Impact: Designing a Fall Prevention Program for Seniors

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1 Impact: Designing a Fall Prevention Program for Seniors Carla Bacon Smith, B.S., CDP Lifetime Expressions lifetimeexpress@aol.com Falls pose a big problem for seniors and those who care for them. One in four persons over the age of 65 will experience a fall this year, which can have a negative impact on their health and lifestyle. Expand your knowledge of fall risk and prevention, and explore techniques for implementing a multi-faceted fall prevention program that can make a big impact on quality care and quality of life for your seniors. Just the Facts: Falls in the Senior Population Understanding the Scope: Statistics o One in four Americans over 65 falls each year. o The number of falls for seniors residing in nursing facilities is twice that of those residing in the community. o An older adult who experiences a fall is at increased risk for additional falls. o As Americans age, with 10,000 people turning 65 every day, the number of falls is expected to continue to rise. Health Risks o One in five falls results in serious injury, such as broken bones or head injuries. o Every 11 seconds, an older adult is treated for a fall in the emergency room; every 19 minutes, an older adult dies from a fall. Financial Factors o In 2014, falls in older adults accounted for 31 billion dollars in Medicare costs. o Seniors who experience a fall may incur costs associated with hospitals, skilled care and rehabilitation facilities. Facilities that care for seniors may also incur increased costs, regulatory issues and increased risk of litigation related to patient falls. The bottom line: experiencing a fall may have serious repercussions that include limits in a senior s lifestyle, mobility and quality of life. Carla Bacon Smith Lifetime Expressions copyright 2017 Page 1

2 Multidisciplinary Approaches to Fall Prevention Identification Systems : Medical History, Clinical Risk Assessments, Facility Specific Identifiers, Interdisciplinary Discussions, Care Plans, Shift Reports Monitoring Programs: Clinical Rounds, Watch Programs, Electronic Systems, Call Lights Mobility Programs: Therapy Evaluation and Treatment, Restorative Programs, Exercise Classes Environmental Safety: Physical Plant, Housekeeping and Safety Practices, Staff Education/Awareness, Positioning What s the Buzz? : Mottos to Focus Efforts, Staff Education, Best Practices, Patient Education Tracking and Trends: Fall Investigation, Root Cause Analysis, Metrics Impact!: Activity and Recreational Interventions to Make a Difference Assessment: the Heart of Person-Centered Care o Understanding interests, patterns and routines can aid staff in adapting activities to promote comfort and anticipate needs of seniors, especially those not able to verbalize their needs. o Daily observation and awareness of any changes in function or behavior can help in early detection of metal status changes and medical issues that can cause falls. Structure and Routine can help promote optimal cognitive function, relieve anxiety and provide appropriate supervision for those with cognitive or memory loss, as well as those with decreased safety awareness. Stimulating and Diversional activities can be utilized in a group, independent or one to one setting to encourage seniors to engage in pleasurable pursuits to divert behaviors that contribute to falls and provide cognitive stimulation to promote optimal function. Relaxation Techniques: Impact pain and anxiety and contribute to fall prevention. o Consider techniques such as aromatherapy, massage, meditation, guided imagery, yoga, zentangle, music listening and other activities that promote mindfulness and comfort. Carla Bacon Smith Lifetime Expressions copyright 2017 Page 2

3 Exercise for Fall Prevention o Although many types of movement help contribute to fall prevention, exercises in the categories listed below may be particularly effective: Posture exercises help maintain center of gravity. Vestibular exercises promote body awareness and balance. Range of Motion exercises promote the flexibility needed to adjust position and maintain balance. Core strengthening exercises teach the body to maintain alignment and promote balance. o Tai Chi is recognized by experts as an evidence based method for fall prevention. o Exercise can also help regulate sleep patterns and release excess energy to help those at risk for night-time falls. Education: The Key to Unlocking Understanding Empowerment through Education o Falls are not a normal part of aging. o You are never too old to improve your strength and balance. o Seniors, family and staff can benefit from education. Techniques for Adult Learners o The Rule of Seven: Making the Message Stick o Meaning Matters: Make it Relevant and Practical o Teaching Tales: The Power of the Story o Engage them with Experiential Learning o Reference Materials: Tips, Risk assessments, Checklists, Exercises, etc. Risk Game: An Interactive Tool for Exploring Risk and Prevention Carla Bacon Smith Lifetime Expressions copyright 2017 Page 3

