General

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Falls prevention General health and medication
Working together to prevent falls
Education program developed by Boroondara
Primary Care Partnership This is a detailed
education program. There are four sessions, each
developed to run for 2 ½ hours, to groups of up
to 20 people. Sessions are conducted by
multi-disciplinary staff and target seniors (and
their families/carers) who have a moderate to
high risk of falls. Sessions include 1)
general health and medication 2) home
safety and public safety 3) exercise and
fitness, and feet and footwear and 4) vision
and healthy diet. The manual includes a program
outline, sample letters, handouts (although it
has also been designed for discipline specific
handouts to be provided by the various
disciplines presenting), evaluation forms and a
participant falls risk check list. The program
also includes discipline specific PowerPoint
presentations. (Downloadable) ---???????????---
In 2005 the Department of Human Services funded
the National Ageing Research Institute to review
and recommend a set of falls prevention resources
for general use. The materials used as the basis
for this generic resource were developed by
Boroondara Primary Care Partnership under a
Service Agreement with the Department of Human
Services. This and other falls prevention
resources are available from the departments
Aged Care website at http//www.health.vic.gov.au
/agedcare.
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FALLS PREVENTIONGENERAL HEALTH AND MEDICATION

• By
• General Practitioner

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Why so important?

• Falls are common
• Falls can have significant consequences
• broken bones hips/arms
• painful bruising
• head injuries
• time in hospital
• loss of confidence
• loss of independence

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• MOST FALLS CAN BE PREVENTED!!

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To walk safely we need

• Physical wellness
• balance
• healthy feet (includes sensation)
• healthy joints especially hips knees
• muscle strength and flexibility
• good vision
• good hearing
• adequate nutrition

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To walk safely we need

• A friendly environment
• even surfaces
• non-slip areas especially kitchen bathroom
• adequate lighting
• properly installed rails
• good footwear

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We also need to

• Be confident
• Be familiar with our route
• TAKE CARE!

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Things that contribute to falls

• Previous falls
• A new illness (flu, urinary tract infection etc)
• Funny turns, fainting, dizzy spells, vertigo
• Arthritis
• Neurological conditions
• Parkinsons disease
• epilepsy
• mini strokes, strokes

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Things that contribute to falls

• Depression or dementia
• Bladder problems (urgency, incontinence, etc)
• Impaired vision (esp. overnight when reduced
  perception of contrasts)
• Glare
• Impaired hearing
• Foot problems
• Leg weakness, lack of fitness flexibility

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Things that contribute to falls

• Low or high blood pressure
• Heart problems (fast/slow/irregular pulse)
• Medications
• a high number in combination
• act to lower blood pressure or cause sedation,
  confusion, impaired balance and reaction times

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Things that contribute to falls

• Medications
• for blood pressure
• fluid tablets
• heart tablets fibrillation or angina
• sleeping tablets
• valium-like tablets
• sedatives tranquillisers
• antidepressants

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Things that contribute to falls

• Medications (contd)
• tablets for Parkinsons disease
• tablets for bladder problems
• tablets for migraine
• phenergan-like tablets
• tablets for epilepsy
• pain-relievers
• some diabetic tablets

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Things that contribute to falls

• Alcohol use
• Shoes
• poor fit/ slippery-soled/ slippers/ thongs
• Inactive lifestyle
• Hurrying!
• Things around the house
• rugs
• wet or slippery floors
• inadequate lighting

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Strategies for improving safety

• See your doctor
• especially funny turns
• blood pressure and heart checks
• health assessment
• medication review
• bring all tablets, vitamins, herbal treatments,
  creams
• simplify regimen
• discard expired or unnecessary items

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Strategies for improving safety

• medication review (contd)
• clarify doses
• ask about possible side-effects
• clarify what the medication is for
• is there an alternative to another tablet?
• ensure lowest dose for maximum benefit
• stopping sleeping tablets can cut falls risk by
  2/3
• discuss your fear of falling with your doctor

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Strategies for improving safety

