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National Fall Awareness Month

Updated: Aug 31

You can prevent a fall: Guide to simple things you can do now to prevent a fall and age in place.


#NCOA, #youcanpreventafall, #OT, #bettertogether #fallprevention

Here are some stats for starters. More than 1 in 4 older adults will fall each year. 1 out of 5 falls will result in serious injury and 95% or more of hip fractures are caused by falls. Having a fall will also increase your risk of more falls.


The good news is that there are things you can do to prevent falls!


The following conditions can increase your risk of falling (CDC, 2021). Most falls are caused by a combination of risk factors.

  1. Lower body weakness

  2. Vitamin D deficiency

  3. Difficulty walking or balance

  4. Certain medications

  5. Vision problems

  6. Foot pain or improper footwear

  7. Home hazards (clutter or throw rugs)

By addressing the risk factors above,, you can reduce your chances of falling and sustaining an injury. Click here to take the National Council on Aging (NCOA) Fall Assessment. Knowing your risk factors can help you develop an action plan to reduce your risk.


 

Exercise is King


The many health benefits of exercise are overwhelming for general health, mental health, disease prevention, and fall prevention. Exercises that improve your lower body strength. Weight-bearing exercises can help improve bone strength and reduce your risk of broken bones. Low-impact exercises like walking can build up bone density, and improve strength and endurance (Ansorge, 2020).

It is a good idea to follow up with your primary care physician or physical therapist before starting a new exercise program.


There are several community-based exercise programs that have been proven to reduce falls. Click below to see the NCOA recommended community-based exercise programs.


2022_FPAW_Saving_Lives_Saving_Money_infographic
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Download PDF • 135KB


Check out this chair-raise exercise:

STEADI-Brochure-CheckForSafety-508
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Download PDF • 2.69MB

 


Vitamin D: Can improve muscle function and strength


Vitamin D is an essential vitamin that is necessary for bone and muscle health. Vitamin D also plays a role in keeping us healthy. We can get vitamin D through sunlight, food, and supplements.

Vitamin D deficiency is common as we age. Approximately 35% of adults in the US have a vitamin D deficiency (Cleveland Clinic, 2022). Many factors can increase your risk of having a vitamin D deficiency.

  1. Darker skin (can result in less vitamin D absorbed through the skin)

  2. Obesity

  3. Kidney disease

  4. Certain medications

  5. Chrones disease

  6. Weight loss surgery

  7. Decreased mobility

  8. Lack of time spent in sunlight

Vitamin D deficiency can be easily treated through diet and supplements. The following foods provide vitamin D naturally or are fortified. A general recommendation is that adults 70 years and older get 20 mcg (800 IU) of vitamin D a day (National Institute of Health, 2022). It is important to always check with your physician or healthcare provider to see what is recommended for your specific situation.

  • Fatty fish such as salmon, tuna, mackerel, and sardines

  • Rainbow trout

  • Beef (cow) liver

  • Mushrooms

  • Egg yolks

  • Cod liver oil

  • Cow’s milk and soy, almond and oat milk

  • Breakfast cereals

  • Orange juice

  • Other dairy products, such as yogurt

Although sunlight is a good way to get vitamin D, it is important to be careful about how long you spend in the sun without sunscreen.


 

Taking multiple medications can increase your fall risk


Taking medications with side effects can impact how we think, remember, and how our bodies react (shaky, blood pressure changes, dizziness, double vision, hallucinations...) which can put us at risk for falls. Taking more than 1 medication with side effects can further increase your risk of falls. It is common to see several physicians or healthcare providers as we age. Even with the best healthcare team, it may be that your physician might not know what medications your other physicians have prescribed or what all you are taking. It is important that you talk to your primary care physician or pharmacist to review all of your medications. Check out this resource below from the CDC.


Medication-Fact-Sheet_FINAL_Updated-URLs_508
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Download PDF • 485KB

It is always a good idea to keep an updated list of your medications that you can take to your medical appointments. Check out this medication sheet below.


