Preventing Falls

Sometimes I wonder what residents from our long-term care home are thinking and feeling as I speed past them with ease, my balance and my strength at their peak. I breeze past some residents who are only able to use wheelchairs and others who can walk only slowly with the use of a walker or cane. I take it for granted that I can mobilize without fear and I do not need to rely on a device to assist me.

Many people in our society think otherwise. Every time they walk, they may be afraid of injury resulting from falling. This fear may be even stronger in those who have a history of falls as they recall past injuries. Their fears are not unfounded as falls are after all, the leading cause of injury among the elderly in Canada. In fact, 20-30% of Canadian seniors experience one or more falls each year and 85% of injury related hospitalizations among seniors are caused by falling (Government of Canada, 2011). Falls are also responsible for 95% of all hip fractures in Canada (Government of Canada, 2011).

The statistics show that 50% of falls resulting in hospitalizations occur in the home. This is due to the fact that homes often do not have adequate supports in place to help prevent falls. Of these hospitalizations over one third end in long-term care home admissions (Government of Canada, 2011).

It is no wonder then that it is imperative to reduce the risk and the occurrence of falls in the home. This can be done in a myriad of ways. For instance, many falls occur when trying to sit on the toilet as homes often lack the tools to support balance. People often misjudge the distance to the toilet seat and have nothing to hold onto when attempting to sit down. A raised toilet seat and/or a pole or grab bars installed next to the toilet can help provide support, resulting in a reduction in number of falls.

A cluttered environment is another contributor to fall-related injuries. Clutter and objects in the home that are laying on the floor can cause people to trip. Conversely, trying to clean clutter by bending over can also put some at risk of losing their balance. Poor or inadequate lighting conditions can reduce visibility of clutter and wet floors resulting in falls. Something as simple as better lighting or a clean living environment can go a long way to reducing risk of injury.

The topics described above are causes of falls and strategies to reduce them that are external to the individual. What about those that are internal? There are many health challenges that can put someone at increased risk of falling such as Parkinson’s Disease or Multiple Sclerosis, among a plethora of other illnesses. Any illness affecting the strength of one’s muscles can contribute to injuries from falls. These health challenges tend to cause a constant risk of falling. Other illnesses that result in an intermittent or occasional increase in number of falls are caused by infections.

Infections such as those of the urinary tract or respiratory tract can cause confusion, disorientation and weakness. In long-term care homes delirium resulting from these infections is often found to be the main cause of frequent falls. There is often a significant reduction in number of falls after successful treatment of these infections through the use of antibiotics. Staff such as care aides, physio and occupational therapists and nurses are pivotal in reducing falls as they are able to recognize changes in a resident’s health status, thus prompting the investigation into the reasons or causes of falls.

There is no question as to whether or not a given individual would rather live at home or in a long-term care facility. The vast majority would choose home as they are afforded with a greater degree of independence. While many lose a sense of independence in long-term care homes due to their decreased mobility, they do have the benefit of having a continuous presence of staff to decrease the risk of falls through some of the external means described above or through investigations into one’s health.

This is where private home care services such as those provided by CANE come in. Having a support/care staff in your own home can be especially beneficial. The staff member can help to recognize those things in your home that increase risk of falls and can make suggestions to mitigate those risks. Workers can keep your house clean and clutter free or suggest modifications to your home to provide support during mobilization.
The bond and relationship they build with clients can also help them to recognize when there is a change in a client’s health status thus prompting crucial investigations into reasons for falls. Private home care services essentially provide a win-win situation where clients can have support for their independence and a decrease in the risks related to living alone at home.

Government of Canada. (2021, November 9). Seniors’ Falls in Canada - Infographic. https://www.canada.ca/en/public-health/services/health-promotion/aging- seniors/publications/publications-general-public/seniors-falls-canada-second- report/seniors-falls-canada-infographic.html