Interventions should be tailored to the older adult’s functional level based on their own risk factors for falls and should be evidence-based. Interventions should include the following: ● Balance exercise. ● Strengthening exercise. ● Gait training. ● Adapting the home environment. ● Management of foot problems and footwear. Resources National Fall Prevention Guidelines & Position Papers ● Centers for Disease Control and Prevention, National Center for Injury Preventions and Control, Division of Unintentional Injury Prevention. STEADI (Stopping Elderly Accidents, Deaths, and Injuries) Tool Kit for Health Care Providers. Available at: Retrieved from https://www.cdc.gov/steadi/ index.html. Accessed July 13, 2018. This is an excellent website for resource materials for healthcare providers and older adults , along with patient education handouts and screening forms. ● American Geriatrics Society (AGS) and British Geriatrics Society (BGS) Panel on the clinical Clinical Practice Guideline for the Prevention of Falls in Older Persons. AGS/BGS Clinical Practice Guideline: Prevention of Falls in Older Persons. 2010. Retrieved from http://www. geriatricscareonline.org/ProductAbstract/updated-american- geriatrics-societybritish-geriatrics-society-clinical-practice- guideline-for-prevention-of-falls-in-older-person-and- recommentdations/CL014. Accessed November 18, 2016. This link provides a full description of the most recent practice guideline related to fall prevention in older adults, written from a physician prospective. Or access a free copy of the guideline at https://onlinelibrary.wiley.com/doi/pdf/10.1046/j.1532- 5415.2001.49115.x; Accessed July 13, 2018. ● US Department of Health and Human Services Administration for Community Living: A profile of Older Americans 2016: https://agingstats.gov/docs/LatestReport/Older-Americans- 2016-Key-Indicators-of-WellBeing.pdf. Accessed July 13, 2018. This link provides up -to -date statistics regarding our the older population and their changing health conditions. ● Leland NE, Elliott SJ, O’Malley L. Murphy SL. Occupational therapy in fall prevention: current evidence and future directions. Am J Occup Ther. March/April 2012. ;66; :149- 160. This article is posted on the AOTA website as a guide for occupational therapists interested in fall prevention. ● Chase CA, Mann K, Wasek S, Arbesman M. Systematic review of the effect of home modification and fall prevention programs on falls and the performance of community dwelling older adults. Am J Occup Ther. May/June 2012. ;66; :2284-291. This article is also posted on the AOTA website as a guide for occupational therapists interested in fall prevention. Glossary Definitions important to understanding course content include the following terms used by the American Geriatrics Society, the British Geriatrics Society, and the American Academy of Orthopedic Surgeons in “Prevention of Falls in Older Person: AGS/BGS Clinical Practice Guideline” (AGS/BGS CGG, 2010): ● Ankle balance strategy : Balance adjustments made at the ankle joint as the person sways much like an inverted pendulum in the anterior/posterior or medial/lateral directions. ● Cross-over strategy : Lateral step of one lower extremity over and across the other leg in order to prevent a loss of balance. ● Fall : An event whereby an individual unexpectedly comes to rest on the ground or another lower level without known loss of consciousness. ● Hip balance strategy : Adjustments made at the hip in the anterior and posterior planes, involving hip flexion and
Further research is needed for effective fall prevention for more frail or institutionalized older adults. Therapists should promote a sense of urgency in their communities that results in a wider implementation of fall risk screenings, fall prevention interventions and education, and a team approach to attacking this epidemic.
Fall Prevention Programs Each of these links will provide more details on the specific fall prevention program identified, along with information on training/certification as needed: ● Otago certification : (http://www.med.unc.edu/aging/cgec/exercise-program) ● Matter of Balance : http://www.mainehealth.org/mob ● Stay Active and Independent for Life (SAIL) : https://www.doh.wa.gov/YouandYourFamily/ InjuryandViolencePrevention/OlderAdultFalls/ StayActiveandIndependentforLifeSAIL ● Stepping On : https://wihealthyaging.org/stepping-on. ● Tai Chi : http://taichiforhealthinstitute.org/how-to-become-an- instructor-of-dr-lams-program-3/ Fall Prevention Materials Each of the following links will take you to helpful websites that share educational handouts, screening materials, and patient education information related to fall prevention: ● Toolkit for National Fall Prevention Awareness Day : https://www.ncoa.org/healthy-aging/falls-prevention/falls- prevention-awareness-day/(https://www.ncoa.org/healthy- aging/falls-prevention/falls-prevention-awareness-day/). ● Canadian Fall Prevention Community of Practice : http://www.fallsloop.com/( http://www.fallsloop.com/). ● Fall Prevention Awareness: Advanced Training for Home Health Aides : https://phinational.org/resource/fall-prevention-awareness- enhanced-training-curriculum-for-home-health-aides/ ● Community Powerpoint: Take a Stand to Prevent Falls- AOTA/AGPT Fall Risk Presentation : http://geriatricspt.org/pdfs/AOTA-APTA-Falls-Prevention.pdf ● Centers for Disease Control and Prevention, National Center for Injury Preventions and Control, Division of Unintentional Injury Prevention. STEADI (Stopping Elderly Accidents, Deaths, and Injuries) Tool Kit for Health Care Providers : https://www.cdc.gov/steadi/materials.html This link provides instructions for functional tests, measuring orthostatic blood pressure, and many other materials for healthcare providers. extension in order to remain upright. The challenge to postural control that elicits a hip strategy is typically stronger than that for an ankle strategy (a stronger push or larger shift in the support surface). ● Intervention domains (categories) : Medication, exercise, vision postural hypotension, heart rate and rhythm, vitamin D, foot and footwear, home environment, education. ● Multicomponent intervention : A set of interventions addressing more than one intervention domain or category offered to all participants in a program (population approach). ● Multifactorial fall risk assessment : Assessment of known predisposing factors within the person and in the environment that increase the risk for falling. ● Multifactorial intervention : An intervention made up of a subset of interventions that are selected and offered to
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