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The 5 Stops to Fall Prevention in the older adult

One of the largest barriers for an older adult to age at home is fall risk. As adult children, we understand that falls can be the major difference between our parents living a happy, active life and being very limited in what they can and cannot do. The concern is backed by astounding statistics. According to the Journal of Geriatric Orthopaedic Surgery & Rehabilitation, it has been estimated that the mortality rate after a hip fracture is as high as 58% in the first year following the hip fracture. The mortality risk decreases significantly following the first 2 years, but does not return to prior levels.

These startling statistics bring to mind the importance of making sure our aging parents avoid falls at all costs. Unfortunately, falls in the older adult have come to be accepted as a normal part of the aging process. It is no wonder considering that the vast majority of falls occur in adults over the age of 65. However, it does not have to be this way.

On the road of aging, there are several stops along the way where specific actions can be taken

1. According to the National Osteoporosis Foundation, menopause is a significant factor in increasing the risk for osteoporosis and therefore, risk of falls and fractures. Naturally, as women reach the age of menopause, it is important for them to speak with their physician to begin early management of the aging process. To prevent osteoporosis, your physician will likely recommend a healthy diet, regular strength training, and perhaps medication.

2. As one gets older, strength training can become more difficult making fall risk more likely. Being that spinal loading will be the most important aspect to increasing and maintaining bone strength, one must consider the factors that can prevent us from safely strength training such as chronic pain and cardiovascular diseases. It is at this stop that it is time to speak with your primary care physician about beginning physical therapy. A Doctor of Physical Therapy (DPT). Your DPT will not only be able to address your chronic pain, but will also monitor comorbidities to make sure that you can improve your strength and balance in a safe and efficient manner. This can be done in an outpatient clinic where you will have access to several resistance training tools.

3. Continuing the road of fall prevention, the older adult who has done outpatient physical therapy is not immune to accidents. As fall risk increases, initial action needs to be in home modification to reduce the risk factors in one’s home. As a home health physical therapist, it is part of my job to evaluate the environment in which a patient lives to ensure that their home is accessible and as safe as possible. Some modifications I commonly recommend include:

  1. Carpet removal
  2. Grab bars
  3. Walk-in shower
  4. Night lights
  5. General neatness

This coupled with consistent in-home therapy helps make sure that the older adult can continue to live safely in their home and avoid accidents that can have serious consequences.

4. Once it is apparent that the older adult can no longer safely perform daily chores and it has become to much of a burden for the family, it is time to hire a caregiver. Caregivers can reduce the risk of falling by taking over tasks that are too difficult to perform for the older adult. This includes things like laundry, light cleaning, bathing, and errands that require driving. How many hours might they need? A base number of hours to start with is 4 hours/day for 3-4 days/week. This will be enough to take care of the difficult tasks without being financially overwhelming. Often times, family members can divvy up the costs and ultimately save money by preventing the repercussions of a serious fall.

5. The final stop of Fall prevention further expands the role of home health services for the older adult. A home health company can provide a live-in caregiver, home physical and occupational therapy, as well as nursing services as needed. A live-in caregiver will provide close supervision in all activities as a backstop to fall prevention. The home health aide can also be in close contact with the DPT in order to ensure that the home exercises the patient is receiving continually reinforced.

With the proper resources and coordination of care under a primary care physician, falls can be prevented and do not have to be a normal part of aging. We hope that this information has been useful to you. If you are in need of our services, please feel free to contact us. We would be happy to help.