• Have an eye check at least every 12 months
• cataract and refractive errors the commonest
  visual impairment
• advice on the right glasses (take extra care
  with bifocals on stairs) advice on reducing
  glare
• Contact Vision Australia
• visual contrast aids, night lights, glare
  control
• Consult an audiologist for advice on hearing aids

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Strategies for improving safety

• Invest in sensible, comfortable footwear
• Wear shoes indoors
• See a podiatrist at least every 6-8 weeks
• nails
• corns, bunions, areas of rubbing or redness
• fit of shoes
• orthotics other products

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Strategies for improving safety

• Ask for help
• family, friends, neighbours
• Lobby for safer public areas
• floors footpaths
• overhanging trees
• steps
• public transport

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Strategies for improving safety

• Exercise more!
• getting started
• getting involved in activities outside the home
• a weekly walk
• build up gradually aim for at least 30 minutes
• most days of the week
• small bouts can be additive
• running errands, doing odd jobs, walking the dog,
  getting
• the paper

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Exercise - The facts

• Why exercise?
• increases muscle strength
• increases joint stability
• increases bone density (especially weights)
• improves balance/decreases postural sway
• REDUCES FALLS!

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Exercise - The facts

• Why exercise?
• increased energy levels
• sounder sleep
• maintaining old and making new friends
• more positive balanced outlook
• better concentration
• improved self-confidence and independence
• improved posture
• improved digestion bowel movement

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Exercise - The facts

• Why exercise?
• decreases tendency for
• diabetes
• high blood pressure
• high cholesterol
• heart disease
• bowel cancer
• anxiety depression

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Exercise - The facts

• What exercise?
• walk with a friend
• home exercise program
• exercise with a group
• stretching class
• tai chi
• hydrotherapy/ swimming/ water aerobics
• join a gym
• cycling
• tennis
• dancing eg. tap dancing, line dancing

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• EXERCISE SHOULD BE ENJOYABLE SUSTAINABLE!!

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Strategies for improving safety

• For information on exercise contact
• local senior citizens club
• local leisure centre
• local community health centre
• Council on the Ageing 9654 4443

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Strategies for improving safety

• Maintain healthy bones
• adequate calcium
• well-balanced diet
• no smoking
• minimal alcohol
• regular exercise

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Strategies for improving safety

• Maintain healthy bones (contd)
• adequate sunlight exposure
• ? calcium vitamin D supplements
• drugs that prevent further bone loss after a
  fracture

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Diet - The facts

• Well balanced
• Regular meals
• Fruit and vegetables daily
• More fish, less meat
• Adequate fluids 6-8 cups/day

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Diet - The facts

• Adequate calcium 3-4 serves/day
• milk, cheese, yoghurt (low-fat)
• fortified cereals or calcium-rich soy
• canned fish (plus bones!)
• ? calcium supplement eg. caltrate

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Need help?

• Home safety assessments (occupational therapist)
• Home or hospital-based walking assessments
  (physiotherapist)
• Home exercise program
• Walking aids

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Need help?

• Community programs/community health
  centre/community therapy services
• physical therapy or rehabilitation
• works on improving
• mobility
• balance and co-ordination
• muscle strength
• advice on getting up off the floor

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Need help?

• Ask your doctor to arrange a referral
• Ring your local community health centre

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Local community health centre/s

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Acknowledgement

• In 2005 the Department of Human Services funded
  the National Ageing Research Institute to review
  and recommend a set of falls prevention resources
  for general use. The materials used as the basis
  for this generic resource were developed by the
  Boroondara Primary Care Partnership under a
  Service Agreement with the Department of Human
  Services. This and other falls prevention
  resources are available from the departments
  Aged Care website at http//www.health.vic.gov.au
  /agedcare.
• Special thanks to the specific organisations
  involved in the development of the original
  product Inner East Community Health Service,
  Inner East Division of General Practice, Elgin
  Street Centre, City of Boroondara, Vision
  Australia, St Georges Health Service.