Fall Prevention


Monday, February 4, 2019 at 12:00:00 am Comments (0)

by Tom Boenning

Today we are going to go over a topic that should be of concern to all individuals reading this blog. We are going to be talking about falls and the things we can do to decrease our risk of injury related to them. It is vital to understand the importance of fall risk management.  When an individual sustains a fall there is a lot of kinetic energy in play that can convert to force in an instant, the circumstances dictate how much force but even a mild fall can have lasting effects. The effects of a fall can be life altering or even potentially fatal. Think for a moment about an elderly person living in a community, this person is able to; attend social functions, visit friends, and even drives themselves to church weekly. This person has an accident and suffers a fall resulting in a fracture. While this individual is recovering they cannot do the things they used to, they are for a time more limited. The major problem comes into play when a person who has suffered such an event cannot get back to the baseline they were previously at. If the individual cannot recover to there baseline then this persons world changes. Changes might be as minor as needing to rehab on a skilled unit for a short period of time or fundamentally changing the care level needs of the individual resulting in a move to a more advanced care setting. When we know what is at stake we know how much emphasis needs to be put on the prevention of fall events. Falls happen due to a variety of reasons and each fall should be evaluated with an eye for the circumstance in play that contributed. Falls can be boiled down to slips, trips, and collapse. A slip would be if you lost your footing due to losing traction, a trip is a result of something physically impeding a individuals gait, and a collapse could be many different reasons from generalized weakness to a specific condition such as Parkinson's. Now that we understand why we need this information we can proceed to detail how each of us can reduce our own risk of falls.

There are a variety of things an individual can do to maximize safety and minimize risk.  Let us begin at the feet, more specifically the shoes you are wearing. Take a good look at them and ask yourself “Do these shoes need a cobbler?”, if the answer is yes then your shoes are likely contributing to your risk of falling. Shoes that are in disrepair or have a worn out sole are hazardous. Additionally shoes that have an open back or that do not fit properly also increase the risk. The absence of a shoe can be an issue.  To walk about in socks or stockings without shoes reduces a person's ability to grip the floor leading to an increased risk for slip type falls.  In the same vein many of us have those “hospital socks”, the ones with the grippy stuff, and are told that they help prevent falls. What can happen with those socks is that the grib will have traction of the floor but that traction does not transfer to the foot. That type of sock is not advisable to use as a primary method of prevention. So regarding footwear you want to make sure your shoes are fit well, are in good repair, have a flat sole, and has a sole made of slip resistant material.  If you are already wearing something that matches that description you are doing your future self a favor. I did mention that falls have many contributing factors and ones shoes are not the be all end all of prevention, another huge risk is environmental. Take a look around; is your space cluttered?, do you have open pathways to all areas of your living space?, is the light sufficient for you to be able to see trip hazards?. Asking yourself these questions before you attempt to transfer and walk around could save yourself complications down the line. Space that is not well lit or is cluttered increases the risk for trip type fall events. If an individual cannot see a potential hazard there is little hope of avoiding it. If a room is cluttered and there is not ample space to maneuver, especially if a assistive device is in use, the process of navigating becomes more time consuming and dangerous. If you ask yourself the questions above you will be given insight into potential hazards you may not have considered. Another leading cause of trip related falls are door mats.  Door mats much like throw rugs increase the risk for falling by being an uneven surface leading to more trip related falls.  Keeping a well maintained and hazard free environment will go along was to prevent tripping. The final type of fall I am going to address is collapses. When an individual collapses the reasoning behind why is not as readily apparent. When you slip or trip you know what happen but if you collapse it can be a mystery. Examples of this type of fall would be if you attempted to stand up but felt dizzy and fell or if your legs gave out.  If this type of thing is happening then you should immediately bring it up with your doctor because there is something going on that must be addressed. There are a couple of things you can do to mitigate this type of fall as well.  Know your limits for starters, it is all to common for an individual be be unaccepting of the physical decline that happens as we age. If you elect to not use the devices that have been recommended for you then you are increasing your chances of falling. It would also be prudent to give yourself time to adjust to new medications to see how you are effected by them. Additionally certain conditions can increase risk, such conditions include; any that result in muscle spasm, osteoporosis, and orthostatic hypotension. The aforementioned conditions are a small sample of things that could commonly increase a person risk but is by no means comprehensive and you should talk to your doctor about any concerns you have regarding how your diagnosis affect your risk.

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