Falls can change lives – in the worst of ways. Each year, one in three seniors falls, and 20 percent sustain a serious injury, from head trauma to a broken hip. These injuries can reduce mobility and independence, and increase the risk of premature death. In fact, falls are the top cause of injuries, and death from injuries, among older Americans.
The good news is that falls are preventable. In the quest to reduce falls among seniors, leading senior living communities are implementing structured programs that take a long-term, unified approach to fall prevention.
Preventing falls through teamwork
“It’s important to know that falls are not a normal part of aging and that preventing falls is a team effort,” says Callie Whitwell, chief operating officer, and founding partner at Lifetime Wellness. Her company provides person-centered wellness, life enrichment, and recreational programming to independent living, assisted living, skilled nursing and rehabilitation, and memory care facilities. A key Lifetime Wellness initiative is offering fall prevention programs at partner senior communities.
“From nursing staff to housekeeping, everyone needs to work together in making the environment safe for senior residents. Guidelines for fall prevention provide a shared structure to reduce the risk of falls and to keep seniors well.”
In the team approach, staff are vigilant in observing residents and reporting mental and physical changes that may increase fall risk – from confusion to struggles in standing or walking. Residents may be evaluated for treatment options, from changing medication to starting exercises that strengthen muscles and improve balance.
Pinpointing who’s at risk
“The aging process brings many changes,” Whitwell says. “These changes often raise the risk of falling, increasing the need for care teams to keep a close watch.” For example, seniors may have reduced strength and coordination, along with impaired vision and hearing. Some medicines cause dizziness and make a fall more likely. Such chronic conditions as diabetes and heart disease can affect balance. Seniors living with Alzheimer’s and related dementias may be more likely to fall because of diminished reasoning in daily activities.
Care teams must also monitor residents with osteoporosis, a disease that makes bones thin and prone to break. “When bones are fragile, even a minor fall can cause one or more bones to break,” Whitwell says. “When a senior falls and breaks a bone, it’s often difficult to recover and may be the start of serious complications.”
The care team must also be mindful of residents who have already experienced a fall, information that is reported on the resident’s medical record. Studies have found falling once doubles the chances of falling again.
Participating in exercise programs
A key strategy in preventing falls is exercises that improve strength, muscle tone, and balance. Lifetime Wellness provides programs for residents of all physical abilities, from strength-building classes to flexibility and aerobic exercises. A special program for seniors with limited mobility offers such activities as seated exercises, wheelchair dancing, and Tai Chi.
“Seniors often become inactive because they’re afraid of falling, which may increase their risk of future falls because it leads to a decrease in activity, along with a loss of muscle strength and balance,” Whitwell says. “Physical activity can be the best defense against falling. The more active seniors are, the less likely they will fall.”
Partnering with physical therapy
Residents who are recovering from injury, illness, or surgery typically receive physical therapy as part of their rehabilitation program – including exercises to improve balance and strength. “While physical therapy can reduce the risk of falls during treatment, the risk of another fall soars when rehab stops,” Whitwell notes. “Seniors who continue to reside at the care facility often decline after discharge from rehab, if they do not continue to maintain their level of function achieved.”
To promote continued recovery, Lifetime Wellness provides a post-discharge maintenance program. “Our wellness specialists pick up these residents and work with them one on one. We practice the exercises they learned in physical therapy and begin to assimilate them into group exercise classes. If they start to decline, we partner with physical therapy to determine the best course of action.”
Providing ongoing education
“Although we can’t control the disease process, we can control many environmental factors that raise the risk of falls,” Whitwell says. “Staff need to be observant of all areas of the resident’s environment, especially the bedroom and the bathroom, where most falls occur. From securing rugs to installing handrails, adding bright lights, and removing clutter, we can make our senior communities more ‘fall proof.’”
Lifetime Wellness produces a newsletter about falls, conducts fall prevention campaigns throughout the year, and provides classes for senior living staff. “The more staff know about falls, the faster they can intervene with preventative measures,” Whitwell says. “And the more they can keep the seniors in their care active, aware, and safe.”