Medication List
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Download PDF • 43KB

 

Vision: Regular eye check-ups can reduce your fall risk


According to the CDC, there are 12 million adults 40 and older living with a vision impairment. Having impaired vision can double your chances of having a fall. Many medical conditions and medications can also impact our vision. It is important to follow up with your eye doctor every year and talk with them about any concerns you might have regarding your vision. Getting regular eye exams can help reduce the chance of any irreversible vision loss and maintain eye health.

The amount of light we need to see well increases as we age. Having good lighting and even automatic lighting (motion lights) is an easy way to reduce your fall risk. There are occupational therapists who specialize in low vision. There are many ways your house can be adapted if you have low vision or conditions that impact your visual perception. Using contrast is a simple way to accommodate for vision deficits and reduce your fall risk.


Action steps

  1. Get a yearly eye exam

  2. Increase the lighting in your home

  3. Reduce clutter or trip hazards

  4. Use contrasting colors

Check out these pictures of a bathroom. The bottom right is designed using contrast to accommodate for visual deficits. The top left shows how the different patterns makes it harder to distinguish and could cause a fall.
































 

Feet: Taking care of your feet can reduce your fall risk


Our feet play a vital role in how we walk and balance - which directly impacts our fall risk. As we age, the following changes can occur in our feet which can result in increased fall risk

  1. Sensory changes (conditions like diabetes and neuropathy can cause numbness or lack of sensation in the feet/lower legs.)

  2. Foot pain (from arthritis or old injuries)

  3. Foot orthosis (braces in your shoes that might be needed after a stroke or other injury)

  4. Foot deformities (from injuries or chronic conditions)

  5. Limited range of motion (arthritis or old injuries can limit how much the ankle moves)

  6. Decreased ankle strength

  7. Skin or soft tissue changes (conditions like diabetes can cause issues with skin and soft tissue on the feet)

It is important to follow up with a podiatrist if you are having any issues with your feet that impact your ability to walk or balance. If you have diabetes, you might be eligible for diabetic shoes.


The Journal of American Geriatric Society recommends athletic and canvas sneakers to reduce your fall risk. Make sure to look for shoes that:

  1. You can easily get on and off

  2. Fit you well (not too loose or tight)

  3. Have a non-slip sole

  4. Have a lot of contact with the ground (low sole with a wide heel)

Avoid

  1. Walking in socks or barefoot

  2. Shoes with a high or narrow heel

  3. Shoes that don't fit you well

  4. Shoes that you can't tie or fasten


 

Home set up: Easy changes to your home to reduce your fall risk and age in place.


Aging in place is defined as - a person living in the residence of their choice, for as long as they are able, as they age. Most people want to stay in their own homes as they age. As we age our bodies and needs change. Making some changes NOW before you need them can reduce your risk of falling and sustaining an injury. There are simple things you can do NOW that will reduce your risk of falling and help you age place.


I could talk all day about aging in place and setting up your home to meet your needs at all stages of life. Don't worry - I will keep it short and simple for now. Below are some simple things you can do to reduce your fall risk.

  1. Lighting - As we age our pupils get smaller and less light gets in. As we age, we need 6 x as much light as we did in college. Having proper lighting, especially at night is related to reduced fall risk. Consider changing your light bulbs for brighter bulbs. Motion-activated lights are a great option - especially in the garage (where you might have your hands full) or in the bathroom (for nighttime trips). Motion nightlights can also be a big help. Sometimes people don't like to sleep with a nightlight. Motion active nightlights only come on when they sense motion, so they don't disturb sleep.

  2. Assess your throw rugs. If your rugs can be easily moved use nonskid grips to secure them. Some places in the home need rugs to improve safety (in the entryway or outside the shower), however, too many throw rugs throughout the house can pose a fall risk.

  3. Remove clutter and increase pathways.

  4. Add grab bars to the bathroom and nonslip strips or a mat in the shower/tub. The bathroom is the most dangerous place in the house and where most falls happen. Having grab bars installed before you need them can prevent a fall with an injury. There are many new stylish grab bars that do not look medical. There are even products that are classified as functional grab bars. That means the grab bar "functions" as something practical (like a shower shelf) as well as a grab bar.

  5. Add grab bars or hand grips by any steps to enter the house. Going in and out of the house are common places for falls to happen - especially if there is a step to enter or exit your home. Having a grab bar or rail in place is an easy way to reduce your fall risk. This also makes your house easier for other family members and friends to visit.


