1. A Lifetime of Quality Care That’s Convenient & Complete Preventing Falls Robert Grimshaw MD FACP A Lifetime of Quality Care That’s Convenient & Complete

2. Some 30% of older Americans who live in their communities fall every year, as do more than half of nursing home residents. Falls are the 6th leading cause of death in the elderly, killing some 10,000 a year. And they cost some $13 billion a year. So reports Mt. Sinai’s Dr Helen Edelberg. In fact, falls cause about 40% of all nursing home admissions.

3. A Lifetime of Quality Care That’s Convenient & Complete Why do people fall? Only 10% of falls occur due to a single event; most occur due to multiple factors: arthritis muscle weakness foot disorders vision loss balance loss medication effects Parkinson’s disease other nerve disorders acute illness

4. A Lifetime of Quality Care That’s Convenient & Complete Home Issues Are Important, Too: Stairs - 10% of falls occur on stairs, usually the last step Slippery floors Beds too high or too low Trip risks: cords, etc. Inadequate lighting

5. A Lifetime of Quality Care That’s Convenient & Complete What Can Be Done? 1)Indoors: Eliminate clutter, especially on the floor Floors should be smooth, not slippery Carpets & rugs should be tacked or have skid proof backing NO THROW RUGS!! Stairs should be well lit and have handrails on both sides. Fluorescent tape on the edges of the top and bottom steps can help. Grab bars should be beside tubs, showers and toilets (there’s no ‘good’ place to fall in the bathroom!) Tub seats and hand-held shower heads help also Place rubber mats or non-skid strips in tubs and showers Furniture should be out of the flow of traffic in the house, stable and without sharp corners

6. A Lifetime of Quality Care That’s Convenient & Complete What Can Be Done? 1)Indoors (continued): Improve lighting - add ceiling fixtures, use sound/motion activated lamps, increase wattage Use night lights Keep a flashlight at the bed Don’t use step stools, or if you must, make it sturdy with a handrail and wide steps Carpeting and curtains can minimize echoes and sharp noises Avoid shiny surfaces/glare Colors: yellow, orange & red are easiest for people with poor vision; contrasts help for doorways, stairs and walls Use a portable phone Get a "Lifeline" button-type emergency call service OR arrange for daily contact with a friend or family member.

7. A Lifetime of Quality Care That’s Convenient & Complete What Can Be Done? 2) Outdoors: In rain/snow/ice, use a cane or a walker Wear warm boots with rubber soles Carry salt or kitty litter in your pocket or car in icy weather Stay away from slippery floors in public buildings. 3) Exercise Helps! Balance and gait training help. So does walking (improves endurance) and Tai Chi meditative movements. In an Australian study, group exercise was the single most important intervention in a fall prevention effort. When combined with home hazard reduction and vision improvement, falls dropped 14% annually.