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Falls Prevention

Date:

Presenter:

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Land Acknowledgement

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THE INJURY PREVENTION CENTRE (IPC)

Aims to change beliefs, attitudes, and behaviours so that Albertans can live, work, and play free from life-changing injuries.

Shares knowledge, data, evidence, and best practices for injury prevention with our partners and Albertans.

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Provides information and resources on falls prevention.

Aims to help adults live an active and independent lifestyle.

Finding Balance is a program that is coordinated by the Injury Prevention Centre (IPC). The main objectives are.

To provide older adults and practitioners with the latest information and resources.
Aim to help older adults live an active and independent lifestyle.
We engage in partnerships with seniors’ groups, health care organizations and practitioners across Alberta.

Over the years, the Finding Balance program has delivered a wide variety of falls prevention strategies and developed resources that have been shared with older adults, their families and practitioners to help prevent falls.

For this whole presentation, please ensure that older adults check with their healthcare practitioner.

Always refer to your workplace specific policies and procedures.

Finding Balance Website: Finding Balance

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Learning Objectives

Participants will:

Recognize risk factors that can lead to a fall.
Identify interventions that help prevent falls.
Become familiar with falls prevention resources that can be shared.

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1 in 3 �older Albertans �fall each year.

Falls are the leading cause of injuries among older adults.

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Fall Facts for Older Adults

(Injury Prevention Centre. Fall Facts infographic 2021. Edmonton, AB: Injury Prevention Centre; 2021.)

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Fall Facts for Older Adults

(Injury Prevention Centre. Fall Facts infographic 2021. Edmonton, AB: Injury Prevention Centre; 2021.)

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Could a fall change your lifestyle?

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After a fall, people may…

Lose confidence
Be afraid they might fall again
Stop going out and doing things they enjoy
Not be able to live the way they want to

Even if a person is not hurt, there may be consequences to a fall. Falls can change a person’s routine and their lifestyle. After a fall, some people may lose their confidence in their ability to get out and about. They might become afraid they’ll fall again and stop doing things like meeting with friends, volunteering, working, or spending time with family. They may become weak, isolated, depressed, stop exercising or eating well, experience less independence, and live in fear of falling again.

A fear of falling may lead to a decrease in physical activity, which in turn leads to muscle weakness and poor balance, and poorer self-reported health. There is also the belief that by staying home or limiting their activities, they won’t fall. However, this is not accurate. Research supports that moving and being physically active helps people stay independent and allows them to connect with others.

When adults have been asked, remaining independent and not being a burden on others are important motivators for them.

For some, to overcome the fear of falling, may require gentle encouragement from multiple people or from a trusted person they know, including discussing the benefits of moving.

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Risk Factors

No two people fall the same way and people fall for a variety of reasons. 70% of falls do not have a single cause. Falls can be complex, being caused by more than one thing. Risk factors interact and can influence each other. The more risk factors present, the higher the risk of falling. However, not everyone who is at risk of falling will fall.

Risk factors may include balance and leg strength, environment, vision, medication, nutrition, hydration, any chronic health conditions, footwear and foot care, cognitive changes, depression, and dizziness. Risk factors are specific to a person, their environment, and their health.

Some risk factors can be changed. For example, footwear, eliminating clutter, and eating balanced meals.

Some risk factors cannot be changed. For example, age, some medical conditions, and medications. We need to learn how to prevent falls in spite of these risk factors.

Cognitive impairment can affect a person’s attention and concentration when they move. They may have more impulsive or risk-taking behaviours that can increase their risk of falling. Memory issues can result in people not remembering to use their cane or walker. Cognitive impairment can also affect coordination, balance, and depth perception.

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Are you at risk

of falling?

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If you’ve had a fall, we want to help you to NOT fall again.

This image shows the Falls Self-Risk Assessment resource questionnaire available from the Finding Balance website. This is a validated, self-rated questionnaire that is a useful tool to utilize in your practice. You can encourage older adults to use this tool to assess the risk of falling and understand action steps to reduce risks. Some questions on this assessment tool cover risk factors that people might not realize increase their risk of falling.

Once a possible area is identified, they can help take action to reduce their chance of falling. The first 2 questions are weighted more because they are more indicative of a fall but all of these are predictors. These 2 questions are “have you fallen in the last 6 months?” and “Do you use, or have you been advised to use, a cane or walker to get around safely?”

