Falls Prevention presentation
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Transcript Falls Prevention presentation
Sara Taylor
Senior physiotherapist
Jan Benfold
Senior Occupational Therapist
Babington Specialist Falls Cilinc
September 2014
Contents
• Introduction to falls and statistics
• Discussing risk factors for falls
• Effects of falls
• Discussion of falls prevention (tips to staying steady)
• Outline of falls service for Amber Valley
• Practical session on balance
• Questions and open discussion to finish
Introduction to falls
World Health Organisation defines a fall as:
“An event which results in a person coming to rest
inadvertently on the ground or floor or other
lower level”.
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
Polypharmacy
Postural hypotension
Medical conditions e.g. PD
Poor hydration
Anaemia
Psychological
Reduced motivation/ depression
Memory problems/ confusion e.g.
dementia
Physical
Reduced balance
Walking problems
Reduced muscle strength in legs
and arms
Poor vision
Poor hearing
Loss of sensation in feet
Environmental
Unsafe walking aids
Inappropriate footwear
Home hazards- lighting, dogs,
loose mats, grandchildren, wires,
hosepipes
Transfers- bath, stairs, bed, chair
Effects of falls
Psychological
Loss of confidence
Loss of motivation
Isolation/loneliness
Depression/anxiety
Fear of further falls
Physical
(Hip) fractures
Pain
Bruising
Head injury
Hypothermia
Infection
Other MSK injuries
Functional
Loss of independence/increased dependence
- impact on social care costs
Reduced mobility/activity
- impact on quality of life
Quality of life
Negative circle
Risk
factor(s) for
falls
Depression,
reduced
motivation
Reduced
activity e.g.
socialising
Fall
Loss of
confidence
What can we do?
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
Chair based exercises
Spot the hazards
Did you miss anything?
Falls hazards:
Stairs without handrail
Loose extension cords in traffic
areas
Outdated medications in
cabinet
Open bottles of medicine
Loose rugs
Clutter on staircase
Flip-flop slippers
No handle and no deadbolt on
door.
Other hazards:
Deactivated fire alarm
Overloaded outlets
Cloth on space heater
Smoking. Cigarettes left
unattended
No automatic shut-off on coffee
maker
Newspapers too close to lamp
Thank you for listening!
Any questions?
References
C. Todd and D. Skelton (2004) What Are the Main Risk Factors for Falls amongst
Older People and What Are the Most Effective Interventions to Prevent These Falls?
Copenhagen, WHO Regional Office for Europe (Health Evidence Network report.
Available at: www.euro.who.int/document/E82552.pdf
Age UK http://www.ageuk.org.uk/professional-resources-home/services-andpractice/health-and-wellbeing/falls-awareness-week-18-22-june-2012/
Spotlight Report 2008 (2008) Help the Aged
Age UK and Department of Health calculation combined health and social care
based on 2010 Department of Health and Personal Social Services Research Unit
figures (unpublished) and 2011 census
Age UK and Department of Health calculation combined health and social care
based on 2010 Department of Health and Personal Social Services Research Unit
figures (unpublished)
J. Roche et al. (2009) ‘Effect of Comorbidities and Postoperative Complications on
Mortality after Hip Fracture in Elderly People: Prospective observational cohort
study’, British Medical Journal, 331 (7529): 1374
http://www.who.int/mediacentre/factsheets/fs344/en/
http://www.phac-aspc.gc.ca/seniors-aines/index-eng.php