Why is it important to be aware of preventing falls?

Transcription

1 Why is it important to be aware of preventing falls? One in three people over the age of 65yrs. will fall in a year. Falls can happen to anyone, but the chance of having a fall increases with age and the damage done, especially for those over 80 years. Falls can result in loss of independence and the ability or confidence to do the things people enjoy. Falls can also cause major injury, and even death. The good news is that falls are NOT an inevitable part of aging and much can be done to prevent them and minimise the damage done. EVERYONE WHO COMES INTO CONTACT WITH OLDER PEOLE HAS A RESPONSIBILITY TO ENCOURAGE THEM TO REDUCE THEIR RISK OF FALLING AND THE INJURY DONE BY A FALL. This folder contains some suggestions and resources that may assist you in helping older people prevent falls. CARERS OF OLDER PEOPLE ARE IN A PARTICULARLY STRONG POSITION TO HELP OLDER PEOPLE PREVENT FALLS AND MINIMISE INJURY. This information has been produced by the CALD Falls Prevention Project for the Commonwealth Department of Health and Ageing. It has been prepared for education and information purposes only and does not constitute medical advice. The CALD Falls Prevention Project assumes no responsibility for the information contained in this resource folder and disclaims all liability in respect of such information. Readers should not act upon such information without seeking personal professional medical advice. 1

2 HOW DO I HELP? Step 1: Recognise falls risks: How do you recognise is a person is at increased risk of falling? They tell you they have had a fall or near miss You observe they have trouble seeing; are unsteady; they walk with difficulty; wear poor foot wear; have weak legs; get tired quickly; suffer from a loss of confidence in moving; look thin and frail, or have injuries such as bruises. There is poor lighting in the home, slipping or tripping hazards Step 2: Encourage them to do something about reducing the risks and make them aware of services if appropriate. Encourage them to speak to their Doctor or other Health Professional Reassure them that getting good advice early is a good way to maintain their health and independence Encourage them to remove home hazards Make them aware of services : (brochures for the following services are at the back of this folder) Commonwealth Care Link for advice on the nearest falls prevention service Taking Steps ph For a comprehensive falls risk assessment and action plan by a physiotherapist for community dwelling older people based at Metropolitan Domiciliary Care Day Therapy Centres for falls prevention programs (contact Carelink to find the nearest one) Independent Living Centre - ph for advice on equipment HomeFront for home modifications for Veterans Home medicine review get them to ask their GP for help with to manage their medicines at home. Make them aware that they can minimise the harm caused by a fall (refer to next page) Get them to read the brochure A guide to reducing your risk of falling (or read it to them) and complete the questionnaire How safe are you from falling? If you do nothing else, report your concern to your supervisor. Step 3: ONGOING Maintain an interest and reward any progress. Discourage risk taking behaviour and help them find alternatives Act as a positive role model See the trouble shooting guide for more information Your support and encouragement may be what motivates them to take action. 2

3 Here are some suggestions: HOW TO MINIMISE THE HARM DONE BY A FALL Encourage them to have a plan of what to do in the event of a fall, as a lot of harm can be done by a long lie. The longer they are on the ground, the poor are their chances of recovery. 60% of falls happen in the home, so there are many things the older person can do to make a fall less traumatic. Learn how to get up if not injured (refer to brochure Getting back up after a fall ). A physiotherapist can teach them how. Have some way of attracting attention/getting help: Refer to brochure How would you get help? - A personal alarm system or monitoring system - Have a mobile or cordless phone with pre-programmed numbers, which they carry at all times. - Wear a bell or whistle to attract neighbours - Consider TeleCross daily telephone calls Make sure the help can get to them: - Give a key to their home to a family member or neighbour so that they can get inside if needed. - Have a box with a key pad lock that the help knows the code to. - Rehang toilet and bathroom doors so that people can get to them if they fall in these places. Minimise damage: - Have a blanket, pillow and bottle of water positioned where they are easy to reach from ground level, so they can be as comfortable as possible if they have to stay on the floor till help arrives. - Wear hip protectors, particularly if they are thin and/or have osteoporosis (thin bones). (refer to flyer on hip protectors) - Skin protectors also protect fragile skin from tears and reduce bruising (refer to flyer on skin protectors) ALWAYS LET THEIR DOCTOR KNOW THEY HAVE HAD A FALL, EVEN IF THEY THINK THEY ARE NOT INJURED. 3

