Getting Up After a Fall

Transcription

1 Getting Up After a Fall Session 2 Handout: Activity Session One 1. Don t panic; take your time. 2. Bend both of your knees. 3. Roll onto one side. 4. Push up onto one elbow. 5. Move into a kneeling position on hands and knees. 6. Stop and get your balance. 7. Crawl to a phone on a low table or to a chair. 8. Using both hands, pull yourself up. STEPPING ON BUILDING CONFIDENCE AND REDUCING FALLS

2 Check the box next to the improvements you need or want to make. Entrances and Exits Create a zero-step entry into the home Install a no-step, notrip threshold Add handrails to both sides of all steps Install lever-style door handles Install deadbolt locks and/or slide latches or chain locks on exterior doors Install a security peephole or viewing panel on the exterior door Install a camera or other electronic system for seeing who s at the door Put a bench near the exterior door for placing packages while locking or unlocking the door Install sensors on outdoor light fixtures to automatically turn lights on at dusk and off at dawn and/or when motion is detected Add easy-to-see address numbers that are visible from the street Repair holes, loose bricks or uneven pavement on exterior walkways Clear paths so they re free of leaves, moss, mold or other slipping hazards Remove scatter or throw rugs from the front stoop and inside the foyer Remove clutter from hallways Widen doorways to at least 36 wide by replacing traditional door hinges with swing-away or swingclear hinges Steps and Stairways Repair or renovate stairways that are weak, have open backs, raised nail heads, missing treads, loose steps, etc. Cover steps with a tightly placed, woven low-pile carpet with thin padding Apply nonslip adhesive strips to uncarpeted steps Install handrails on both sides of all staircases Install a light fixture to illuminate the entire staircase, and place a light switch at the top and bottom of the stairs Plug automatic nightlights into outlets near steps and staircases Clear the stairs of clutter Kitchen Install task lighting for the sink, stove and other work areas Replace knobs on cabinets and drawers with easy-to-grasp D-shaped handles Purchase a stove or cooktop with controls near the front of the device Place a lightweight, ABC-rated fire extinguisher in an easy-to-reach location Purchase a step stool that has nonslip steps and a grip handle Install adjustable, pull-down or similar shelving for safe access to upper cabinets Install pull-out cabinetry shelves beneath counters and place Lazy Susans in corner cabinets Install a lever-, touchor sensor-style kitchen faucet (ideally one that s pressurebalanced, temperatureregulated and kept at or below 120 F) Establish a kitchen surface for working while seated Bathroom Install easy-to-use lever-, touch- or sensorfaucets for the sink, bathtub and shower Install a nonskid mat or nonslip strips in the bathtub and/or shower Use rubber-backed rugs (or mats secured with double-sided rug tape or rubber carpet mesh) on the bathroom floor Install attractive grab bars in the bathtub, shower and adjacent to the toilet Install a comfort-height toilet (or a toilet seat riser) This worksheet is a supplement to the HomeFit Guide. For more information visit

3 My Room-by-Room HomeFit List (continued) Insulate exposed pipes beneath the sink to protect against touching a hot pipe Install a hand-held or adjustable showerhead Install or purchase a shower seat Set the water heater at or below 120 F to avoid scalding Install night-lights and/or illuminated light switches in the bathroom and the hallway leading to it Living Room and Bedroom Arrange furniture to allow for clear, wide passageways Place the bed so it allows easy access to the bathroom Use natural light to the fullest by opening curtains, blinds and shades during daylight hours Remove scatter and throw rugs, and secure large area rugs to the floor with double-sided tape or nonslip mats Install interior lights and adjustable rods and shelves in closets Elsewhere and Throughout the Home Place flashlights in multiple rooms Replace a top-loading washer with an easierto-use front loader and place the washer and dryer on a raised platform if additional height is needed Check that the light bulbs used for fixtures are the proper rating, are of the highest allowed wattage and do not produce an excessive amount of glare Plug automatic nightlights into hallway and bathroom outlets, and near stairs too Replace traditional toggle light switches with easier-to-use rocker-style switches Install smoke and carbon monoxide detectors on every floor, and ensure they can be heard in all bedrooms Be sure a telephone is available in or near multiple rooms (including the bedroom and bathroom) Get some touch control lamps and devices that automatically turn lights on and off at set times Place electrical and phone cords out of the way and along the wall to prevent tripping Other Tasks: A Note to Renters Many of these suggestions are doable even if you don t own the house or apartment where you live. For changes that will require some remodeling or installation work, you may need to seek permission from the property owner. You can indicate those items with a question mark as a reminder. This worksheet is a supplement to the HomeFit Guide. For more information visit Copyright 2015 AARP