There is also an online version of this tool on the Finding Balance website.

SHOW: Falls Risk Self-Assessment Checklist brochure. Poster with just the questions is available on the FB website. Falls Risk Assessment

Or direct them to the ONLINE assessment quiz on the website.

This resource also includes action items they can take that can help lower their risk of falling.

For example, if they answer yes to the second question “Do you use, or have you been advised to use, a cane or walker to get around safely?” the step would be to talk with a physiotherapist to get the best walking aid for their needs and to ensure that any mobility aid they are using is the correct height and in good condition.

Another example is “do you take medication that sometimes makes you feel lightheaded or more tired than usual?” The step they would take would be to talk with their doctor or pharmacist about medication side effects of causes of lightheadedness. Dizziness or lightheadedness can be caused by many different things,including some medications, anxiety, depression, low blood sugar, problems with vision, inner ear problems, postural hypotension and dehydration.

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Quality of Life

There are many things you can do to help prevent falls. Think of older adults who have fallen or may be at risk of falling. How are they doing and what can you assist them with? Maybe they need a ride to get groceries, or help getting dressed or being transported to meals. Ensuring safety is key. If something doesn’t feel right or you see a change in an older adult, consider talking with your team or supervisor about it.

Part of quality of life is finding people's motivation and helping them to maintain independence. This could be encouraging them to make choices that will help them look, feel, and move better, or do the daily activities they enjoy.

Take into consideration any barriers that may prevent the older adult from being active or making changes that could reduce the risk of falling.

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Medication

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True or False:

When you are talking to your pharmacist or doctor about your medications, you should

mention taking over-the-counter items like supplements and cough syrup.

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True or False:

When you are talking to your pharmacist or doctor about your medications, you should

mention taking over-the-counter items like supplements and cough syrup.

True!

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Medications include:

Prescriptions
Supplements
Over-the-counter medications
Vitamins

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Medication may increase the risk of falling if it makes people:

sleepy, dizzy, weak or confused.

go to the washroom more often.

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Review your medications

with a doctor or pharmacist.

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Medication

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Always follow the instructions and doses.
Keep a current medication list in your wallet and in their home.
Do Not share prescription medications.
Tell your healthcare provider about any new symptoms such as dizziness, blurred or double vision.

Medication

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Drinking Guidelines for Older Adults 2023

“When it comes to drinking alcohol: Less is better.” CCSA

As you age, your body becomes more sensitive to alcohol. Your age, your body weight, and other health conditions will impact how you respond to alcohol.

Drinking alcohol has negative consequences.

If you’re worried about a person’s drinking, connect them with a healthcare provider.

Alcohol can cause you to fall due to:

○ Impaired gait, coordination and balance and a slower reaction time, loss of muscle strength

○ Reduced vision and hearing

○ Reduced cognitive function, increased confusion and forgetfulness

○ Drowsiness and unsteadiness (especially when combined with medications)

○ Negatively impacting other health conditions such as high blood pressure, Osteoporosis, Diabetes, Congestive heart failure, Cancer (at least seven types), Stroke, Liver problems, Malnutrition and Mental illness and brain damage.

The Canadian Centre on Substance Use and Addiction (CCSA) in 2023 recommends that people consider reducing their alcohol use.

According to the Center for Disease Control and Prevention from the US, Falls are considered a short-term health risk from excessive drinking.

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Alcohol & Health

Source: Canada’s Guidance on Alcohol and Health - Low-Risk Drinking Guidelines https://www.ccsa.ca/canadas-guidance-alcohol-and-health

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Q. For how many minutes each week should older adults (65+) be active?

a) 60 minutes

b) 120 minutes

c) 150 minutes

d) 180 minutes

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Q. For how many minutes each week should older adults (65+) be active?

a) 60 minutes

b) 120 minutes

c) 150 minutes

d) 180 minutes

A: c) 150 minutes

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Everyday Exercises Posters

The Everyday Exercise Poster for Older Adults is a great tool for older adults just getting started or are looking to improve their strength and balance.

It is one of Finding Balance’s most downloaded and ordered resources. It is available in French and has recently been adapted to include counter tops and arms on the chair for more support.

SHOW: Everyday Exercises for Older Adults Poster

Everyday Exercise for Older Adults Poster - ADAPTED

Use the song, My Bonnie Lies over the ocean, to demonstrate Heel Raises - If they are able to stand safely, with hands hovering over the table or a stable chair, have the older adults raise up their heels onto their toes when singing a word that starts with the letter “B”, then lower back down on the next “B” word. Do one verse and the chorus.

