Fall Prevention in the Elderly
By Connie Vosberg COTA/L
Falls are a major health problem in the elderly community including nursing homes. It has been estimated that approximately 25% to 35% of older adults (65 years old and older) experience one or more falls a year. Among older adults, falls are the leading cause of injury and death, with the most common being nonfatal injuries and hospital admissions for trauma. Fall rates among older adults residing in institutions such as hospitals and nursing homes are even higher. Making it necessary to have Therapy intervene as soon as possible, to possibly prevent falls before they happen. As many as 75% of nursing home residents fall each year. The most common injury from falls are hip fractures.
Among the elders that live at home, which is the primary setting, is where the unintentional falls occur. The outside environment also poses problems with safety, this includes outside entry, stairs and uneven pathways.
Some common risks for falling are:
- Lack of current or previous physical activity; muscle weakness or balance problems that contribute both to the risk of falling and the inability to break the impact of the fall
- Cognitive impairments or dementia
- Dizziness/vertigo
- Psychoactive medications (anti-depressants)
- Combinations of medications
- Environmental factors (tripping hazards ex: throw rugs, clutter in hallways)
- CVA (stroke)
- Parkinson’s disease or any neuromuscular disease
There are several more risks for falling in the elderly. It is important to remember to get help with therapy at the first sign of weakness in ADL’s to prevent falls.
In the nursing home the above are factors, however here are some risks to look at in the nursing home:
- Poorly maintained and improperly fitted wheelchairs
- Poor transfer techniques
- Assistive devices (canes, walkers etc.)
- Level of care
- Poor fitting shoes
- Depression
- Poor lighting
- Restraints
- Decreased alertness
- Sleep disorders
- Wandering/disorientation
Intervention is the key to fall prevention.
Physical therapists have a number of tests and measures to determine a person’s risk of falling. These tests focus on range of motion, muscle strength and sensory integrity. They will also work at reducing the fear of falling, improving cardiovascular health, and functional tasks in the home, and decreasing depression and reducing sleeping disorders. Based on the physical therapists tests, you will be set up either for therapy or educated and instructed on a home exercise program to decrease the risk of falling.
Two of the most important factors will be to look at your gait pattern, which involves a person using an assistive device such as a cane, walker, using a w/c in home/community, or if you are independent with ambulation and just need some strengthening.