4 OLDER ADULT FALLS: A GROWING DANGER The Concern: IN 2014: Every second an older American falls. These falls threaten the health and independence of older adults and result in high medical costs across the U.S. healthcare system. 1in4 older adults reported a fall. More than 7 MILLION of those falls required medical treatment or restricted activity for at least a day. More than 27,000 older adults died as a result of falls that s 74 older adults every day. A Growing Burden: Over 10,000 people in the U.S. turn 65 every day and Americans are living longer than ever. 46M PEOPLE Falls and fall injuries are increasing in the U.S. Annual medical expenses for older adult falls cost over $31 billion, these costs will surge unless preventive measures are adopted. 74M PEOPLE M INJURIES TOTAL OLDER ADULTS 29M FALLS M INJURIES TOTAL OLDER ADULTS 49M FALLS

5 OLDER ADULT FALLS: A GROWING DANGER Who is at Risk? Falls Increase with Age:* While the percent of older adults who fall varies by location and demographics, all older adults are at risk for a fall. Falls Vary by Race and Ethnicity:* 40% 40% 30% 20% 27% 30% 37% 30% 20% 20% 23% 26% 30% 34% 10% 10% Years Old Years Old 85+ Years Old * Percent of older adults who reported a fall Asian/Pacific Islanders Blacks Hispanics Whites American Indian/Alaskan Natives Falls Vary by State: Even in the state with the lowest percentage, 1/5 of older adults reported a fall. Low of 21% in Hawaii High of 34% in Arkansas

6 OLDER ADULT FALLS: A GROWING DANGER What Can Be Done? Falls aren t just a normal part of aging they are preventable. Screening and effective strategies can save lives and money. A Preventable Problem: CDC, healthcare providers, and older adults and their caretakers can work together to reduce these devastating injuries. 1. CDC: Developed the STEADI (Stopping Elderly Accidents, Deaths & Injuries) initiative to help healthcare providers incorporate fall prevention into routine care for older adults. STEADI includes screening tools, educational materials and resources, and online trainings. Worked with healthcare partners and electronic health record (EHR) vendors to integrate the STEADI materials and resources into EHR modules. The modules prompt clinicians to screen for falls risk, review medications, and recommend vitamin D. Continues to track the nation s progress in addressing older adult falls Did You Know? CDC funded health department and health system partnerships to implement STEADI into their primary care practices. For example, in Oregon and New York clinical practices: Before STEADI, clinicians rarely talked to their older adult patients about falls. After STEADI, clinicians screened and assessed 50-65% of their older patients for falls risks.

7 OLDER ADULT FALLS: A GROWING DANGER 2. HEALTHCARE PROVIDERS: Identify patients who are at risk, identify modifiable risk factors, and offer effective fall strategies. Talk to older patients about falls using these three initial steps. 1. Screen for fall risk using these three questions: Have you fallen in the past year? Do you feel unsteady when standing or walking? Do you worry about falling? 2. Review and manage medications linked to falls. 3. Recommend vitamin D for improved bone, muscle, and nerve health. 3. OLDER ADULTS & CAREGIVERS: Reduce the risk of falling and stay independent longer: Speak up. Talk to their doctor about fall risks and prevention. Tell their doctor right away if they have fallen, or if they re afraid they might fall, or if they feel unsteady. Keep moving. Activities that strengthen legs and help balance (like Tai Chi) can help prevent falls. Check their eyes. Have a vision screening once a year and update glasses as needed. Check home safety. Most falls happen at home. Get rid of hazards. Keep floors clutter free. Remove small rugs or tape down or secure them. Add grab bars in the bathroom. Have handrails and lights installed on all staircases. Make sure there is plenty of light. STEADI Material For Older Adults: Stay Independent Brochure: What You Can Do To Prevent Falls Brochure: cdc.gov/steadi/pdf/what_you_can_do_brochure-a.pdf Check for Safety Brochure: cdc.gov/steadi/pdf/check_for_safety_brochure-a.pdf RESOURCES Older Adult Falls webpages: cdc.gov/homeandrecreationalsafety/falls/ adultfalls.html STEADI Patient Materials: cdc.gov/steadi/patient.html STEADI Initiative: cdc.gov/steadi

