Monday, September 7, 2015

FALL EDUCATION & PREVENTION (PART 1)

FALL EDUCATION & PREVENTION (PART 1)

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!


FALLS
Does just seeing that word bring about a frightening memory for you? You are not alone!  It frightens many people!  With good reason!  Falls occur frequently among those of us with chronic pain.  Injuries obtained from a fall may have even been the origin of your chronic pain, or your chronic pain may have caused a fall.  Either way, falling has negatively impacted many lives!

Working in Occupational Therapy for almost 25 years, primarily with the elderly, I have experienced treating firsthand many patients that suffered moderate to severe injuries due to falls (various head injuries, broken shoulders, broken arms, broken pelvic bones, broken hips, and legs, etc.).

Not only that, but over the past five years, being involved with several spine surgery and chronic pain support groups, I have been a part of many discussions with various ages of people that have reported falls, as well as the resulting pain and injuries. Unfortunately, statistics show many of these injuries  may have been preventable! 




Image result for broken bones images
All this leaves me feeling very passionate about the necessity for awareness and education of fall prevention, thus the reason for me writing this blog article.

While researching statistics for this article I have not been able to obtain information on falls for those with chronic pain or invisible illnesses, so the information I share is on falling and the elderly (65 years of age and older). However, it is reasonable to assume that those of others ages suffering from various illnesses, including chronic pain, are at high risk for falling.

In an article written July 1, 2015, by the Centers for Disease Control and Prevention, it stated that every year millions of older Americans (65 and older) fall at home, but less than half discuss it with their doctor. "Falls among the elderly are the leading cause of both fatal and nonfatal injuries.  In 2013, 2.5 million nonfatal falls among the older adults were treated in emergency rooms and more than 734,000 of these patients were hospitalized. In 2013, the direct medical costs of falls, adjusted for inflation, was $34 billion." 

These are more statistics regarding falls that were given in the article as well:
  • Twenty to thirty percent of people who fall suffer moderate to severe injuries such as lacerations, hip fractures, and head traumas. These injuries can make it hard to get around or live independently, and increase the risk of early death.
  • Falls are the most common cause of traumatic brain injuries (TBI).
  • About one-half of fatal falls among older adults are due to TBI.
  • Most fractures among older adults are caused by falls. The most common are fractures of the spine, hip, forearm, leg, ankle, pelvis, upper arm, and hand.
  • Many people, who fall, even if they are not injured, develop a fear of falling. This fear may cause them to limit their activities, which leads to reduced mobility and loss of physical fitness, and in turn increases their actual risk of falling.  The full article can be seen at,  Home and Recreatonal Safety - Falls  CDC. Centers for Disease Control and Prevention. CDC 24/7: Saving Lives. Protecting People.
As you can see, falling occurs frequently and can seriously impact our lives in many areas!  

RISK FACTORS THAT CAN LEAD TO FALLS
Being only 53 years old it is embarrassing to admit that the several falls I’ve had were preventable, especially since a part of my career included teaching safety awareness and fall prevention education.  However, the lingering pain over several weeks, from “just bruising”, was a good reminder to me that this is sadly, part of my new "normal!"

Listed below are many potentially problematic factors with physical issues and limitations from medical conditions that make us more susceptible to falling. Being aware of this information and taking precautions may help you to prevent a fall that can negatively impact your life!
  • Medications and side effects - being on certain medications can lead to many side effects. Being on multiple medications can also increase our risk.  Be aware of how your medication affects your body (side effects, such as causing dizziness, hypertension, hypo-tension, visual changes, disorientation, confusion, etc.)
  • A history of falls-leaves us at risk of falling again.
  • Having a hard time getting around your home due to decrease strength or various physical issues 
  • Sitting or lying down a lot during the day can lead to muscle weakness
  • Being incontinent (urine and bowel) can lead to rushing to the toilet, as well as slipping on the floor on wet spots
  • Poor eyesight can be a factor. Wearing glasses is important.  
  • Decreased balance and strength can affect your coordination with walking, standing and turning, as well as standing up from a chair or your bed.
  • Unsafe practices with using a walker and wheelchair.
  • High or low blood pressure - Have you reported any issues with your blood pressure medications to your physician? Do you have a problem from lying and standing with getting dizzy? Sometimes if you're having a blood pressure problem you can have dizziness or feel off-balance which can make you at risk for falling.
  • Chronic pain – living with this can make us predisposed at being at risk for falling.
  • Diseases and disorders - vertigo, having a history of stroke, Parkinson's disease, loss of a limb(s), seizures, arthritis, osteoporosis, fractures, dementia, neuropathy, as well as many other diseases. These are just some of the many factors we need to be aware of that can potentially increase our risk of falling. And having more than one issue can increase that risk even further.
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.
As stated previously, we need to be aware of these issues that can increase our risk of falling. 
My next blog article, (FALL EDUCATION AND PREVENTION (PART 2), will provide more interventions for both the physical risks listed above, as well as environmental risks that will be discussed. The interventions can be implement to decrease your chances of falling and keep you safe as possible.

In closing, I'd like to provide this video from the University of North Carolina Chapel Hill showing an occupational therapist giving a few simple tips that can be integrated into one’s life.  

Click here to watch the video.  EXTRA PRECAUTIONS CUT RISKS OF FALLING AT HOME


Blessings to you and may you stay safe!


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