentially prevent a life altering tragedy.  So, in this article, I will cover some interventions that you can implement to decrease your chances of falling and keep you safe as possible. 

Remember, as a part of our new “normal” of living with chronic pain, not only do we all need to be aware of what we can do to keep us living as functional and safe as possible, but we all also need to share this information with others to help educate them to deal with similar risks of falling.  Please share this information to help keep others as safe as possible! It could save their life.

Environmental factors around our homes that can increase our risk of falls:
Be aware! We all need to take a look around our homes, as well as wherever we are, to see what potential dangers are around us and know the changes we need to make to keep ourselves safe and hopefully free of falling!
  • Throw Rugs-can be dangerous, tripping on the rug or the rug slipping can lead to a fall – you should seriously consider removing throw rugs.
  • Electrical cords-from lamps, extension cords, computer cords, phone charging cables, etc. going across where you walk should be removed. They can cause you to trip.
  • Items lying around on the floors in your pathway-books, magazines, papers, shoes, clothes, towels and any other items lying around should be picked up off the floor to keep you safe and free of falling.

  • Stairs-need to be kept clear at all times of any items, as well as need to be in good repair to prevent tripping and falling.  They should be well lighted. Carpeting should not be loose.
  • Handrails-should be in good repair, not loose or broken. 
  • Carpet-should be attached securely, not have any holes and not loose.
Kitchen
  • Items that are out of reach in your cabinets can be moved to a lower shelf to prevent having to use a step stool and overreaching.
  • Step stools- If you feel unsafe using a step stool then listen to your instinct.  Don't use it! Ask someone for help to move all items you need to a lower and safer area for you to obtain them. Never use a chair to stand on to reach items. Many fall from using step stools, and chairs, leading to broken hips, shoulders, arms, legs, etc. I have worked with many patients over the years that said, "I knew I shouldn't have used that step stool!"
Bathroom
  • Be aware! The bathroom is the number one place where most falls take place.
  • Tub and shower floor-a nonslip rubber mat or non-slip strips on the floor of the tub and shower can prevent slipping.
  • Grab bars-grab bars by the tub and next to your toilet can help for support and safety getting in and out of the tub and off and on the toilet
  • Shower chair or tub transfer bench-an Occupational Therapist can help assess if you need to use one of these to keep you safe while showering or taking a tub bath. They will assess which item is best for you, also make sure these items are at the proper height and provide training on how to use them properly. (Please do not attempt to use these items without proper training on how to do so safely)
  • Adaptive equipment with bathing/showering- an Occupational Therapist can also help assess needs for other adaptive equipment that can be used to keep you safe while bathing or showering, such as a long handled sponge, shower sprayer, etc.
  • Commode-commode with arms or toilet arms placed on your toilet at the appropriate height can help with standing and sitting safely when toileting. Please be sure these items are safely placed by an experienced person to prevent injury.
  • Night light-a night light in the bathroom can help with seeing where you are going during nighttime visits to the bathroom.
    Bedroom
    • Lighting-light switches or lamps should be easily accessible where you can reach them
    • Night light-having a night light so you can see where you're walking in the dark can help prevent falling
    • Bed rail-is helpful if you have a difficult time going from sitting to lying down and visa-verso
    • Transfers-get up slowly and sit for a while before you walk, this is especially helpful if you have blood pressure issues or other medical issues.
    • Sturdy shoes-wear sturdy shoes with nonslip bottoms to avoid slipping. Many slippers and other shoes can be slippery and increase your risk for falling. Also, avoid walking around in stocking feet, which can be slippery. 
    • Lighting-making sure your light bulbs are replaced to keep areas well light.

