Fall prevention is a huge part of what we do in the physical therapy community.
Every second of every day in the United States an older adult falls, making falls the number one cause of injuries and deaths from injury among older Americans.1
Fall prevention is a top priority in acute care, skilled care, and home health. Many outpatient clinics have a fall prevention emphasis also.
The reason: Falls happen. A lot. And the costs are astounding.
In 2014 alone, older Americans experienced 29 million falls causing seven million injuries and costing an estimated $31 billion in annual Medicare costs.2
Beyond simply being a cost to the healthcare system, falls also frequently result in loss of independence.
Here is how I see it happen frequently in home health:
- An older adult falls and fractures a bone, maybe a wrist, humerus, hip, or ankle.
- After surgery and a brief hospital stay, he or she moves to a skilled facility of some sort. This could be a dedicated rehab facility, skilled care, nursing home, or assisted living.
- In many cases, patients don’t return to their home to live because of the fear of falling again or lack of help at home.
- And once someone assumes official residence in a facility, the chances of living independently again are very minimal.
Can we prevent falls?
The PT community debates if falls can truly be prevented and what specifically can be done to help.
While the total effectiveness of specific exercises and activities are uncertain, we know that strength training, balance activities, and education help in fall prevention.
People with chronic and/or progressive diseases like Parkinson’s, MS, COPD and many others benefit from these activities for certain.
As a home health professional, I prescribe functional exercises most of time.
Squats help build up leg strength for getting out of that oversized recliner. Reaching exercises enable people get things out of the cupboard easier. And ankle pumps, well, they don’t really help! 🙂
Education is key. Practice makes perfect.
The goal of the therapist is always to get patients to a place where they can take ownership of their health and manage their condition as independently as possible.
There is no substitute for working with a patient in person. The ability to guide, correct, and encourage a patient in a balance activity or exercise is one of the quickest paths to building his or her confidence.
These times together are valuable but too short to reach the end goal.
It’s clear patients who want more independence must work on their activities and/or exercises on their own to keep progress headed in the right direction.
I typically provide materials for patients to use as reference for these between session times.
In the past, these materials range from printed sheets of information to stick figure drawings for less technical patients. I am currently exploring the In Hand Health system for those who are tech savvy.
This system puts me in a HIPAA-compliant communication environment (texts, videos, images, and audio clips) with a patient and/or a caregiver.
In Hand Health provides narrated videos that clearly explain the movements of an activity (even things like wound management or preparing an ice pack) or exercise. Patients don’t have to worry about misplacing printed documents. Very helpful!
An Ounce of Fall Prevention
Most home health professionals know the steps to reduce falls. Offering balance exercises and encouraging screenings for eyes and vitamin deficiencies all matter. 3
Caregivers can help by removing trip hazards from homes and installing grab bars in bathrooms and other logical places.
Despite all these efforts, patients will experience falls.
Perhaps with more awareness, we can lower the rate and empower patients to maintain their independence as long as possible.
1 CDC stats on falls: https://www.cdc.gov/media/releases/2016/p0922-older-adult-falls.html
2 CDC STEADI Program with provider and patient resources: https://www.cdc.gov/STEADI/
3 CDC Important Facts About Falls: https://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html