Integrated Senior Serivces, PLLC
Fall Risks And How To Prevent Falls
Is your home a safe enviornment?
As we age, some things in our homes become obstacles. Stairs, pets that do not get out of the way when we walk, dimly lit hallways, bathrooms, and more clutter around the house could all be safety hazards. There are so many small and fairly easy adjustments that could be made in the home environment to greatly reduce the risk for falls.
Approximately one third of the elderly population fall each year (over age 65). This increases to one half for seniors over the age of 80. This is a rough estimate because many falls per year do not ever get reported.
Approximately one half of the elderly population that have been discharged from the hospital for a fall related hip fracture tend to fall again within six months.
Falls are the leading cause of death due to injury among the elderly population.
Usually 20-30% of elderly people fear falling, even if they have had a fall that did not result in injury in the past. They tend to loose confidence and restrict their own activity due to this fear.
How you can minimize your risk for falls?
Clean eye glasses regularly to improve your vision.
Have regular eye check ups. Proper vision helps maintain balance.
Drinking plenty of fluids and staying hydrated can dramatically reduce the risks for falls.
Sit up or stand up slowly, as this will reduce dizziness especially if you take medications for high blood pressure. Dangle your legs over the side of the bed before standing.
Research shows that taking more than four (4) medications daily may increase the risk for falls. Before taking a new medication, ask your PCP or pharmacist to check and see if that particular medication will interact with other medications you are currently taking. Also ask what possible side effects may be caused by that new medication.
Have any medical equipment in your home in good repair. Devices such as walkers and wheelchairs need periodic checks to make sure they are not defected in any way.
Remove loose rugs or non-sturdy furniture from the home.
Concentrate when you move around and walk. Walking and talking can lead to increase incidents of falls. Minimize distractions as much as possible.
Wear proper fitting shoes with low heels and safe rubber type soles.
Use grab bars and handrails in the home. If you do not have these, have someone to install for your safety.
A physical or occupational therapist will be able to do a walk through of the home to identify risks factors and make suggestions to reduce the risk for falls.
Keep outside walk areas clear of clutter, rocks, snow, and ice. Install adequate lighting along walkways leading to the doors of the home.
Secure rugs with nonskid tape as well as carpet edges to reduce risk of tripping and causing a fall.
Have emergency numbers at each phone in the home. Maintain night lights throughout the home.
Install electronic emergency systems if needed; many are monitored by a third party company for increased safety.
Mount a soap dispenser on the shower wall and install and handheld shower head.
Have a shower chair for bathing needs.
Install a raised toilet seat if needed.
Avoid using floor polish or wax; slippery floors will look good but will cause falls.
Wear skid proof socks.
Use television remote controls and phones without cords.
Have a bedside lamp that is easy to turn off and on during the night.
Use a lift chair if unable to get up and down with ease from a regular chair.
Have a firm chair with arms available to sit and dress in the mornings.
If installing handrails in the home, it should be 34 inches high and a diameter of 1.5 inches.
What are some common medical conditions or diagnosis that increase the risk for falls?
Heart Disease/CHF- this can cause dizziness, problems with balance, fatigue and muscle weakness.
CVA/Stroke- Often this results in muscle weakness and sensory imbalances on one side of the body which compromises fluid and safe moving when walking or transferring from one surface to another.
Parkinson's Disease- People tend to walk with a small and shuffled steps with feet close together and they tend to bend forward slightly at the waist. More falls occur as times goes by because this is a progressive disease process. People affected by this disease also have stiff aching muscles and tremors. Movement is very slow in motion and very limited.
Hypotension- This is low blood pressure and is a very common cause of falls due to dizziness and even fainting episodes occur. This may happen more when a person is rising from a sitting or lying down position.
COPD- This is a chronic disease process that is evident by shortness of breath and other symptoms are weakness, dizziness, and fainting. Minimal exertion will cause an increase in shortness of breath and could result in frequent falls.
Diabetes- Neuropathy is a loss of feeling in the fee, which will compromise balance and cause falls.
Arthritis- This loss of joint flexibility could result in unsteady gait/walking and loss of balance.
Vision impairments- Glaucoma, cataracts, macular degeneration are just a few vision diagnosis that can be associated with increase in falls.
Dementia- People diagnosed with this become impulsive, has no safety awareness, and will eventually forget how to walk.
Osteoporosis- This is when the bones become more porous, less resistant to stress thus causing fractures. Causes of this disease process are hormonal changes in the body, lack of calcium and vitamin D, and decrease in physical activity.
What does medications have to do with the risk of falling?
Medications are prescribed to stabilize a medical condition but they can also put a person at a higher risk for falling.
Some drugs have side effects that may make you feel confused or dizzy which will cause a potential for falls.
Two or more drugs a person is taking may interact together that could produce and undesirable side effect.
Not following a doctor's order on how to take a medication may cause complications. Unfortunately, some people forget doses or they may feel it is okay to "double up" on doses they have missed.
What should you do when medications may become a problem?
Keep a dated list of all the mediations you take, prescription and non-prescription ones.
Report any new symptoms to your physician immediately.
Always take the medications as prescribed.
Combine all your prescriptions with only one pharmacy.
Do not drink alcohol while taking your medications.
Remove all out of date medications from the home or medications that are no longer prescribed.
IS A NOT-FOR-PROFIT HOSPICE BETTER FOR THE COMMUNITY THAN A FOR-PROFIT HOSPICE?
Absolutely not because all Medicare certified hospices must adhere to the same guidelines and must continue to undergo the same survey's to assure compliance is maintained with all regulations.
All of the certified hospice companies receive the same exact dollar amount paid for the services rendered also. However, the not-for-profit hospice companies can solicit moneys from the community in order to stay financially stable and viable. A for-profit must maintain their viability 100% from the monies received from the services they provide to their patients. A for-profit company pays taxes thus contributing to your community needs and tax base. A not for profit hospice company does not pay taxes thus they do not contribute to the community tax base.
All Medicare certified hospice companies located in the same geographical area, charge the same rates. The amount charged is strictly determined by Medicare and not by the individual hospice companies.
For-profit must maintain their financial viability solely from the monies received for services provided and manage inefficiencies whereas a not-for-profit company can readily overcome such inefficiencies through asking for the community to contribute dollars needed to keep that company in business.
In the for-profit hospice companies, all patients, regardless of ability to pay, are subsidized...they will get hospice services if they meet the Medicare hospice criteria to come on to services for their end of life care.
So, just because a company may state and push the not-for profit terminology, this is really insignificant in the way care is provided. It would be in your best interest to choose a company, when needed, that has a low patient to nurse ratio and hopefully will respond to your needs quickly; always available to come out in the middle of the night if you need a nurse!