4 Trouble shooting guide: Things to do with the person Decreased balance Dizziness May have many causes Inactivity leads to weakness and poor endurance, thinning of the bones, poor walking, increased dependence and increased likelihood of falling. Weak Muscles Can be caused by illness and injury as well as inactivity Changes in vision Changes in eyesight as part of ageing or eye disorders Wearing multi-focal or bifocal lenses while moving around Changes is health What can be done and who can help increase activity and exercise (Active Ageing SA can help) seek advise from their Doctor specific exercises devised by Physiotherapist walking aids may be needed consult a physiotherapist move more slowly when standing up from a chair or going up and down stairs. Many causes are treatable, encourage them to: seek advise from the Doctor move more slowly when standing up from a chair or going up and down stairs have their blood pressure checked regularly. take care when turning or reaching up slow down. Encourage them to : keep doing as much around the house as they can keep involved in activities outside the house get involved in planned activities eg. Contact Active Ageing SA or the Local Council Aim for 30 minutes of physical activity a day (refer to be active flyer. Encourage them to do strengthening exercise best prescribed by a physiotherapist Inform them of Living longer, living stronger program (see brochure). Encourage : regular eye checks good lighting in the home use of lights at night (eg. when they get up to go to the toilet) separate glasses for reading and walking healthy eating (green and yellow vegetables) walking aids may help wearing sunglasses and a hat to reduce glare when outside. stop and allow eyes to adjust when going from light to dark rooms and dark to light rooms. Encourage them to see their GP 4

5 Poor walking Shorter steps, less picking up of feet, feet closer together, pain, shuffling, unsteady, slower. Foot problems Pain Decreased sensation Decreased circulation Inappropriate footwear Medications Some medications such as antidepressants, sleeping tablets, and anti anxiety agents can cause dizziness and lethargy. Taking more than 4 medications each day has been shown to increase the risk of falls Medications may interact with alcohol. Osteoporosis Thinning of the bones increases the risk of a broken bone in the event of a fall. Chronic Conditions eg Arthritis, Diabetes, Stroke, Parkinson s disease. see a physiotherapist walking aides may help them walk more safely, but should be prescribed by a physiotherapist. pick up their feet as they walk, to reduce your risk of tripping, slipping or falling. Encourage them to : see a podiatrist foot massage and exercise to improved circulation in feet, legs and care of the skin wear supportive shoes suited to the activity (see poster of safe shoe). replace old shoes or have them repaired to reduce the chance of slipping. avoid slippers that are sloppy or too large. Wear closed in slippers with good supportive and non-slip soles. Encourage the to: know what they are taking, why, how much and when to take it. let their Dr. or Pharmacist know of any side effects experienced. inform their Doctor or pharmacist of all the tablets they are taking including over the counter of herbal medicines. ask their Doctor for a home medicine review if they are taking 4 or more medicines (see brochure). reduce or eliminate alcohol intake. return out of date medicines to the pharmacy for safe disposal. eat enough calcium rich food, such a dairy food (3-4 serves per day) to keep bones strong. If they can t manage this, encourage them to speak to their Doctor about other options. Get a little sunlight to make vitamin D which keeps bones strong (about 10 minutes 3 times a week). 30 minutes of weight bearing exercise (eg walking) on most days of the week. reduce intake of alcohol, coffee, and cigarettes, as they can reduce the body s ability to absorb calcium. Encourage them to learn how to manage their condition by working with their Dr. Encourage them to contact the self help organisation for their condition e.g. Diabetes Australia, The Arthritis foundation, etc. (See end of this document for contact details) 5