    Dressing
    • If you have difficulty with balance you can sit to put your pants on over your feet
    • Adaptive equipment for dressing –You can use a reacher to help put your pants over your feet, pick up items off the floor with, such as clothing, shoes, etc. to help decrease your risk of falling while dressing. (Just an FYI, if you are having difficulty with dressing, there is a variety of adaptive equipment available for dressing. Reachers, sock aids, dressing sticks, etc. An Occupational Therapist can assess what would be beneficial to you to increase your independence, as well as provide proper training on how to use these items.
    Mobility
    • Walking- Be sure to walk at a safe pace to keep yourself as safe as possible. Be aware of turning to change directions, this can potentially cause loss of balance.  Don’t hurry to get to the phone, the bathroom, on stairs, etc.
    • Sturdy shoes-wear sturdy shoes with nonslip bottoms to avoid slipping. Many slippers and other shoes can be slippery and increase your risk for falling. Also, avoid walking around in stocking feet, which can be slippery.
    • Wheelchairs- you need to make sure close to what you were transferring to and put your brakes on. Don't bend forward in the wheelchair without support because you could tip over. Wheelchair use should be assessed by a therapist to give proper safety training. (There are many different types of wheelchairs and if you use one that is loaned, or given to you, it may be the wrong size or may have problems with the tires, brakes, footrests or other components that can be potentially hazardous to you. Please ask your doctor for a referral to a therapist for education of proper use of a wheelchair that is appropriate for your body type.
    • Walkers- you need to put the brakes on and use safely as taught by your therapist that gave you the walker. Walker use should be assessed by a therapist to give proper safety training. Please do not borrow someone’s walker to use. It has not been adjusted appropriately to your body and may not be an appropriate walker for you to use. There are many types of walkers out there, some with 4 wheels, 2 wheels and no wheels, as well as some with seats and brakes.. (These are the same concerns for canes, crutches and other walking devices-they need to be adjusted to your height).
    Outdoor problems - ice, snow and uneven surfaces you walk on increase your risk for falls. Make sure you are aware of the surfaces you are walking on outdoors.  Remove, or have someone help remove, ice and snow to prevent slipping and falling. Also, be aware while walking on grass, gravel, dirt, sand, cracks in sidewalks and many other areas can be uneven and lead to falls.

    What can your physician do?
    If you are having difficulty with any of the areas discussed please talk with your physician.
    There are several things they can do to help decrease your risk for falls and prevent the potential injuries they can cause.
    • Your physician can perform a physical to check for any medical reasons that may make you high risk for falling. They evaluate your body systems including your vision, as well as your strength, balance, coordination and signs and symptoms of any diseases or disorders that you may have.
    • Your physician can perform a medication review to see if any of your medications (prescribed and over-the-counter meds) are negatively impacting your safety due to side effects, such as dizziness, blood pressure changes, visual changes, disorientation, confusion, etc.
    • Your physician can give you a referral for Occupational Therapy of which an Occupational Therapist can perform a home assessment to address any problems within your environment, as well as difficulties you may have with strength, balance, coordination, vision, bathing, dressing, cooking, etc., that may place you at risk of falling. They can provide recommendations and training as to home modifications, adaptive equipment use and mobility aids, so you can be as independent, safe as possible and reduce the risk of falls. For more information please see, Occupational Therapy and Prevention of Falls
    • Your physician can also give you a referral to a Physical Therapist who can assess your neuromuscular skeletal systems and provide treatment to address any deficits such as decreased strength, balance, coordination, walking problems, etc. They can positively address any areas showing a problem, as well as a give you a home exercise program to help you maintain your strength and balance.
    OTHER THINGS YOU CAN DO TO BE SAFE AT HOME 
    • Have an eye exam once a year
    • Keep a list of emergency numbers readily available if needed
    • Keep the phone near you in case you fall and can't get up 
    • Subscribe to medical alert provider- They provide a bracelet or necklace you can wear in case you fall and can't get up. Many have low monthly fee to subscribe. 
    These lists provided are not all encompassing of what can be a risk to you, nor are the lists of items that can make you safe. There are many factors out there. However, being aware of what potential physical problems that make us at risk for falling and addressing all of them with our physician, as well as any therapists our physician refer us to, may decrease our risk for potential falls and the devastating injuries that can result.

    Also, being aware of what is a possible danger within our own homes and making needed changes to our environment may also decrease our risk of falls.

    Accidents do happen and the best we can do is be as prepared as possible! Please do all you can to make yourself as safe as possible! And please remember to share this information with your friends and loved ones to keep them safe too!

    For more information please see the Adults Falls Prevention Tip Sheet  provided by the American Occupational Therapy Association.

     

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