Arcavia

The Home Care Advantage: Prevent Slips, Trips & Falls

Cause of Slips, Trips and Falls

Many things can cause slips, trips, and falls, especially for the elderly. Sometimes it can be from a strain on eyesight, or difficulty hearing, possibly reflexes might not be as sharp as they once were when you were. Certain conditions, such as diabetes, heart disease, or problems with the thyroid, nerves, feet, or blood vessels, can all affect balance and lead to a slip and then fall. Conditions that cause rushed movement to the bathroom, such as incontinence, may also increase the chance of slipping and falling. 3

Older adults with mild cognitive impairment or certain types of dementia are also at higher risk of falling. Age-related loss of muscle mass (known as Sarcopenia), problems with balance and gait, and blood pressure that drops too much when you get up from lying down or sitting (called postural hypotension) are all risk factors for falling. Foot problems that cause pain or discomfort, or unsafe footwear such as those that offer limited support, especially during the winter, can also increase your risk of falling. Some medications can increase a person’s risk of falling because they cause side effects such as dizziness or confusion. The more medications you take, the more likely you are to experience a slip and fall. Safety hazards in the home or community environment that are not addressed, such as lack of railings, can also cause an opportunity for falls.3

Concern with Slips, trips, and Falls

“Falls remain the leading cause of injury-related hospitalizations among Canadian seniors. It is estimated that between 20% and 30% of seniors fall each year. For example, data from the Canadian Community Health Survey – Healthy Aging indicates that 20% of seniors living in the community reported a fall, with a higher prevalence among older seniors, i.e., those over 80 years. Research suggests that falls are the direct cause of 95% of all hip fractures, leading to death in 20% of cases. Falls also appear to be a catalyst for the transition to long-term care.” 2

The key takeaway from the public Health Agency of Canada is that slips and trips, which lead to falls, can also become the precursor to future falls, injuries, hospitalization, and long-term care. In other words, preventing falls is an essential step to staying healthier longer. Reducing fall risks through personalized risk assessments are practical way to address safety and health concerns associated with an increased chance of a tumble.

Complete Risk Assessment

The best approach to fall prevention among older adults should be based on a Multi-Factorial Fall Risk Assessment’ and a subsequent fall prevention management program tailored to an individual’s risk factors and environment. Single interventions have also been shown to be effective, particularly for healthier older adults who have a limited number of risk factors. It is recommended that primary health care providers ask all older adults at least once a year about any falls, the frequency of falling, and any difficulties in gait and balance. 2

“According to the recommendation, any older person who presents with an acute fall (fall with an injury), has difficulty with gait or balance or reports two or more falls in the previous 12 months warrants a comprehensive risk assessment. For those without a reported fall or with a single fall in the previous 12 months, a comprehensive assessment is not required, unless the older adult has difficulties with gait or balance. A comprehensive clinical assessment can determine the risk of falls, identify the risk factors, and assist in identifying the most appropriate tailored interventions.” 2

A comprehensive clinical assessment can determine the future risk of falls, identify the risk factors, and assist in identifying the most appropriate tailored approach to reduce risk. It is recommended that the following components be included in a comprehensive clinical assessment: 1. Medical history, physical examination, cognitive and functional assessment; 2. History of falls; taking multiple medications (particularly psychotropic medications); problems with gait, balance, and mobility; impaired vision; other neurological impairments; reduced muscle strength; problems with heart rate and rhythm; postural hypotension; foot problems and incorrect footwear; environmental hazards. The assessment may be carried out by a single clinician or, alternatively, several clinicians, such as physicians, nurse practitioners, physical therapists, occupational therapists or pharmacists, may complete the components most relevant to their expertise. This process ensures a complete risk assessment is established while addressing all the risk factors when developing the multi-factor Approach. 2

Develop a Successful Multi-factor Approach

Risk factors for seniors often differ according to health and social circumstances, which typically reflect where they live (i.e., in private homes in the community or institutional settings). Recent research highlights the importance of developing a settings-based multi-factor approach. The reasons for falls among community-dwelling seniors are typically different from those of seniors living in institutional settings. In turn, the nature of effective multi-factor approaches differs between community-dwelling and non-community-dwelling seniors. 2 Thus, the findings for multifactorial approaches change from person to person, but the overall factors are presented below:

