Fall Risk Screening and Prevention
Part 3: How do we stop falls from happening?
Once we have identified individuals who are at risk for future falls, we need to implement an
intervention to stop falls from happening. All the current evidence indicates that the best defense against falls is a multidisciplinary team approach. This means that multiple healthcare providers and community members will likely need to be involved. It is not surprising, as we saw above how many different factors can contribute to fall risk, that we need a variety of different providers to help prevent falls. Here are some of the recommended interventions to prevent falls.
Physical Therapy: If you have been determined to be at risk for falls (and other serious problems such as cardiovascular disease have been ruled out) you should participate in physical therapy. Your physical therapist will be able to perform a detailed evaluation (as discussed above) and develop a customized exercise program to help address any strength, balance, or proprioception deficits that are contributing to your fall risk. They can help you progress to independence with an exercise program that they’ll recommend you continue, even after physical therapy.
Address Incontinence: Incontinence should not be considered a normal part of the aging process. While you may have to use the restroom more frequently, you should not suffer in silence if you are having trouble with leaking or control of your bowel and bladder. See your doctor and discuss it if you are suffering from incontinence; it may seem like an embarrassing topic to bring up, but your doctor or physical therapist discuss these kinds of things every day, and will know how to help you. Your doctor can refer you to a pelvic floor physical therapist, such as Claire Shores, PT, DPT at Paradigm’s South Valley Clinic (learn more about Claire and the South Valley Clinic here—include link) to improve your control over your bowel and bladder. When you are hurrying to rush to the restroom, your risk of falls increases, so make sure not to leave incontinence unaddressed.
Regular Exercise: The importance of a regular exercise program cannot be overemphasized. As we age, it is more important than ever to make regular exercise part of our routine to maintain our strength and cardiovascular endurance. It is tempting to decrease our exercise and activity level as we age, and it is true that you need an exercise routine that is appropriate for you if you are struggling with pain problems, osteoarthritis, etc., but regular exercise is more important now than ever before! It is crucial to work with a physical therapist, occupational therapist, or athletic trainer once you have been cleared to exercise by your physician to develop a program that is right for you. You will need to include not only cardiovascular exercise, such as walking, running, bicycling, and swimming, in your program, but also a regular resistance training program to build muscle strength.
Healthy Diet: A healthy diet is also an important component of decreasing your risk for falls. You will need to work with your physician, and a dietician or nutritionist if needed, to ensure that you are getting the appropriate nutrients to stay healthy and help you build muscle.
Community Programs: There are many community programs available that are free or low cost at community centers and senior centers, and some are even specifically targeted at fall prevention. Not only is this a wonderful opportunity to get out of the house and meet new people, but exercising with a group often improves compliance with an exercise program. You are more likely to stick with group exercise than to go the gym or do an exercise program at home by yourself. Grab a friend and find out what is available in your community! Transitioning to a community exercise class can also be a great way to keep up the momentum and keep exercising after you are discharged from physical therapy!
Regular follow-up with doctor/optometrist, etc.: As Erin pointed out in the previous post, falls are not always just a result of weak muscles and poor balance. The health of your cardiovascular system (heart and lungs), the number of medications you take and what type of medications you take, and how well you can see can also contribute to your fall risk. Make sure you continue to follow up with other healthcare providers as needed to address any other factors contributing to your risk of falls.
Home safety modifications: Your environment, both inside and outside the home, can also contribute to your fall risk. If you have a number of slippery throw rugs, you don’t have hand rails near your stairs or your banister is about to come off the wall, or you have a lot of clutter in your home, you likely need to make some modifications to make your home safer. Work with your insurance company, your family, and an occupational or physical therapist that can visit you in your home to modify it as needed to improve your safety.
Good footwear: Flip flops, high heels, slip on shoes, or shoes that are too big or too small can greatly increase your risk for falling. Talk with your physical therapist, athletic trainer, or local shoe salesman to ensure that you choose appropriate shoes that fit well and won’t cause you to slip or trip.