See below resources from the CDC and NCOA for a home safety checklist and home modification recommendations.


Five-Quick-Easy-Home-Modifications-You-Can-Do-Infographic-v9
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Download PDF • 499KB

STEADI-Brochure-CheckForSafety-508
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Download PDF • 2.69MB

CDC-AdultMobilityTool-9.27 (2)
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Download PDF • 4.76MB


This is your call to action! What can you do NOW to reduce your fall risk?


Accidents do happen and we can't prepare for everything, but most falls are preventable. I challenge you to find at least 2 things you can do now to reduce your fall risk. You can prevent a fall! If you are concerned about falling or if you want to make sure your house is ready to age in place, reach out to your healthcare provider or your occupational/physical therapist for a check-in. St. Louis has an awesome community of professionals to help you age in place and stay strong. See my list of recommended professionals below!

I hope you all have a lovely September and enjoy some cooler weather.


Jenny - your community OT




P.S. See this list of local resources and people I have worked with who can help you with aging in place and/or reduce your fall risk.


Occupational therapy


Forward Function Therapy - owner Arthur Kern. Arthur offers mobile outpatient services in the comfort of your home. (314) 200-5486 https://www.forwardfunctiontherapy.com/


Empowered Homes - owner Gretchen Kingma. Gretchen is an OT, realtor, and certified aging-in-place specialist. She is your go-to if you are thinking about remodeling or selling your house. She can provide home safety and aging-in-place consultations. https://empoweredhomes.com/


Blue Day 2 Designs - owner Tiffany Dill. Tiffany is an OT, designer, and universal design advocate. She will help you create a beautiful space to help you age in place! https://www.blueday2.com/


Your Supportive Place - owner Dr. Jane Bufe. Jane provides mobile outpatient services focusing on home safety and professional organization!

Email: jane@yoursupportiveplace.com

Phone: (314) 200-2610 Fax: (314) 353-9030


Toilet Talk - owner Maria Lindberg. Maria specialized in all things toileting. She is your go-to stop for information in the bathroom. You can purchase beautiful quality grab bars that will make your bathroom look like a spa while being safe. https://toilettalk.me/



Physical therapy


House Fit - owner Dr. Beth Templin. House Fit has a spectacular office in south county where they offer individual therapy and small groups. House Fit offers innovative small group classes to keep you strong. They also offer special classes where they teach safe falling techniques and fall recovery. House Fit also offers mobile outpatient visits that bring therapy to your home. https://www.housefitstl.com/ (314) 939-1377


Mobile-PT - owner Brad Abrams. Mobile - PT offers mobile in-home PT services. Mobile-PT covers the greater St. Louis area and brings quality PT services to the comfort of your home. https://www.mobile-pt.com/ Phone: (314) 690-9995


Spine Rehab at Home - owner Kyle Winters. Spine Rehab at Home offers mobile outpatient services in the comfort of your home. They serve the greater St. Louis.

https://www.spinerehabathome.com/ (314) 626-3161


Handyman services


The Grab Bar Guy - https://www.grabbarguysstl.net/ I LOVE that the Grab Bar Guys offer free home safety assessments. They can do simple grab bar installation to ramps and everything in between. It never hurts to get a free home safety assessment and see what you can do to make your home safer.


Mr. Fix It - Click here Mr. Fix It is a local handyman service. What I LOVE about Mr. Fix It, is that they offer home warranty programs that are affordable and helpful. If you purchase a home warranty program you will get quarterly home maintenance services that include everything from cleaning your vents, changing light bulbs, and changing the batteries in your smoke detectors, to heating and air service. It is nice to have someone in the house 4 x a year check in on things.



References

Ansorge, R. (2020). Best exercises for osteoporosis. https://www.webmd.com/osteoporosis/guide/osteoporosis-exercise


Centers for Disease Prevention and Control (2021). Older adult fall prevention. https://www.cdc.gov/falls/index.html


Cleveland Clinic (2022). Vitamin D deficiency. https://my.clevelandclinic.org/health/diseases/15050-vitamin-d-vitamin-d-deficiency


National Institute of Health (2022). Vitamin D: Fact sheet for health professions. https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/



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