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Coastal Palliative Care

Supportive care, Palliative care and Hospice services for Coastal

 

Staying fall-free can help you to stay independent and avoid the need to be admitted to hospital or enter a long-term care facility.

Falls usually happen due to the combined effects of factors that may be prevented -the more risk factors a person has, the greater their chances of falling.

Why Falls Occur

Falls occur due to a loss of balance and an inability to recover balance.
The complex set of conditions and circumstances that lead to this loss of balance are known as fall-related risk factors.

The factors that contribute to a loss of balance are represented by the following:

  • Biological  factors- include those pertaining to the human body and are related to the natural aging process, as well as the effects of chronic, acute or palliative health conditions.
    Biological risk factors include advanced age, decreased mobility and balance, muscle weakness, visual impairment, acute or chronic illness and disability (i.e. cognitive impairment, stroke, arthritis).
    Some conditions cannot be changed, such as gender or age, while others may be prevented or compensated for, such as muscle weakness or poor vision.
  • Behavioural factors – include actions, emotions or choices of the individual.
    Behavioural risk factors include history of falls, fear of falling, poor nutrition and/or hydration, lack of physical activity, inappropriate footwear and clothing, and taking multiple medications, particularly psychoactive medications like tranquilizers or antidepressants.
Do you take medicine that makes you feel light-headed or more tired than usual?
Do you take medicine to help you sleep or to improve your mood?
Do you take fluid tablets or blood pressure pills?
Do you take four or more medications?
Do you get dizzy when you stand up or walk?
Do you have problems understanding your medications?
Do you drink more than two glasses of alcohol per day?

 

 If you have difficulties with any of the above it is important to discuss them with a health care professional.

 

  • Environmental factors – Studies have shown that on average, 50 to 60 percent of falls occur within the home.
    Environmental factors include home hazards, such as clutter, lack of stair railings, loose rugs or other tripping hazards, lack of grab bars in the bathroom, and poor lighting, especially on stairs.
Do you use or have been advised to use a cane or walker to get around safely?
Do you steady yourself by holding onto furniture when walking at home?
Do you need to push with your hands to stand up from a chair or toilet?
Do you have trouble stepping up onto a curb?
Do you have weak legs, pain or stiffness in the joints?
Are you already having falls or near misses?
Do you become unsteady when you turn around?
Is it difficult or are you unable to get up from the floor?

If you have answered yes to any of the above statements, it is important to discuss these with a health care professional.

Suggestions

  • When getting up, especially from bed, sit on the edge of the bed for a few moments to allow your body to adapt. Getting up too quickly can cause your blood pressure to drop rapidly, which may put you at a higher risk for a fall.
  • Take your time to turn slowly, using several smaller steps, do not turn suddenly. Physiotherapists and can provide exercise programs and equipment (i.e.walking aids) to improve balance, strength and walking.
  • Mobility aids should always be fitted and used correctly. Physiotherapists and occupational therapists can be accessed through health services or privately in some areas.
  • If a medication is causing side effects, such as becoming unsteady, dizzy, confused or drowsy, or if you have a fall, speak to your doctor or pharmacist immediately.
  • Avoid taking medication and alcohol together – alcohol can add to the risk of falling by affecting your alertness, judgement, physical co-ordination and reaction time.
  • Always know why you are taking medications and what side effects they have.
  • Keep a chart, including instructions on time and dose in a place that is easy to see. Use a dosage dispensing pack.
  • Choose footwear that offers good stability. Make sure your shoes are firm and supportive around the heels and the instep of your feet. They should be flexible and have enough room around your toes. Shoes with laces or velcro fasteners are best. Choose footwear that is enclosed front and back, and avoid slip on shoes and unsupportive slippers. Do not wear your socks without your shoes.
  • Incontinence (loss of bladder or bowel control), frequency (going to the toilet often) and urgency (going in a rush) all increase the risk for a fall, especially at night. Discuss your health conditions with an occupational therapist or continence specialist who can advise on bladder and bowel conditions, how to improve control, how to manage your condition and provide information on continence aids.
  • REMOVE ANY POTENTIAL TRIPPING HAZZARDS IN YOUR HOME -Falls are often due to hazards that are easy to overlook but also easy to fix. Making changes in your home to prevent falls is beneficial both for you and your family members, as well as for guests and visitors to your home.

Work through the list of common areas to identify and remove hazards:

Are there any loose mats or rugs inside your house?
Is there any furniture that obstructs your movements or that clutters the room?
Are there appliances or cords crossing your floors?
Do you have difficulty with showering, dressing or using the toilet?
Do you have poorly lit areas inside or outside your house?
Are there hoses, moss, bushes or any other objects that may obstruct the path outside your home?

What to do if you fall-prepare

  • If you are prone to falling, have poor balance or are in poor health, consider using a personal alarm that is connected to an emergency response system so that you can call for help.
  • In common rooms (e.g., bathroom, bedroom and living room), place your telephone somewhere that it can be easily reached from the floor.
  • Keep a blanket within a reachable distance from the floor in case you are unable to get up and need to keep warm.
  • Have someone close to you check on you daily, such as a family member or neighbour, and let them know when you will be away.

And if you fall?

  • Stay calm and assess your situation.
  • Turn onto your side, bend the leg that is on top and lift yourself onto your elbows or hands.
  • Crawl on your hands and knees toward a chair or other sturdy piece of furniture, then kneel while placing both hands on the stairs or furniture.
  • Place your stronger leg in front, holding on to the furniture for support.
  • Stand up and, carefully, turn and sit down.

If you can’t get up –

  • Stay calm and assess your situation.
  • If you have an emergency call device or telephone at hand, use it.
  • If you don’t, call out for help if you think you can be heard or try to slide or crawl towards a telephone or a place where you will be heard.
  • Make noise with a cane or any object at hand to attract attention.
  • Wait for help in the most comfortable position for you.
  • If you can, use anything that is accessible to help you stay comfortable and warm.
  • Try to move your joints to ease circulation and prevent stiffness.