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https://www.youtube.com/watch?v=AZ5p47arB1I&t=2s

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The Band Exercise Booklet, created in partnership with Alberta Blue Cross and reviewed by physiotherapists, is another great resource for adults to do at home or in a class.

The booklet explains how to use using a resistance band can help to build strength and prevent falls.

The bands, sometimes called resistance, exercise, loop bands, can be purchased locally or online and are available with different resistance. Bands need to be best suited for the people and their abilities.

Unfortunately, the colours of bands vary between companies so a green band itself may offer less or more resistance depending on where it was purchased.

It is important to remind people to start slowly and work their way through the movements safely.

The booklet has recently been reviewed and updated and can be ordered online from the website.

SHOW: Band Exercise for Older Adults Booklet

SHOW: Theraband and Band Booklet

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How many minutes per week should older adults (+65) be active for?

60 minutes
120 minutes
150 minutes
180 minutes

Answer c) 150 minutes

Improves mood and concentration.
Reduces stress and anxiety.
Improves sleep quality.
Keeps lungs, heart, muscles and bones strong.
Stay at a healthy weight and have a good appetite.
Keeps bowels healthy.
Reduces the risk of other health conditions.
Improves balance.

Benefits of being active:

Reduces the risk of falling.

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Vision

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Did you know?

1 in 9 Canadians will develop irreversible vision loss by age 65.

1 in 4 Canadians develop irreversible vision loss by age 75.

The National Coalition for Vision Health. 2011. Vision Loss in Canada 2011

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Many eye diseases have no early signs or symptoms.

.

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Find an

optometrist nearby.

Alberta Health coverage is available towards the annual eye exam for Albertans 65 years and older.

Get your eyes checked every year!

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Home and Community

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In the Bathroom:

Add a rubber, non-slip bath mat inside and outside the tub and shower.
Install grab bars near the tub, shower, and toilet.
Clean up water. Make sure floors are dry.
Keep a night light on in the bathroom.

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Use railings and walk slowly up and down stairs.
Have at least one railing the entire length of the stairs.
Keep stairs free of clutter.

Steady on the Stairs

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Create a trip-free home

Remove throw rugs or use non-slip mats.
Keep pathways clear. Remove clutter from floor and stairs.
Increase lighting. Use nightlights or motion sensors in the bathroom and hallways.
Keep your phone and items you use often within reach.

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Remove trip hazards

Move furniture so you can reach all light switches and lamps.
Ensure furniture is stable. Repair or replace broken furniture.
Run electrical cords along walls and behind furniture.
Use mobility aids correctly.

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Nutrition and Hydration

Healthy eating can:

» Give you the energy you need to do the things you enjoy.

» Prevent muscle and bone loss to reduce the risk of falling or breaking bones.

» Prevent, lower the risk, or

slow chronic diseases

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Nutrition and Hydration

Hydration promotes balance and reduces falls. Sip water throughout the day to stay hydrated.

Use the “Healthy Plate” from Canada’s food guide: Include protein food with every meal.

Eat plenty of fruits and vegetables.

Choose whole grains options.

Drink plenty of fluids – 6 – 8 cups per day.

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Footwear & Foot Care

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Feet that are healthy and

pain-free can help people keep their balance.

Wear supportive, non-slip footwear inside and outside.

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Heel cup is deep with a snug collar to provide support and prevent heel slipping

Laces or Velcro® closure allows a snug fit and room for swelling

Toe box is deep and wide

enough to allow toes to move

Shoe length is no more than 7 mm (1/4") longer than your longest toe

Sole provides good grip but does not stick to carpet

Heel is wide and flat to provide better side stability

Heel should be no more than 10 mm (3/8") higher than the toe

For better stability, the thickness of the midsole should not be thicker

than 25 mm (1")

The Proper Shoe resource is an information sheet available from the Finding Balance website. It illustrates things that may be easy to fix with a person’s footwear but which are sometimes overlooked.

Is the heel too high. Does the shoe fit properly? Does the shoe allow room for the feet to swell up?

Check grip on winter boots to see if a new pair is needed.

