"Help! I Have Fallen and I Can't Get Up..."

How many times have you turned on the TV and a commercial for the "Life Line" comes on and an elderly person states, "I've fallen and I can't get up!".  This popular device is a great idea for people that are older and may tend to fall, however, we can help prevent that risk of falling with physical therapy.  So, we live in Wisconsin, and let's face it...our winters aren't pretty! As we age, it puts us at increased risk for falling.  And if you're elderly or have poor bone density due to unhealthy diet, lack of exercise, and decreased vitamin/mineral intake, you are at risk for fractures (broken bones) when you fall.  Today I am going to discuss falls risk in the older adult.  You may not think this blog post applies to you if you are still young and "unbreakable", however, you will be elderly some day too and need this information.  Take a look and see what your future holds and help inform your relatives of their risk.  The more we plan ahead, the better chances we have for a healthier, longer life and the more we can protect our family members. 

The Facts:

·         1/3 of people over the age of 65 fall each year

o   Leading cause of unintentional injury and death

§  Every 18 seconds an older adult is treated at the ER for a fall

§  Every 35 minutes an older adult dies from a fall-related injury

·         Those who fall once are 2-3x more likely to fall again

·         10-15% of falls results in injury

·         Falls affect quality of life

·         Wisconsin is 2^nd in the nation in fall-related deaths

Risk Factors for Falling:

·         Age

·         Vision

o   Multi-focal lenses

o   Cataracts

·         Medications – Taking 4+ medications significantly increases risk for falls

·         Vitamin D Deficiency

·         Diabetes

o   Neuropathy – Loss of sensation in the extremities

·         Weakness

·         Neurological Impairments

·         Environmental Factors

·         Hypotension – Low blood pressure

·         Improper Footwear

Falls Screening:

·         All older adults aged 65+…

o   Should be asked whether they have fallen in the past year

o   If a fall is reported, they should be screened about the frequency and circumstances of the fall(s) and if injury occurred

o   Should be screened on their balance or walking difficulties

o   Screening should be done annually

General Prevention:

·         Home Modifications

o   Remove loose rugs

o   Reduce clutter

o   Proper hand railings on stairs/showers/toilet

o   Slip proof flooring for bathrooms or shower

o   Proper lighting

General Prevention Cont’d:

·         High tread footwear when outdoors, especially in winter

o   Yak-Trax   - attach to the bottoms of shoes to help grip the ground

·         Cane/Walker Modifications

General Interventions:

·         Specific balance exercises paired with a walking program

·         Strengthening

·         Vision improvement

·         Vitamin D supplementation

o   Reduces risk of falls by more than 20%

***We suggest that if an individual is at a high risk for falls that they be referred to physical therapy due to individual differences – falls prevention programs must be tailored for each individuals’ needs for safety and effectiveness***

What Physical Therapy Can Do For You:

·         Improve overall strength of your muscles in your legs and core to help decrease pain, improve balance, and improve ability to walk, climb stairs, and perform daily activities you may currently be struggling with.

·         Increase your endurance so you can walk further and make it through the grocery store or neighborhood without needing a rest break.

·         Educate you on safety and the risks of falling and injury with common daily activities such as lifting, squatting to sit down, and walking.

·         Help to improve your body’s proprioception (awareness of where your body is in space) to aid in balance during daily activities such as opening a door, walking, or even standing. 

·         Help improve flexibility to decrease strain on the joints of the body with daily activities.

Resources:

·          http://www.fallpreventiontaskforce.org/index.html

·         Dane County Falls Task Force: www.safercommunity.net

·         Wisconsin Falls Initiative: http://dhs.wisconsin.gov/health/InjuryPrevention/FallPrevention

·         Centers for Disease Control and Injury Prevention:  www.cdc.gov/ncipc

·         Shumway-Cook, A., Brauer, S., & Woollacott, M. (2000). Predicting the probability for falls in community-dwelling older adults using the timed up & go test. Physical Therapy, 80(9), 896-903.

·         Shea, Terry. Falls Prevention 2010. PT 636: Motor Control Dysfunction II.

·         Dewane, Judy. Cognition and Its Impact on Motor Control. PT 636: Motor Control Dysfunction II, 2010.