6 Fear of Falling make a plan of how to get help if you should fall. Avoid truly risky situations such as slippery areas on a rainy day Encourage them to address the hazards in their environment eg. the bath Develop their coping skills and confidence (an occupational therapist can help with this) As we get older, it can be more difficult to divide our attention. If the person has to stop what they are doing to talk to you, this a sight that dividing their attention is difficult for them. Reducing distractions such as the TV or talking while walking can help them concentrate on moving safely. Making the environment safer Hazards in the home environment Just because they have lived in the same place for many years does not mean that it is safe. The house and they have aged and things that were not a problem for them when they were younger, can be a problem as they get older, such as: Lighting hazards Tripping hazards Slipping hazards Structural hazards What can be done and who can help Contact Taking Steps or HomeFront(Veterans) for a home safety assessment (if they are living in their own home) They could contact the nearest Day Therapy Centre to ask for an Occupational Therapist to do a Home Safety Assessment Contact the Independent Living Centre for advice on equipment to make things safer, such as the bathroom. A home safety checklist can be downloaded from the NSW Muliticultural website (see end for useful contacts) Wear clothes that don t restrict movement or catch on things. Wear shoes that have a broad supportive heel, not too high, are a good fit with fastening that can be adjusted, and with some grip, but not too much. (see poster of safe shoe) Increase the amount of light Decrease glare eg. put net curtains in windows or blinds. Increase contrast eg. put a light strip on edge of dark steps Have light switches easy to get to Use the light, even when getting up at night Use non-slip floor surfaces Remove rugs and mats on slippery surfaces (or put non-slip backing on them) Clean up spills immediately Keep walkways clear 6

7 Tuck electric cords under furniture or around skirting Fit a draft excluder rather than use a sausage type at the bottom of the door that they could trip over. Remove small changes in level or mark them with contrasting colour so they are easy to see. Have bed spreads and curtains neatly tailored so that they don t spread over the floor Install rails in the bathroom/toilet/front and back door Use a non slip mat or strips in the shower/bath Eliminate dangerous lips in to the shower If they are unsteady in the shower, they may need to sit on a shower chair. Have outdoor paths that are level Keep paths free of moss and leaves Hazards in the community environment Report Community Hazards to the appropriate Council or shop/business owner. Avoid poorly lit places. Take time walking up and down stairs Always use handrails provided Make a request to council to install handrails where steps are in high use areas. Be alert and aware of surface changes when walking. Watch where you put your feet Avoid slippery, wet or uneven surfaces. Increase their awareness of ways to age healthily Healthy ageing involves physical activity, healthy eating and a little sunshine. Keep actively involved with friends, family and the community. Be sensible, and recognise your limitations. Do things safely and don t be too proud to ask for help. Manage your health problems and medicines well. Speak to their doctor about how to do this together. Make their home and surroundings as safe as possible. Have a plan of how to get help in an emergency. Take steps to minimise any harm done in the event of a fall. 7

8 Places to get help or advice Active Ageing SA or Ph: Alzheimers Australia Arthritis Association Commonwealth Care Link provides information about services available in the area, how to contact them, who is eligible and whether there are any costs involved. (see brochure) Commonwealth Carer resource centre Continence helpline Diabetes Australia ph Falls prevention brochures ( a set of 10 different brochures covering different aspects of falls prevention can be downloaded from Metropolitan Domiciliary Care website at Heart Foundation for heartmoves exercise Home Activity Monitoring Project - Katrina Reschke ph (see brochure) Independent Living Centre for professional information about equipment and home modification Living Longer Living stronger contact COTA National Seniors Low vision Australia NSW Health multicultural website Osteoprosis Australia: Parkinson s South Australia Inc Stroke SA ph Taking Steps (a service offered by Metropolitan Domiciliary Care) for in-home assessment by a physiotherapist ph Veterans Affairs

9 HIP PROTECTORS: One of the common and most devastating bones broken in a fall is the hip. Hip protectors help to reduce the likelihood of a broken hip. They are shields that sit in a pocket over the hip joint in specially made underpants. Hip Protectors are a CRASH HELMET FOR THE HIP Speak to a health professional about where to get hip protectors from. 9