Before the Fall — Fall Risk Assessment and Conditioning Program

Maine Coast Memorial Hospital, Rehabilitation Services

Ask your physician about participating in a Fall Risk Assessment and Conditioning Program.

Consistent with American Geriatric Society clinical practice guidelines for prevention of falls in older adults.

• Determine whether patients are at risk of falling
• Identify the factors that put them at risk
• Modify the risk factors
• Improve mobility
• Maintain independence

About the Program:

• Fall Risk Assessment and Conditioning Program Decrease risk factors
  • For older adults, falls are one of the greatest causes of serious health problems. Studies show that approximately 5% of falls by older adults result in a fracture... 25% of patients over the age of 65 with hip fractures die within six months...25% lose significant function, and 50% experience a decrease in mobility.

• Entry into the Program
  • A doctor's referral based on increase risk due to age, history, medication changes, muscle changes, degenerative joint disease, post arthroplasty or osteoporosis. The program consists of two parts.

• Assessment
  • The assessment determines if you are "at risk" of falling. A series of tests will identify the factors causing you to be "at risk". The factors may be physical, such as strength, balance, walking speed, step length, flexibility, cardiovascular fitness or environmental, such as hazards around your home.

• Conditioning
  • The conditioning part of the program is designed to modify the factors causing you to be "at risk". The physical factors are modified with an exercise plan designed just for you. Environmental factors are modified by helping you to eliminate hazards at home.
  • Modifying the factors that lead to falls will increase mobility and confidence, both critical to maintaining an independent life style.

• Strength
  • Strength is a critical factor for a rapid response to a balance disturbance. Testing will identify weakness and, if necessary, exercise will significantly improve ankle and leg strength.

• Balance
  • Normal balance is controlled by a complex combination of visual, muscular and neurological systems. Together, these factors keep us from falling when we encounter an unexpected disturbance. Testing and, if necessary, exercise will improve an individual's ability to remain upright under challenging conditions.

• Walking Speed and Step Length
  • Older adults typically display a slower walking speed. Steps are also shorter and vary in length. These are all factors related to falls. Independence is directly related to walking sped. Testing and, if necessary, exercise helps you learn how to walk more safely and confidently.

The Program

The program consists of an initial evaluation that takes 45 minutes and, if required, 7 visits (1 hour each) over four weeks.

Visit 1: Evaluation

• General health questions
• Blood Pressure and Heart Rate
• Knee and Ankle Strength Test
• Balance Test
• Walking Test

Visit 2: Review Results and Recommended Exercise Programs

The test results from the evaluation are reviewed with you. We will advise if you are at risk of falling and, if you are, why. If the cause is physical, such as poor strength and balance, we will plan an exercise program just for you. We will also help you identify and eliminate environmental factors that you may find at home or in your community.

Visit 3-7: Interventions

• In Clinic Exercise - Exercise targeted to improve strength, balance, walking speed, step length, flexibility andcardiovascular fitness.
• Home Exercise - Instruction for simple exercises that can be done at home.

Visit 8: Re-Evaluation

A report is provided to you and your referring physician summarizing the effect of the four week program. Your physician may recommend continued structured exercise to address specific problems.

Most insurance plans, including Medicare, cover assessment and conditioning for fall programs. For additional information, speak with your doctor, physical therapist or insurance agent.

Hazards at Home

Many of the biggest causes of falls are in the home and easily correctable. Simple changes may reduce the risk. This is a list of some of the risk factors which may exist in your home.

General:

• Poor lighting
• Slippery floors
• Throw Rugs
• Runners
• Mats Curled carpet edges
• Electric or telephone wires in the areas where we walk
• Clutter
• Small objects in pathways
• Unstable seating such as swivel chairs or chairs on casters
• Pet or children's belongings left in walkways
• Newspapers left on floor in walkways
• Laundry left on floor in pathways
• Cleaning products that leave slippery surfaces

Stairways:

• Missing light switches at top and/or bottom of steps
• Unsturdy handrails
• Uneven steps or steps needing repair
• Items places on stairs

Kitchen:

• Unstable Step Stool
• Storage areas that require excessive reaching or bending for access
• Appliances arranged inefficiently
• Unstable Seating
• Wet floors

Bathroom:

• Lack of grab bar in shower or tub
• Toilets that are wobbly or too low to floor
• Unstable towel rack or sink
• Wet floors

Outside:

• Walkways in disrepair
• Wet smooth surfaces (i.e. slate)
• Cluttered walkways and storage areas
• Poor night lighting
• Poor placement of trash and recycling bins
• Garden hose across the walk area
• Children's toys
• Pet toys and leashes
• High curbs

Participate in a Fall Risk Assessment and Conditioning Program ...Before the Fall

For more information please contact Somesville Rehab 207-244-7161

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Reference:
http://mcmhospital.org/site/index.php?option=com_content&view=article&id=155&Itemid=443#