Crocs are an excellent example of what not to wear. They have no support, no back strap and they allow the foot to move around within the shoe. If possible, avoid crocs, flop flops, high heels or floppy slippers with heel or that have no heel support. Pressure stockings and bare feet on certain flooring can also be hazardous.

Instead choose a shoe that has:

A deep, snug heel collar
A heel is wide and flat
Laces or velcro that allow for a snug fit and room for swelling
Soles that provide good grip

Encourage older adults to speak to their healthcare provider or doctor if they feel pain or notice any changes in their feet.

SHOW: Ideal Shoe Info Sheet

SHOW: Shoe with good sole, velcro, no heel; Supportive slipper

SHOW: Footwear and Foot Care Tips for Seniors Information Sheet

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Tips for Winter

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Tips for Winter

Make sure footwear for winter has:

the proper amount of grip, try ice grips over footwear.
soles that stay flexible in the cold.
a wide, flat heel.

When possible, avoid walking on snow and ice.
Put a retractable ice pick on the end of a cane.
Carry a small bag or container of sand to sprinkle on icy spots that can’t be avoided.
Keep hands free for gripping handrails or supports.

In a survey conducted by the Public Health Agency of Canada, walking on snow or ice was cited as the second most frequent activity where people fall. . Take your time and avoid rushing

Winter footwear should have the proper amount of grip. Winter grips with spikes or coils can be added to footwear to assist with this.

One difficulty with them is that they are harder to put on and take off if a person's grip strength is limited. The winter grips cannot be worn inside.

If an older adult walks with a cane, a retractable ice pick can be used on the end for added stability.

Remember the Sunlight and snow can be challenging during winter months:

The sun can shine directly into your eyes and reflect off the snow making the light too bright and harsh.
Snow may make things appear to vibrate, or not be as clear or sharp.
In bright or low light, it can be hard to see if the ground may be icy, slippery or a sloped surface. Loose snow can also hide the condition of the surface.
Dim light in the evenings and night can make it harder to see all of your surroundings.
Snow can also affect hearing because it might muffle sounds like approaching vehicles.
Be sure to wear sunglasses all year.

SHOW: Bag of sand; Cane tip; grips for footwear.

SHOW: Video - Winter walking on IPC Youtube

SHARE and SHOW: Winter Walking

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How to Get Up from the Floor

In previous slides ways to avoid a fall were covered. It is also important to educate people on the proper technique to get up from a fall if they have not injured themselves. If you witness a person fall at your workplace, please refer specifically to your employer’s requirements.

You can also encourage people to:

PREPARE for when they do fall, PLAN what to do, and PRACTICE How to Get up from the Floor safely if they fall.

The How to Get Up from the Floor resource found on the Finding Balance website provides illustrated steps for getting up from a fall safely and is available in 15 languages. (English, French, Traditional Chinese, Simplified Chinese, Cree - Plains (dialect Y), Korean, Polish, Punjabi, Russian, Serbian Croatian, Spanish, Tagalog, Urdu, and Vietnamese). Hindi, nepali, arabic

Arabic, English, French, Traditional Chinese, Simplified Chinese, Cree - Plains (dialect Y), Hindi, Korean, Nepali, Polish, Punjabi, Russian, Serbian Croatian, Spanish, Tagalog, Urdu, and Vietnamese).

The How to Get Up from the Floor resource is a popular and most used resources. It is one more tool to educate yourself, older adults, clients, friends or family on how to get back on your feet after a fall.

A short video on How to Get Up from the floor video is on the IPC Youtube channel or accessed through the Finding Balance website.

SHOW: How to Get up from the Floor Information Sheet or How to Get Up - NEW

Ask for a volunteer, if appropriate, to demonstrate this as presenter describes the steps.

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Alberta’s Elders

In partnership with the Kee Tas Kee Now Tribal Council

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Resistance Band Exercise Booklet

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Resources to order from the Finding Balance website: findingbalancealberta.ca/resource-catalogue

Keeping Well for Older Adults - Booklet

Could a fall change your lifestyle - Brochure

Everyday Exercises for Older Adults - Poster

Are you at risk of falling? Self-assessment checklist - Brochure

Band Exercises for Older Adults - Booklet

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Name one change

you will make

to lower your

risk of falling.

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QUESTIONS?

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Thank you for attending!

Visit findingbalancealberta.ca

for more information

and to order FREE resources!

Email:

info@findingbalancealberta.ca

Phone:

780-492-6019