8 Four things you can do to prevent falls: Stay Independent 1 Begin an exercise program to improve your leg strength & balance 2 Ask your doctor or pharmacist to review your medicines 3 Get annual eye check-ups & update your eyeglasses 4 Make your home safer by: It s not the broken hip, it s the nursing home I don t want. I need to be independent, so I take Tai Chi. Leonard Jones, age 74 People who use canes are brave. They can be more independent and enjoy their lives. Shirley Warner, age 79 n emoving clutter & R tripping hazards n utting railings on all stairs P & adding grab bars in the bathroom n H aving good lighting, especially on stairs Contact your local community or senior center for information on exercise, fall prevention programs, or options for improving home safety. For more information on fall prevention, please visit: This brochure was produced in collaboration with the following organizations: VA Greater Los Angeles Healthcare System, Geriatric Research Education & Clinical Center (GRECC), and the Fall Prevention Center of Excellence Centers for Disease Control and Prevention National Center for Injury Prevention and Control 2015 CS259944D Falls are the main reason why older people lose their independence. Are you at risk?

9 Check Your Risk for Falling Please circle Yes or No for each statement below. Why it matters Yes (2) No (0) I have fallen in the past year. People who have fallen once are likely to fall again. Yes (2) No (0) I use or have been advised to use a cane or walker to get around safely. People who have been advised to use a cane or walker may already be more likely to fall. Yes (1) No (0) Sometimes I feel unsteady when I am walking. Unsteadiness or needing support while walking are signs of poor balance. Yes (1) No (0) I steady myself by holding onto furniture when walking at home. This is also a sign of poor balance. Yes (1) No (0) I am worried about falling. People who are worried about falling are more likely to fall. Yes (1) No (0) I need to push with my hands to stand up from a chair. This is a sign of weak leg muscles, a major reason for falling. Your doctor may suggest: Having other medical tests Changing your medicines Consulting a specialist Seeing a physical therapist Attending a fall prevention program Yes (1) No (0) I have some trouble stepping up onto a curb. This is also a sign of weak leg muscles. Yes (1) No (0) I often have to rush to the toilet. Rushing to the bathroom, especially at night, increases your chance of falling. Yes (1) No (0) I have lost some feeling in my feet. Numbness in your feet can cause stumbles and lead to falls. Yes (1) No (0) I take medicine that sometimes makes me feel light-headed or more tired than usual. Yes (1) No (0) I take medicine to help me sleep or improve my mood. Side effects from medicines can sometimes increase your chance of falling. These medicines can sometimes increase your chance of falling. Yes (1) No (0) I often feel sad or depressed. Symptoms of depression, such as not feeling well or feeling slowed down, are linked to falls. Total Add up the number of points for each yes answer. If you scored 4 points or more, you may be at risk for falling. Discuss this brochure with your doctor. This checklist was developed by the Greater Los Angeles VA Geriatric Research Education Clinical Center and affiliates and is a validated fall risk self-assessment tool (Rubenstein et al. J Safety Res; 2011:42(6) ). Adapted with permission of the authors.

10 Winterize to Prevent Falls Below are five simple steps that YOU can take today to reduce falls among older adults and adults with disabilities in your community Raise awareness Post and share this simple and colorful infographic 6 Steps to Prevent a Fall from the National Council on Aging. Winterize shoes, boots, and assistive devices Attach spikeless ice and snow shoe gripper sole covers to shoes for extra stability when walking on slippery surfaces. Look for these at sporting goods stores. Attach an ice gripper cane tip that has spikes on the bottom to penetrate the ice and secure a firm grip. Ice grip tips can be purchased online. Choose winter shoes with rubber soles to maintain traction on slippery surfaces. Try this inexpensive way to make wheelchair snow tires. Carry kitty litter for slick surfaces Encourage older adults to carry a zip top bag filled with a lightweight kitty litter in their pocket and cast it out ahead of themselves on slick surfaces. Screen older adults for fall risk Health care providers: begin to check ALL older adults with the STEADI fall risk screening tool as part of your normal intake and reevaluation process. Learn more about administering the STEADI screen and using evidence-based falls prevention programs in your community. Give the gift of falls prevention Encourage adult children to give fall-proofing gifts to their parents: Fall alarm systems that are motion triggered without hitting a button Higher toilets in the home Replace multifocal glasses with single vision eyeglass lenses Grab bars in bathroom and next to outside steps or inside thresholds Install firm stair railings on both sides of stairways and set automatic lights over stairways and by outside entrances Cover the entryway to the home and provide a table to set down bags while finding keys Shorter days mean more time in the dark give tiny flashlights to attach to keys, hats, and coat buttons Help make this season a safe, warm, and wonderful one for your patients, family, and community! Source: Mindy Oxman Renfro, PT, PhD, DPT; Chair, American Physical Therapy Association s AGPT Balance & Falls SIG; Lead, Montana's Falls Free Coalition; University of Montana Rural Institute/MonTECH programs.