This month is April Falls – a time when we raise awareness about the impact of falls and share best practice fall prevention strategies. The theme for 2023 is, “Better Balance for Fall Prevention”.

Falls have a physical, emotional and financial impact on the person and their family. Falls can be costly for Federal and State governments, through acute care bed use, surgery, nursing and Allied Health care demands. Falls also contribute significantly to the increased need for residential care, if the person has lost their independence and cannot return home.

Falls prevention and management goals

The immediate and most powerful goal is to not fall. It’s well known that poor balance and strength will affect a person’s mobility and put them at an increased risk of a fall.

Staying active in later years is a great way of improving balance and strength and it doesn’t need to be complicated or expensive. One of the most effective and positive activities to stay physically healthy and reduce your risk of falling is walking.

It is also important to carefully plan and consider any changes you may need to make at home, to ensure a positive and safe living experience. Changes to the home set up, furnishings or routines around the home can all play an important part. You can find Pearl Home Care’s “7 tips to keep the home safe and accessible as we age” here.

Setting realistic and achievable goals for falls prevention and management may also include:

• Being able to get up safely following a fall.
• Being able to gain assistance when needed.

 

Falls prevention and management plans

Your Pearl carer, doctor or other health professional can work with you to develop a simple plan specific to your needs that will:

• Assist you to prevent falls.
• Identify various supports available.
• Arm you with the knowledge of how to get up and receive assistance if you do fall.

The plan will be developed from the information gathered during a Falls Risk Screening and Assessment. In this assessment, the assessor will discuss some of your health and social circumstances with you. It is important you are very honest and open with the information you provide, to ensure you receive the best available support to achieve a full, happy and healthy lifestyle.

The assessor will need to know:

• Whether you have had a previous fall.
• Any medications you are currently taking.
• Your current and previous health status.
• Your mental fitness.
• Details about your home, yard and places you frequently visit.

 

Risk factors for falls and actions you can take

Often falls are unpreventable accidents. However, most falls can be avoided. We recommend you be mindful of your individual circumstances and make changes as needed and/or seek assistance or guidance from your health professional or Pearl carer.

Some factors contributing to falls are outlined below, including some actions you can take to avoid them.

