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FALL PREVENTION MOBILITY

Falls have many different causes and seniors may have several fall risk factors.  Assessing fall risk can help caregivers and seniors prevent falls.
 
Examples of fall risk factors are:
  • poor vision
  • orthostatic (postural) hypertension
  • cognitive impairment
  • gait/ balance disturbances
  • muscular weakness
  • degenerative joint disease of hips/knees
  • foot disorders
  • peripheral neuropathy
  • unsafe home related environmental conditions
  • multiple medication interaction
The relative importance of each fall risk factor differs according to the senior's underlying medical condition, functional level, and home safety environment (including the presence of hazardous conditions such as poor lighting, slippery floor surfaces, cluttered pathways, and bathrooms without hand rail support). The more fall risk factors a senior has, the higher the senior's risk of falling will be

Certain gait and balance abnormalities are good predictors of recurrent falls:
  • Difficulty with rising or sitting down 
  • instability immediately after standing 
  • staggering on turns 
  • walking with short, discontinuous steps. 



Goals of a fall prevention program are to maximize mobility, reduce the threat of falls and their complications, and maintain the senior's autonomy. Potential interventions are based on known fall risk factors and consist of medical, exercise-rehabilitative, home safety-environmental and educational approaches


Medical approach to reduce fall risk  
  • Assess seniors for falls, regardless of whether injury results from falls. Because falls may be the indicator of one or more disease or other medical problems, it is important to identify and treat any immediate acute conditions.
 
  • Assess fall risk (including mobility) on a regular basis and attempt to reduce fall risk factors identified. Because the risk of falling increases with the number off all risk factors, modifying even a few factors may substantially reduce risk of falls.
 
  • Review and adjust medications on a regular basis. Attempt to stop drugs that may lead to confusion, sedation, and balance instability
  
  • Medical approach involves a combination of individual medical specialties, the primary areas involve: vision issues, medication interactions, other general medical issues.

Exercise-Rehabilitative approach to reduce fall risk

  • Exercises targeted to the patient's specific gait and balance impairment can improve stability (ability to withstand threats to balance) and reduce risk of falls. Additionally, exercise programs can increase a senior's confidence and reduce fear of falling.
 
  • Canes or walkers can support greater mobility and improve stability. These types of devices also provide reassurance to individuals who are afraid of falling. It is important they are professionally fitted (for size and weight) and the user trained in correct application.  They can pose a hazard if the wrong size, or used incorrectly.

  • A hip protector (consists of two pads that are worn in pockets of a stretchy undergarment) can help to absorb the force of a fall and reduce the risk of a hip fracture.
 
Home Safety-Environmental approach to reduce fall risk

A home safety assessment, conducted by physical/occupational therapists, can help eliminate hazardous conditions; especially in those seniors with chronic mobility problems. Maintaining a safe and secure living environment is a crucial component to a senior reducing their risk of falling.

Educational approach to reduce fall risk 
  • Counseling seniors on ways to prevent falls, and helping individuals to develop safety-related skills and habits allows individuals to regain confidence in their mobility and reduce the likelihood of falling.
 
  • It is important for seniors to constantly talk with their health care professionals concerning how various medical decisions will minimize the probability of falling. Each time a senior changes a prescription or becomes aware of some change in their medical condition they should consult with their health care professional if some specific steps should be taken to reduce their risk of falling.
 
A relatively small amount of time spent understanding, reviewing and assessing fall risk factors can help prevent many falls and reduce a senior's fear of falling.

Source:http://www.seekwellness.com/fallprevention/assessing-fall-risk.htm

http://www.temple.edu/older_adult/fppmanual.html

http://www.learnnottofall.com/index.jsp

http://www.caring-for-aging-parents.com/fall-prevention-in-the-elderly.html

http://www.fpnotebook.com/Geri/Prevent/FlPrvntnInThEldrly.htm

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