- There is a high incidence of falls after hospital discharge, particularly among patients who are functionally dependent. Major fall risk factors at discharge include: decline in mobility, use of assistive devices and cognitive impairment/confusion.
- Patients who were functionally dependent and needed professional help after discharge had the highest rate of falls.
- Hospitalization in older adults, including those who are admitted for medical problems, rehabilitation and acute care, has been shown to be associated with decline in function and mobility – creating a higher risk of slip and fall accidents.
- The period after discharge has been shown to be associated with high risk of falls, social problems and medication errors, with up to 30% of older people experiencing an adverse event following hospital discharge.
- 45% of older people fall in the period following discharge.
- One study examining the incidence of falls in older, recently hospitalized medical patients requiring post-discharge home care, found that falls were substantially increased during the first month after hospital discharge.
- Research has shown that fall prevention home safety assessment and home safety modification intervention immediately following discharge critically reduces the risk of falls once at home.
- A full clinical assessment of function as it relates to how individuals are navigating their environment doing daily tasks (restroom, shower, walking through the home). Installation of safety grab bars, commode risers, shower chairs, ramps and rails are just a few of the modifications which can be made that will reduce fall risk.
- Typically, upon discharge, families and are overwhelmed and often don’t know where to turn for resources (you can bring in MB home safety here if you’d like). Coming home following discharge is a critical time, where patients are often in a weakened, tired and cognitively impaired state. Family members rush to “get something in”. Just having a “safety grab bar” won’t do the trick, where your bar is placed and clinical attention to the placement of any modification is imperative in not risking further injury.
We’ve all read about things we can do to avoid unnecessary slip and fall accidents in our home, but how closely have you looked at specifics. Here are a few things you can do in your home, you may not have thought of, addressed or knew would assist you in being falls free in and around your home:
- Ensure exterior pathways are free of holes, loose stones/bricks, uneven pavement, debris or other slipping hazards.
- All entrances are clutter free.
- Handrails are present on both sides of all steps and stairways both inside and outside the home.
- Kitchen cabinets are easily accessible, with frequently used items placed on lower shelves.
- Uncarpeted steps feature a non-slip surface such as adhesive strips.
- Electrical and phone cords are placed out of the way, along the wall.
- Hallway lighting is easily accessible.
- Safety grab bars are present at shower entry and interior of shower as needed.
- Bathroom rugs should be rubber, based, non-slip. Bathroom floors, tubs and shower surfaces are treated with non-slip product to ensure increased COF (Coefficient of Friction), when surfaces are wet – critically reducing fall risk – Note: The Bathroom is the number one place for falls in the home).
- Access to telephones both landline and/or mobile in or near multiple rooms, including the bathroom.
- Furniture should be arranged to allow for easy, obstacle free passage.
- Do doorways safely accommodate walkers, wheelchairs and/or transport chairs?
If you or a loved one is uncertain about falls risk factors in your home, schedule a free home safety assessment today, performed by a MEASURAbilities Home Safety Physical Therapist, who will provide clinically guided solutions for you in your environment.
We often worry about our aging parents’ safety, well-being and even fiscal health, and many adult children find themselves in the sometimes-awkward position of having to bring up these sensitive conversations with aging parents.
Among these concerns, fall prevention may be the hardest to bring up – especially if your parents have chosen to retain their independence by aging in place. Many older adults experience a certain amount of denial about their physical capabilities, which makes it hard to ring up sensitive issues like fall prevention.
Keep reading for some simple ways to broach the conversation with your parents.
Find Support in Family and Friends
This is a tough conversation but a necessary one. Ask your loved one if they are concerned about falling or have taken any spills. Many older adults recognize that falling is a risk but believe it won’t happen to them – even if they’ve already fallen in the past.
If they’re concerned about dizziness, environmental concerns, medications, foot issues or balance, suggest that they talk to a health care provider who can assess their risk and recommend services that can help.
Discuss Current Health Conditions
Are your loved ones experiencing challenges managing their own health? Having problems or concerns about medication management? Forgetting to take their medications?
Things that were once easily doable tasks are now more challenging for them. Make them aware that Medicare offers preventative benefits which they can take advantage of – such as the Annual Wellness visit. Encourage them to speak openly with their health care provider about all their concerns.
Ask About Their Last Vision Exam
If your elderly family member or friend wears glasses, make sure their prescription is current. Many are not aware that using lenses where the tinting changes can cause problems when going from bright sunlight into darkened areas.
Changing glasses upon entry or exit is often helpful to allow time for their lenses to adjust. Those dealing with low vision issues should consult their eye doctor.
Observe Behaviors of Holding onto Walls, Chairs, Tables, etc. for Ambulating Their Environment
These are all signs there might be balance or other related issues which a trained physical therapist could diagnose. Through physical therapy, increased balance, strength and conditioning and reduce fall risk.
Additionally, the physical therapist may recommend walking and/or assistive devices to help keep them safe when transferring sit to stand or being mobile in their home and outside environments.
Have a Conversation About Medications
If your older loved one is having a hard time keeping track of medicines or is experiencing side effects, encourage them to have a conversation with their doctor or pharmacist. Suggest that they have their medications reviewed each time they get a new prescription.
My mom had an elaborate spreadsheet to keep track of her medications and schedules. Adding a timed medication dispenser that my sister refilled each month promoted her peace of mind and allowed us to ensure her adherence to the prescribed regime.
Also, beware of non-prescription medications that contain sleep aids—including painkillers with “PM” in their names. These can lead to balance issues and dizziness. If your older loved one is having sleeping problems, encourage them to talk to their doctor or pharmacist about safer alternatives.
Do A Walk-Through Safety Assessment of Their Home
There are many simple and inexpensive ways to make a home safer. For professional assistance, consult MEASURAbilities Home Safety. Our physical therapist provides free home safety assessments and customized, clinically guided recommendations and installations.
The Risks of Returning to Work Early Following an Injury
The potential effects of early return-to-work without appropriate physical restrictions can be devastating.
All too often, I hear stories of individuals being released back to work following an injury or illness before they are ready. Frequently, these people are victims of systematic pressure, i.e., someone is trying to control claims costs at the expense of their health.
Many times, the individual is released prematurely or inappropriately due to a doctor’s unfamiliarity with the return-to-work form or the physician just doesn’t have the time or resources to test function and fill the form out correctly.
This potentially puts the individual in harm’s way – especially if the appropriate physical work restrictions aren’t in place. Not all employers offer “modified or light duty” assignments that allow employees to come back to work while they heal and gradually progress back to full duty.
Without the appropriate work restrictions in place when an employee returns to work, they may be required to perform work tasks that put them at risk of re-injury or re-aggravation of their condition.
No one wins in this scenario. The employer is at risk of losing their valuable employee and the individual is at risk of developing a chronic condition.
Workplace interventions for preventing needless work disability start with an accurate understanding of what an individual’s true functional abilities are, and one of the most reliable ways to determine a person’s true functional capacity for return to work is through objective functional testing.