By: Margaret Espino

 Introduction of Falls in Older people

 Statistics of falls amongst seniors
 Risk factors and reducing the risks
 Strategies to prevent falls:
◦ Exercises to improve physical functioning of seniors
◦ Home modifications to prevent falls & injuries within your
home
◦ Practicing Safe transfers
 The role of the OTA and PTA in relevance to fall prevention
 Conclusion
 References
 Falls is a major issue for older adults.
 For seniors, falls in and around the
home are the most frequently
occurring accident.
 One out of three adults age 65 and
older fall each year and these rates
increase drastically with advancing
age.
 Many of these falls cause serious
injuries such as hip, wrist, or
vertebrae fracture and sometimes
death.
 It is falls that commonly results in
seniors being hospitalized and moved
to a nursing home.
 According to the Public Health Agency of
Canada in 2005 shows that falls are the 2nd
leading cause (after MVA’s) of injury related
hospitalizations for all ages
 Falls are the 6th leading cause of death for
those over the age of 75 years old.
 50% of all people over age of 75 fall each year.
 Older people who have suffered a fall are at
increased risk of falling again.
◦ Fear of falling leads to reduced activity and
results in higher risk of falling
 25% of falls cause seniors to limit their normal
activities either because of an injury or the fear
of falling again
 Falls account for 84% of injury related
hospital admissions and 40% of admissions
to nursing homes and a 10% increase in
home care services
 Among older adults, falls are the number
one cause of fractures, hospital admissions
for trauma, loss of independence, and
injury deaths.
 After an older adult falls:
◦ 40% become less active
◦ 40-70% report fear of falling
 Fractures account for 80% of fall related
deaths, one half of hospital admissions
and two thirds of emergency department
admissions.
 Risk factors for falls are caused by
health and age-related changes, such
as:
◦ Lower body weakness
◦ Poor postural stability
◦ Vision changes
◦ Problems with balance and gait
characteristics
◦ Slow reflexes
◦ Use of medication
 Environmental factors in and around the
home is a major cause of falls, such as:
◦ Poor lighting
◦ Slippery floors
◦ Loose rugs
◦ Cluttered floors
◦ Stairs
 Heart disease, stroke, Parkinson’s and
low blood pressure can cause dizziness,
balance problems and fatigue.
 Loss of sensation
 Arthritis results in loss of flexibility, and
increased difficulty maintaining balance
 COPD and Heart Failure result in
breathing difficulties, weakness and
fatigue increasing the risk of falls with
exertion
 Vision problems such as glaucoma and
cataracts
 Keeping active helps prevent falls!
 Staying physically active and exercising regularly
can help prevent or delay some diseases.
 Increase lower body strength and improving
balance through physical activity and balance
exercises
 Seeing a eye doctor for vision problems
 Learning how to fall-proof your home and being
aware of external conditions that can increase
your chance of a fall
 Major benefits of staying active:
◦ Maintains muscle strength
◦ Strengthen bones – slows down process of osteoporosis
◦ Gain flexibility
◦ Increases energy
◦ Strengthens heart and lungs
 Balance exercises and Gait
training
◦ Balance exercises:
 One-leg balancing
 Weight shifting
 Leg lifts
◦ Improve ambulation with use
of mobility aids
 Resistance training and
strengthening
◦ To improve muscle weakness
and prevent inactivity that
leads to atrophy and
deteriorating condition
 Endurance training
◦ An activity like walking,
arm cardio and cycling that
increases the heart rate and
breathing for an extended
period of time. Which
builds endurance and
stamina.
 General exercise program
 To keep seniors healthy,
increase heart rate,
promote physical activity
and staying active!
 Special equipment is used to
prevent falls and/or reduce risk of
injury from a fall
 After patient has been assessed  Equipment used to prevent
for risk of falling, equipment can falls:
be provided for patients who ◦ Low riser bed with
require and would benefit from protective mats
the equipment.
◦ Bed/Chair Alarms
◦ Bed rails
◦ Assistive Devices (long
handle reachers)
◦ Gait Belts
◦ Physical restraints are a
last resort only –
All rooms well lit, and a lamp/light
switch easily to reach without getting
out of bed
Install hand rails on both sides of
stairs
Rails on bed to avoid falling and assist
in getting up
Add grab bars in shower, tub and
toilet areas
Use bath mats and appropriate AD’s in
bathroom ( bench or stool in shower)
Make certain carpets are firmly attached
to stairs
Remove or replace rugs that tend to slip