Condition/Risk factor	Description	Actions you can take
Chronic Conditions	Various chronic conditions can make you feel unwell, influence your balance and at times divert your concentration from your surroundings and mobility, thereby contributing to a high risk for falling.	Talk to your health professional and ensure your medication and other supports are suited to your condition and updated as required.
Dizziness	Can occur for various reasons, such as heart disease, diabetes, dementia, stroke, or low blood pressure. Some conditions be associated with a low blood pressure when standing quickly and can lead to dizziness.	Avoid sudden movements as this can increase the balance problems. Talk to your doctor regarding any possible treatments.
Poor Vision	As we age, our vision may decrease and eye or vision problems, such as cataracts, glaucoma, age related macular degeneration, diabetic eye disease, dry eye, and low vision, can develop. These conditions can result in you not seeing objects or uneven surfaces, which can contribute to a fall.	Ensure your assessments are up to date with your optometrist and you are utilising vision aids provided to you.
Muscle weakness or paralysis	As we age, our muscles begin to lose their tone and begin to weaken. This can contribute to becoming ‘off balance’ and falling. Paralysis, or the inability to move 1 or more limbs will restrict your ability to gain balance when needed and increase your risk of falling.	Speak to your health care professional about programs and exercises you can implement to maintain your muscle tone and fitness.
Heat and Dehydration	A sign of dehydration is dizziness and becoming unbalanced.	Drink the recommended amount of water each day: men – 3 litres per day. women – 2 litres per day. If you suffer from kidney or heart problems, be sure to follow the advice of your doctor or health professional. During hot weather conditions, wear cool, loose clothing.
Ageing factors: stiff joints, decreased concentration or confusion	As we age, our joints tend to stiffen and restricts our ability to move freely and quickly. This increases the possibility of falling. In addition, your ability to maintain good concentration can deteriorate and some people may also be confused at times. A reduced awareness of surroundings can increase your chances of tripping.	Avoid sudden movements. Walk and stand slowly. If you feel there is an alteration in your concentration, your doctor may be able to assist with treatment or support.
Medications	Some medications can have side-effects, which can affect your balance or how clearly you think and concentrate. As we have mentioned previously these factors can contribute to a fall.	Avoid sudden movements. Use walking supports. Talk to your doctor about how you are feeling on your medications. Your doctor may be able to prescribe an alternative medication without these side effects. Your pharmacist will be able to help you with a home medication review.
Slower reaction time	As we age, our mind and muscle reaction times tend to slow down. This means the messages are being passed to the muscles asking them to move or stand, however it is taking a longer time to pass the messages and for your brain to understand the messages. This can contribute to falling as the message to hold onto a piece of furniture or avoid the hole in the pathway may take longer.	Avoid rushing. Keep your furniture in familiar places. Keep hallways and rooms clear from obstruction. Talk to a health professional such as an occupational therapist for further advice.
Uneven surfaces such as foot paths or stone walkways	A break in the surface or unseen hole can result in a fall and possible injury.	Develop a habit to observe the surface of footpaths and other walking surfaces. Use mobility aids such as walking sticks or other supports. Try to avoid walking in poorly lit areas. Talk to a health professional, such as an occupational therapist for further advice.
Stairs, kerb and guttering, sloping surfaces	It can often be difficult to see singular or small sets of stairs, kerbs or a sloping surface. Being unaware of a sudden drop, such as a single stair or kerb, can result in a sudden jolt on your limbs and body and result in a fall.	Try to only walk in areas that have good lighting. Use a support such as a walking stick or handrail or seek support from your family or carer if they are with you. Talk to a health professional such as an occupational therapist for further advice.
Loose gravel or stone	A loose surface can be unpredictable and may have unseen holes, be slippery or difficult to grip with some footwear. Loose surfaces should be avoided, if possible.	If you cannot avoid this area, use caution, walk slowly and use mobility aid, such as a walking stick if possible. Try to walk only in areas with good lighting and talk to a health professional such as an occupational therapist for further advice.
Slippery surfaces	Slippery surfaces are hazards for people of all ages, however as we age our ability to ‘grip’ a slippery surface becomes more challenging.	Avoid slippery areas as much as possible. Try to only walk in areas that have good lighting and use a support such as a walking stick or handrail or seek support from your family or carer if they are with you. Talk to a health professional such as an occupational therapist for further advice.
Over reaching or stretching for item	Many people will stretch to reach an item or hang something high. This can result in overbalancing and falling. An example of this would be hanging Christmas decorations.	Avoid overstretching. Ask for assistance to reach an item or have someone move items so they are more accessible, whenever needed. Talk to a health professional such as an occupational therapist for further advice, as they will be able to recommend assistance aids.
Foot wear	As we age, our feet also change in shape and size. Feet become wider and longer, due to weakening of ligaments. There may be an increase in swelling of your feet and ankles. These changes, along with possible balance problems, arthritis, poor circulation and chronic illnesses, like diabetes, can contribute to falling.	Wear well-fitting low shoes, with non-slip soles and good grip, to avoid falling. Talk to a podiatrist, physiotherapist or occupational therapist for further advice.
Small animals or trip hazards	Items such as small animals, foot stools, magazines, cleaning equipment etc can become trip hazards, as they are often difficult to see. Small animals move quickly and can often not been seen.	Keep your furniture in familiar places. Keep hallways and rooms clear from obstruction. Train pets to avoid being close to your feet and creating a trip hazard.
Anxiety and rushing	When we rush or are feeling anxious, we may not see things that can be a trip hazard, which can contribute to slipping or a fall.	Stop and take a few seconds to slow down and look at the area you need to walk. If you are feeling anxious often, talk to your doctor who will be able to assist you with overcoming this anxiety.
Inadequate support structures such as hand rails or walking sticks /frames	Hand rails, walking sticks, walking frames and other mobility supports are essential for many people to move safely. Poorly sized or inappropriate aids can contribute to falling or tripping over.	All mobility aids should be prescribed and sized by a health professional such as an occupational therapist.
Alcohol	Alcohol consumption can alter your perception, balance and movement. All of this can contribute to mobility issues and injuries.	Avoid or minimise alcohol intake.

 

If you need assistance with Falls Prevention and want to discuss how you or a loved one can live with dignity at home for longer, Contact your local Pearl Home Care office