Preventing falls among elderly

Alan Ong (Occupational Therapist)

Nurul Atiqah (Physiotherapist)

Senthilkumar (Occupational Therapist)

Contents

• What is falls?

• Consequences of falls

• Risk factors of falls

• Health professionals involved in fall prevention

• Home modification

• Recovery from fall

Falls

Defining falls in elderly:-

• Some part of the person comes to rest on the ground

• Unexpected and unintentional event

• Falls that happen due to medical conditions

About 10%-17% of those aged 65 and older have had

falls

Falls

• Approximately 10% of the falls result in serious injuries, such as hip fractures, blood clot, serious cuts and even death.

• Falls among the elderly leaves 30-73% with a fear of falls.

• Accidental falls are the most common, accounting for 25-40% of all falls. Usually caused by environmental hazards.

(Lim, 2010)

• Cost of hip replacement surgery: $6000-$9000 (ward B & C).

(Ministry Of Health Singapore, 2014)

By 2030, 2/10 people in

Singapore will be above 65, another 2/10 above 55.

Consequences of falls

• Fractures

• Dislocation

• Fear of fall

• Loss of confidence to do things independently

• Increased risk of repeated falls

• Activity limitation

• Head injury

Risk factors of falls

1. Socio-demographic

2. Position

3. Impaired functions

4. Psychological

5. Medical

6. Medication

7. Environment

8. Personal

Risk factors of falls

1. Socio-demographic

Increased in age History of falls Female

Living alone

Risk factors of falls

2. Position

-Reduced balance

In standing

During bending/reaching forward

For sit to stand/shifting between places

Risk factors of falls

3. Impaired functions

Poor eyesight

Poor hearing

Pain, giddiness, dizziness

Reduced sensation, strength, reaction time

Risk factors of falls

4. Psychological

-Increased fear of falls

-Risk taking behaviour

Risk factors of falls

5. Medical:

6. Medication:

Side effects

Parkinson’s disease Stroke Diabetes

Dementia

Risk factors of falls

7. Environment

Pets Dim lighting Trailing wires Height of

furniture

Small kids

Risk factors of falls

7. Environment

Clutter Slippery

Too high

Loose rugs

Risk factors of falls

8. Personal:

Slipper Lack of exercise Alcohol

ill-fitting clothes Poor nutrition Compliance

Now let’s take a look at

the various professions

involved in fall prevention

Doctor Nurse Physiotherapist Occupational Therapist

Optometrist

Assessment

Education

Medication

Vision

Exercises

Assistive device training

Home safety

Healthcare professionals involved in fall

prevention

Role of PT and OT

• 46% of SPD HQ DRC clients are at risk of falls

Role of Physiotherapist Role of Occupational

Therapist

Walking speed Home modification

Negotiating on different

surfaces

Energy conservation

Muscle strength Lifestyle redesign

Balance Activities of daily living tasks

Walking aids Cognition/visual perception

Endurance

What is Home Modification?

• Conversion/adaption of environment

Make performing tasks easier

Reduce Accidents

Support independent living

Accidental falls are the most

common, accounting for 25-

40% of all falls. Usually caused

by environmental hazards.

Most common areas for falls

• Falls usually occurred at home as compared to outdoors

• At home, most common area of falls 1. Living room (348 cases)

2. Bedroom (271 cases)

3. Toilet (211 cases)

(The Straits Times , 2012)

How to modify the home to make it safer?

• Living room:

-Place wires along wall

-Tape wires

-Well lit areas

-No clutter

-Avoid low seat

Cordless phone

How to modify the home to make it safer?

• Bedroom:

Urinal bottle -Able to reach lamp switch

-Bed of correct height

Commode

How to modify the home to make it safer?

• Bedroom:

Wireless door bell -Walking aid close

to bed

Night light

How to modify the home to make it safer?

• Toilet:

Non-slip mats/tiles -Grab bars

-Sitting toilet

How to modify the home to make it safer?

• Toilet:

Dry floor Folding door

How to modify the home to make it safer?

• Toilet:

Shower Chair Glow in the dark sticker

How to modify the home to make it safer?

• Kitchen:

Clean up spillage -Turn handles in

-Low glare -Do not stand on

stools

-Place items

within reach

How to modify the home to make it safer?

• General:

Reflective tape on

curbs/step of toilet

Slip resistant backing

How to modify the home to make it safer?

• Stairs:

-Well lit stairs

-No clutter

-No socks/slippers

-Contrasted edges

of stairs

Spot the hazards

Spot the hazards

What to do when a fall occurs?

Step 1: Do not panic!

Step 2: Do not try to stand up and walk immediately

Step 3: To stay there and move your hands and legs slowly

Step 4: Call for help if in severe pain or difficulty with movement

What to do when a fall occurs?

• Video

iNO Mobile

Programmes and Services

• Rehabilitation • Employment and Care Services • Vocational Training and

Technology Services • Psycho-Social Rehabilitation • Early intervention support for

children

Rehabilitation

SPD Rehabilitation Centre

- Adult and paediatric rehabilitation

- Physiotherapy, occupational and speech therapy

- Home assessment and caregiver training

SPD Therapy Hub

- Provides professional therapy services for clients of other VWOs

Therapy@Home

- Provides therapy services at homes of clients who have difficulty leaving their homes

° Contact Details

Headquarters (map on left)

SPD Ability Centre

2 Peng Nguan Street

Singapore 168955

Tel: 6579 0700

Website

www.spd.org.sg

E-mail

information@spd.org.sg

Satellite Centre

SPD@Tampines

Blk 866, Tampines St 83

#01-237

Singapore 520866

Tel: 6587 7611

° Thank You

References

• Lim, S. C. (2010). Elderly Fallers: What Do We Need To Do? Proceedings of Singapore Healthcare, 19(2), 154-158.

• Ministry Of Health Singapore. (2014, January 30). Ministry of Health. Retrieved February 7, 2014, from Costs and Financing: http://www.moh.gov.sg/content/moh_web/home/costs_and_financing/HospitalBillSize/hip_replacement_surgery.html

• The Straits Times . (2012, August 21). Elderly hurt in falls: The Home Danger.