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Falls Prevention
Falls Prevention
Senior physiotherapist
Jan Benfold
Senior Occupational Therapist
Excluded:
- major internal event e.g. stroke
- being hit by an external force e.g. knocked over
Falls statistics
Approx one third of people >65 fall each year
Approx half of people >80 fall each year
Approx 9% of older people who fall will become too afraid
to leave their homes due to fear of falling again
Every year >223,000 people aged over 60 have a fracture as
a result of a fall. This is more than the whole population of
Northampton.
Falls in people aged over 60 account for a cost of
£2billion a year
10% of hip-fracture patients will die within 1 month of
their fracture and 30% will die within the first year
Risk factors for falls
Medical Psychological
Polypharmacy
Reduced motivation/ depression
Postural hypotension
Memory problems/ confusion e.g.
Medical conditions e.g. PD
Poor hydration dementia
Anaemia
Physical Environmental
Reduced balance Unsafe walking aids
Walking problems Inappropriate footwear
Reduced muscle strength in legs
and arms Home hazards- lighting, dogs,
Poor vision loose mats, grandchildren, wires,
Poor hearing hosepipes
Loss of sensation in feet Transfers- bath, stairs, bed, chair
Psychological
Effects of falls
Loss of confidence
Loss of motivation
Isolation/loneliness
Depression/anxiety
Fear of further falls
Physical
(Hip) fractures
Pain
Bruising
Head injury Quality of life
Hypothermia
Infection
Other MSK injuries
Functional
Loss of independence/increased dependence
- impact on social care costs
Reduced mobility/activity
- impact on quality of life
Negative circle
Falls prevention
8 tips to Staying Steady:
1.Exercise
Tailored exercise programmes can reduce falls by 54%
2.Check your eyes and hearing
3.Look after your feet
4.Ask about you medicines
5.Get enough vitamin D
6.Eat a diet rich in calcium
7.Check for home hazards
8.Visit your GP/local falls service
MDT roles and falls
Physio:
Assess and treat physical problems e.g.
- balance
- strengthening
- increasing movement
- exercise tolerance/ stamina
Supply aids to help improve safety of mobility
OT:
Look to return patient back to full function, by working on the following
aspects:
- physical
- emotional
- social
Look into safety aspects within the home environment
Lifestyle changes
Nurse:
Look at medical issues associated with falls:
- Obs- BPs etc
- BMs
- Skin checks
- Continence
- Medication checks
RSWs:
Glue in team
Follow physio/Ot treatment plans
Complete nursing obs
Trained in specialist falls groups- chair based, OTAGO
Deliver equipment to patient's homes
Named key workers for individual patients
Feedback info to therapists and nurses
Falls service- AV
Runs weekly on Mondays or Fridays
7 week duration
10.30- 15.00
Full multidisciplinary assessment (Physio, OT, Nurse) with outcome measures:
- Berg, TUAG, FES, Number of falls
Structure group therapy:
- Chair based exercise class
- OT therapy group
- Balance circuit exercises
- Tai chi style exercises, Wii rehab or relaxation
- Educational talks and group discussions (diet, home safety, getting up of the
floor, correct foot ware, medication, benefits of exercise)
Week 7:
- retested for outcome measures
- ongoing rehab (e.g. OTAGO) arranged
Ideally telephone follow up in 6 months
Linked in services
Hearing support services GP
Sight support Orthotics
Day centres e.g. the Glebe Nurses
Strictly no falling Dr Skelly (PD consultant)
Walking groups Dietician
Active Derbyshire- village games Health trainers
Be Active Care coordinators
Waistwise Neuro outpatients- Ripley
Age UK
Future homescapes- alarms,
adaptations
Medequip
Practical
Can you walk on a “tight rope”?
Can you stand on one leg for 10seconds with your eyes
shut
Can you walk backwards on your tiptoes
Time to exercise
Tai chi