Fall Prevention

1. Fall Prevention Nancy E. Mayo School of Physical and Occupational Therapy McGill University

2. Agenda • Some numbers about falls and accidents • Risk Factors • It can happen to me • I can prevent a fall

3. Lots of people > 65 fall             

4. Fear of Falling • Older persons often develop strong fear of falling whether or not they have fallen • After a fall, fear of falling is very high • Restricts going out in the community • To reduce fear, walk slower, small steps, and shuffle • Mobility is reduced, fitness reduced, leads to poor quality of life • Women fear falling more than men • Interventions to prevent falls are effective to reduce fear of falling

5. Risk Factors / Intrinsic • Normal aging • Muscle weakness • Balance problems • Mobility problems • Many medications (sleeping pills, stress/anxiety pills, heart medications) • Stiff, sore, or diabetic feet • Vision problems (difficulty seeing in dark) • Fear of falling • Bad shoes • Women

6. Why do Women Fall More than Men? • Concept of Reserve • Women have smaller “gas tanks” than men • Normal aging and health conditions use up a greater proportion of “what’s in the tank” • Balance and strength problems have greater impact on women than men • Make the difference between tripping and recovering and tripping and falling

7. Risk Factors / Extrinsic • Bad lighting, • Slippery floor surfaces, • No handrails or grab bars particularly in bathroom • Poor design or repair of stairs. • Pets • Uneven surfaces • Crowded walkways, • Loose carpeting or throw rugs • Clutter, too much furniture • Walkers

8. Impact of Risk Factors • 1 risk factor = ie. Just being over 65 years = 25% risk of falling • 4 risk factors = 75% risk of falling • As many of these risk factors are common – it is likely that many of you sitting here to day will fall in the next 12 months.

9. Falls occur at home! • More time spent indoors than outdoors • More falls occur inside than out • But 1/3 of falls occur outside

10. Where do falls occur? Clutter, getting up suddenly, dark, rushing to bathroom Uneven ground, obstacles

11. Accidents happen outside and in the kitchen

12. Beware the open dishwasher door! and knives pointing upward!

13. Falls on the stairs! Handrails, lighting, surface, correct height (8”)

14. Very few falls have a warning signTop 10 Reasons for Falling • Inattentiveness • Loss of balance • Rushing or hurrying • Walking • Carrying an object • Changing position • Going up and down stairs • Reaching or leaning • Uneven surface • Object in path (pets)

15. Preventing Falls • Number 1 • Recognize that you can fall at any time • Be aware of surroundings • Be aware about how you are feeling • Remove environmental hazards • Declutter, get rid of small rugs, handrails, bathrails, non-slip bathmats, loose stair carpets or treds etc.

16. Drugs and falls • Many drugs are associated with an increased risk of falls • Sleeping pills • Anti-depressants • Drugs for epilepsy • Cardiac drugs • Ask your doctor about these drugs and how to reduce your risk of falling

17. Don’ts and Do’s of Shoes

18. Get Fit • Exercise has been shown to be one of the most effective ways of preventing falls • Better joint mobility • Better balance • Better muscle strength • Quicker reaction time • Less fatigue

19. Many community-based exercise programs for seniors • Joint mobility – joint stiffness can cause a fall when changing position • Balance – train recovery processes and reaction time • Strength – peripheral and core strength • Prevents foot drag • Knees buckling • Pelvis dropping when moving • Fitness – reduces fatigue and improves all of the processes above and is good for the heart

20. Tai-Chi • Improves • Balance • Focus • Muscle strength • Mobility • Reduces • Stress and anxiety • Fatigue among other benefits

21. Core strength • Improves the muscles of the “core” • Abdominals, pelvis, back, hips • Exercises for core strength • Sit backs • One-leg sit • Bridge – one leg lift

22. Nordic or Pole Walking • Poles must be of the height that your elbow is at 90 degrees • Start by walking and dragging the poles to get a natural rhythm • When you see your arms moving in rhythm to legs (right arm, left leg) start to push with tip of pole • Makes you walk tall, take big steps, heel down (toe up so prevents tripping), additional security for balance, walk fast

23. Many resources in the community and on the web • Public Health Agency of Canada • Health Canada • Safety starts at home