A good multifactor approach starts with using appropriate assistive devices for those with gait and balance deficits. Clinical expertise can be sought for the appropriate assessment of equipment needs. Appropriate treatment of medical conditions, including visual problems, cardiovascular disorders, and hypotension has been demonstrated to reduce falls. Education of older adults and their care providers is important for the implementation and sustained use of fall prevention strategies. Many effective programs include opportunities for older adults to access fall prevention resources and to take specific action that maintain or improve health or build fall prevention skills. 2

The multi-factor approach should also include modifications of environmental risks identified in the home, evaluation of daily activities, and an ongoing approach to promote their safe performance. Research has demonstrated that regularly scheduled exercise is effective for community-dwelling older people and should be included in their multifactorial approach. Having routine reviews, adjustments, and removal of unnecessary medications under the supervision of a physician or pharmacist may be effective in reducing slips, trips, and falls in all seniors. All vision and hearing concerns should be formally assessed, and any remediable abnormalities should be treated, as part of the multi-factor approach. 2

Tips to Prevent Slips, Trips, and Falls

Preventing Falls starts with preventing slips and trips. The tips below will help to prevent slips and trips which may lead to serious falls and injury. The tips were compiled from a variety of sources.1,2

  • Stay physically active, including balance and strength training exercises
  • Fall-proof home by adding railings, and slip-resistant carpeting
  • Wear shoes with good support and slip-resistant soles appropriate for the area.
  • Remove tripping hazards in walkways, doorways, and stairs.
  • Keep frequently used items in easy-to-reach areas.
  • Utilize handrails when ascending and descending stairs.
  • Utilize carts to transport large items instead of carrying them.
  • Walk in designated paths when available to avoid unstable footing.
  • Ensure adequate lighting is available.
  • Reduce walking pace when approaching corners, intersections, or surface changes.
  • Stay alert when walking and address any new hazards before proceeding.
  • Identify hazards before approaching to prevent a possible injury.
  • When walking on icy or slippery areas:
  1. Wear shoes or boots with soles that provide extra traction.
  2. Use special care when entering and exiting vehicles. Use the vehicle for support.
  3. Walk with feet spread out slightly and toes pointed outward.
  4. Extend arms out to the sides to maintain balance.
  5. Take short steps or shuffle for stability.
  • Keep regular check-ups on hearing and vision, and report any changes to your Doctor
  • Stand up slowly to avoid dizziness and get enough sleep to prevent fatigue
  • Consider Home Care Services to help with socialization, driving, groceries, appointments, walking, exercise, meal plans, and an array of other beneficial services.

The Arcavia Home Care Advantage

Arcavia Home Care works with all types of organizations that serve and cater to our elderly population. This includes hospitals, rehabilitation centers, local clinics, pharmacies, geriatric centers, and a host of other companies, program providers, and service deliverers, to ensure no one is left unserved. We recognize the growing need for elderly immigrant home care and for temporary quality staff support for our partnering facilities. At Arcavia Home Care our primary goal is to extend the quality of life of our patients. We extend the quality of life of every patient by supplying tailored programs that ensure our patients receive the best level of care at the most affordable rates.

To learn more about our programs or to become a partner organization contact us at homecare@arcavia.ca

References

1Yale Environmental Health Study, Safety Guidelines 2019. Slip,Trip, and Fall Prevention. Toronto, Ontario: http://ehs.yale.edu: https://ehs.yale.edu/sites/default/files/files/slip-trip-fall.pdf

2 Government of Canada, Public Health Agency of Canada, 2014. Seniors’ Falls in Canada: Second Report. Toronto, Ontario: www.hc-sc.gc.ca: https://www.canada.ca/content/dam/phac-aspc/migration/phac-aspc/seniors-aines/publications/public/injury-blessure/seniors_falls-chutes_aines/assets/pdf/seniors_falls-chutes_aines-eng.pdf

3 National Insititute on Health, National Institute on Ageing, 2022. Falls and Fractures in Older Adults: Causes and Prevention. Toronto, Ontario: www.nia.nih.gov :

https://www.nia.nih.gov/health/falls-and-fractures-older-adults-causes-and-prevention

4 Harvard Health Publishing, Harvard Medical School, 2016. Preserve Your Muscle Mass. Toronto, Canada: https://www.health.harvard.edu/ : https://www.health.harvard.edu/staying-healthy/preserve-your-muscle-mass

 

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