4 Resource Websites Games and Tool Kits Fall Prevention Awareness promotion National Council on Aging: Evidence Based Program Information, Resources, Blog Centers for Disease Control and Prevention: STEADI program posters and materials Patrick Griffith s training seminars for certification in teaching a seated tai chi program Sources Rose, Debra, Fall Proof!: A Comprehensive Balance and Mobility Training Program, Human Kinetics, Peterson, Karen, M.A., Move With Balance: Healthy Aging Activities for Brain and Body, Giving Back Books, Argue, John, Parkinson s Disease & the Art of Moving, New Harbinger Publications, Inc., Motivating Moves for People with Parkinson s, DVD featuring Janet Hamburg, Parkinson s Disease Foundation. Smith, Carla Bacon, Move It with Purpose, 2014 Quattrochi -Tubin, Susan, Ph.D., Quality Care Consulting Services. Griffith, Patrick, Chair Chi O Brien, Pam, Greeleaf Yoga Statistical information sources: Center for Disease Control, National Council on Aging and DHS Wisconsin Risk Game Cards Pets, Diagnosis, Socks, Weather, Bed, Stairs, Doing Less, Throw Rugs, Rushing, Getting Up at Night, Clutter, Surfaces, Telephone, Dark Room, Pillows, Spills, Reaching, Plopping, Medicine, Wheels, Cords, Recent Hospital Stay, Age, Clothing, Limiting Fluids, Oxygen Use, Falls, Fatigue, Pain, Circulation, Urinary Urgency, Vision, Posture, Being Careful / Knowledge, Doctor, Vision Check, Zip Ties, Organize, Vigilance, Call Light, Don t Fall, Remember to Call, Exercise, Non-Skid Footwear, Rubber Backing, Night Light, 1,2,3 Wait, Personal Care Products, Glasses, Conversation, Keep Active, Reacher, Grab Bar, Railing, Planning, Light, Tai Chi, Foot Rests, Fluids, Rests, Chair, Brakes// Wheelchair, Appliances, Walker Carla Bacon Smith Lifetime Expressions copyright 2017 Page 4

5 Exercises to Promote Fall Prevention General Guidelines Perform exercises seated in a stable chair with arms. If you are using a wheelchair, make sure the brakes are locked. Feet should be flat on the floor, about hip distance apart or on the pedals of your wheelchair to give you a good stable base. Start with a deep breath: In through the nose, out through the mouth. ( Smell the roses; Blow out the candles ). Pause between exercises or when you feel tired to refresh yourself with another deep breath. Posture Seated Mountain (Yoga pose) o With feet planted flat on the floor, relax your shoulders and extend your spine to sit up straight. o Bring your hands together in front of your chest in prayer position. o Slowly raise the hands above your head to for the mountain peak. Chest Stretches o Bring your fingertips together at the breastbone, then slowly open them wide. o With your hand on your shoulders, bring your elbows together toward the breastbone; then push them back. Balance Hug a Tree o Position your arms like you are hugging a giant oak tree. o Slowly turn your upper body to the left, taking the tree with you. o Return to the center position and then repeat to the right side. Carla Bacon Smith Lifetime Expressions copyright 2017 Page 5

6 Around and Through o Extend your right arm diagonally across your body at shoulder level. o Sweep the right arm around to the right as you swivel at the waist and shift your weight on the chair. o Push the right arm through an imaginary hole positioned in front of your left shoulder. o Repeat sequence several times and then repeat using the opposite arm. The Dragon Whips Its Tail (Chair Chi) o Extend your arms in front of you with the elbows loosely bent: right hand palm down, left hand palm up. o Move both hands horizontally to the left, then bring them up, turning the hands over as you move them to the right. o Continue moving side to side, shifting you weight as your arms move in a horizontal figure 8. Cross Crawl o Lift your left foot off the ground slightly while your right hand touches your left knee. o Repeat, touching the left hand to the right knee. o Continue to alternate: left, right, left, right. Joint Mobility Wrist circles o Extend your arms with hands in loose fists. o Slowly rotate wrists in a circle one way and then the other. Ankle rotations o Raise one foot off the floor and draw a circle with your toe, slowly rotating the ankle. Repeat in the opposite direction. o Repeat with the other foot. Carla Bacon Smith Lifetime Expressions copyright 2017 Page 6

7 Barrel Rolls (elbows) o Hold your arms, bent at the elbows, in front of your chest with one above the other. o Circle the hands around one another, then reverse. Shoulder circles o With hands on your shoulders, circle elbows slowly one way and then the other. Knee Pendulums o Lift one foot off the floor; support it with your hands if needed. o Slowly swing the foot in a circle one direction and then the other. o Repeat with the other leg. Vestibular Exercises The Artist s Thumb o Extend your arm in front of you, with thumbs up. o Look at the thumb and slowly turn your head side to side, keeping eyes focused on the thumb. Head Turns o Slowly turn your head to look right and then left. o Now try it with eyes closed! Walk the Wall o Extend arms in front of you, palms open and facing out. o Slowly walk your hands up and down an imaginary wall in front of you, watching them with your eyes without moving the head. Always check with your physician before beginning any exercise program, and remember to observe any precautions or restrictions. And remember you know your own body best! Stop and consult your healthcare professional if you feel pain; rest when you need to. Carla Bacon Smith Lifetime Expressions copyright 2017 Page 7

The In Bed Workout or the Getting Up Routine

The In Bed Workout or the Getting Up Routine This is a great way to wake up and make good use of time. Just think, instead of lying there wasting 10 minutes thinking about getting up, you can complete