 Keep telephone and electrical
cords out of pathways
 Consider using an elevated toilet
seat
 Make sure their is a non-slip
backing to rug outside of shower
 Purchase a step stool – place
frequently used objects in places
you can reach easily
 Remove all clutter on floors in the
house- organize room for space
of mobility aids
 A transfer is the movement of an individual from one
surface to another or from one position to another
 Patients and healthcare professionals should be educated
and capable of performing safe transfers
 When a patient is educated on how to transfer properly for
example sit from wheelchair to toilet reduces risk of falls
 Client must be able to bear weight through the legs
 The Patient’s position:
◦ Slide hips to the front of the chair-
slightly turned to position being moved
to- anterior pelvic tilt
◦ Feet apart and flat on the floor- feet
pointing to surface being transferred to
◦ Patient has one hand on the chair and
one hand on the walking aid
◦ Bring shoulders forward
 The Caregiver Position:
◦ Standing at the side of the patient
◦ Hand at the clients lower back or at the
scapular level to apply pressure in the
stance
◦ Lead forward and stand up
 The Patient’s Position:
◦ Slide hips to front of chair- turn
client so hips are closer to surface
being transferred to and pointing in
that direction
◦ Feet apart and flat on floor- position
feet in line with pelvis
◦ Client has both hands on chair/bed
◦ Bring shoulder forward (Nose over
Toes)
 The Caregiver Position:
◦ Standing in front of the patient
◦ Hands at lower back or at scapular
area (dependent on patient)
◦ On count of 3 lean forward and turn
to sit on chair/wheelchair...
 The Patient’s Position:
◦ Slide hips to front of chair- turn client so
hips are closer to surface being transferred
to and pointing in that direction
◦ Feet apart and flat on floor- position feet in
line with pelvis
◦ Patient has both hands on chair/bed
◦ Bring shoulders forward – (Nose over Toes)
 The Caregiver’s Position:
◦ One standing in front of patient and the
other behind
◦ Front- Hands at lower back
◦ Back- Hands on patients hips
◦ On count of 3 lean forward and turn to sit
on bed/chair....
 Falls amongst older people is a
current and ongoing issue
related to rehabilitation.
 With falls and fall related
injuries the role of an OTA/PTA
is very significant for recovery
and prevention of falls.
 Both OTA’s and PTA’s provide
treatment and education to
seniors to prevent falls.
 An OTA’s role can consist of:
 Home modifications
 Patient education on use of
mobility aids, assistive
devices..
 Practice safe transfers and
energy conservation
techniques
 A PTA’s role can consist of:
 Ensuring physical fitness of
seniors, providing them
with exercises
 Increase/Improve patients
balance and endurance
 Gait training
 Falls is a major concern in older adults and precautions should be taken
to reduce risk of falls from occurring.
 This includes staying active, exercising regularly to improve physical
functioning such as balance, strength and endurance
 For seniors living at home/in a nursing home certain home modifications
should be made to make your living space a fall proof place.
 An OT/OTA can help one prevent falls by doing home assessments and
making sure your home is safe for a senior. They can also educate and
provide assistive devices.
 A PT can assess patients for risk of falling the PTA’s role is to deliver
treatment as requested by PT which include exercises to improve physical
fitness.
 Both also practice safe transfers with patients so they can practice
independently. As well as educating other caregivers to perform proper
transfer on patient safely.
 With cooperation from patients and other caregivers knowledge on fall
prevention can help promote healthier and safe living of seniors
 1996 Surgeon General’s Report on Physical Activity and Health .
 Early, M. (2006). Physical Dysfunction Practice Skills. Mosby Elsevier.
 Fredrikson, E. (2004). How to Avoid Falling: A guide for active aging and
independence. Firefly Books.
 Lord, S., Sherrington, C., Menz, H., & Close, J. (2007). Falls in Older People: Risk
Factors and Strategies for Prevention. Cambridge University Press.
 Seniors, D. o. (2002). The Safe Living Guide to Home Safety for Seniors. Health
Canada.
 Tinetti ME, Williams CS. Falls, injuries due to falls, and the risk of admission to a
nursing home. N Engl J Med. 1997;337:1279-1284
 National Center of Injury Prevention and Control, Falls and hip fractures among
older adults,
http://www.cdc.gov/ncipc/factsheets/falls.htm
Thank you for listening, I
hope you enjoyed my
presentation. Hope you find
the folder package useful.

Sincerely,
Margaret Espino