Falling: Strategies for Preventing Falls

 

Strategies for Fall Prevention

 

Most falls occur at home because this is where we spend the most time, particularly older individuals who are retired.  Implementing home safety strategies is a critical part of preventing falling.  The following are suggestions for improving the safety of your home:

 

  • remove floor mats and area rugs (uneven surfaces)
  • install grab bars in the shower and next to the toilet
  • utilize night lights
  • keep a flashlight next to the bed
  • turn on the lights when getting up at night
  • install handicap ramps
  • add raised toilet seats
  • install bed rails
  • urinal to avoid nightly trips to the bathroom
  • bedside commode
  • bed alarms
  • use proper footwear

 

Your physician may refer you to occupational therapy for a home safety evaluation, and a handicap placard may be useful.  Physical therapy may help to improve your balance and gait, but it will also be critical that you continue a routine home exercise program to preserve your strength, coordination, and balance. 

Some patients benefit form assistive devices for mobility, such as:

 

  • cane
  • wheeled walker
  • wheeled walker with a seat
  • wheelchair
  • ultralight transport wheelchair
  • electric scooter
  • electric wheelchair
  • lift chair
  • hospital bed 

 

 

Additional suggestions for preventing falls:

 

  • Keep your risk of falling at the front of your mind when walking or transferring
  • Use your common sense
  • Concentrate on the primary task of walking and transferring
  • Don’t get distracted when walking or transferring
  • Don’t try to multi-task when walking or transferring – avoid carrying loads or talking
  • Avoid medications with sedative side effects, such as benzodiazepines.
  • Maintain your ideal body weight. 
    • If you are overweight, your muscles have to work harder, and you are at greater risk of getting off balance.
    • If you are underweight, your strength may be diminished placing you at increased risk for falling.
  • Work on increasing and maintaining strength and balance through a home exercise program, thai chi, or yoga.
  • Attend physical therapy and practice balance exercises at home (patients with Parkinson’s disease should learn cueing strategies).
  • For patients who experience postural blood pressure fluctuations, decreasing medications that lower blood pressure and increasing dietary salt and fluid intake can be helpful.
  • Eat frequent, small meals to avoid low blood sugars (hypoglycemia).
  • For patients who experience anxiety about falling, it is important to practice confidence training, cognitive-behavioral therapy, mobility improvement training programs, and implementing a more active lifestyle.
  • For patients whose cognitive impairment contributes to impaired balance, potentially hazardous behavior should be avoided. 
  • If a patient’s mental impairment produces impulsive or reckless behavior, it may be necessary to supervise gait and to supervise transfers.
  • Patients should be involved in a team approach to manage gait and to prevent falls.  This healthcare team may include: caregivers, neurologists, geriatricians, pharmacists, physical therapists, occupational therapists, rehabilitation specialists, cardiologists, primary care physicians, among others.
  • For patients who forget the fall precautions, who tend to wander, or who show impulsive behaviors, use a bed alarm and consider installing alarms on the doors and exits
  • For patients with osteopenia or osteoporosis, work with your doctor towards improving your bone mineral density, and consider supplementing your diet with vitamin D and calcium
  • Avoid walking on uneven surfaces, particularly if your legs are weak or if you have Parkinson’s disease
  • Avoid walking on wet or slippery surfaces
  • Proper footwear is imperative
    • Avoid walking barefoot because this increases the risk of slipping and falling
    • Wear comfortable but snug-fitting shoes.  Tennis shoes often work best.
    • Do not wear loose fitting shoes that may slip on your feet
    • Make sure your shoes have good soles that are not likely to slip – rubber soles often work best

 

Hope for the best and plan for the worst.  Try to anticipate dangerous situations.  Please discuss these options with your doctor, and please be safe.

 

 

 

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