The Five Daily Fall Prevention Strategies You Will Soon Be Using to Improve Outcomes for Geriatric Patients

By Gina Ianniello, MS, OTR/L, LSVT

Occupational Therapist

As clinicians, we have all experienced the overwhelming curiosity after opening up a new case and seeing an OT or PT referral that reads, “OT/PT eval and treat s/p fall.” Almost always that referral triggers several questions immediately. When was the fall? Where did the fall happen? Has this happened before? Could this fall have been avoided?

Falls occur in many ways, with varying levels of severity; fall prevention is a key component of productive aging. According to the National Council of Aging, “every 11 seconds, an older adult is treated in the emergency room for a fall; every 19 minutes, an older adult dies from a fall.” Through the use of evidence-based practice, this statistic can be significantly reduced.

5 Tips to Prevent Falls & Foster Productive Aging

As an occupational therapist, I find myself using several strategies on a daily basis to address falls with my patients.

1. My first tip involves the environment: What living environment does your patient live in? Is it cluttered? Are their most used pathways clear? Are there unpredictable factors, such as pets or self-run vacuums? Is there adequate lighting.
   There are many simple environmental modifications that can be done in the home to reduce fall risk. The ones I frequently rely upon are removing throw rugs and implementing the use of non-skid mats, investigating the lighting …, and reducing clutter (i.e., cords, shoes, pet toys, etc.).
2. My second tip can be quite a challenge. You need to break old and unsafe habits. For example, have you ever met an older adult that likes to use furniture for support when walking around? This is commonly known as “furniture …..surfing.” It can be a very hard habit to break because for many patients it is comforting and habitual for them. Try to address the habit by providing safer alternatives, such as adaptive device training (cane, walker, or rollator).
3. My third tip involves footwear. How many times have you encountered a patient in ill-fitting slippers, non-skid hospital socks that are worn down and ineffective, or even flip flops? Recommend supportive shoes to your patients. Doing so will directly impact fall risk by providing patients with a safer base of support to facilitate adequate traction between their feet and the floor.
   Sometimes fall prevention is as simple as buying a new pair of shoes.
4. My fourth tip involves playing detective to assess all fall factors once a fall has taken place. In my experience, falls can be caused by many things and it is important to ask the right questions. Key categories I assess include medication, vision, and sensation. Upon assessment, I will communicate with the necessary professionals and/or refer to that professional as appropriate. I.e. patient reports blurry vision when looking ahead when walking to the bathroom; I would refer/recommend patient follow up with optometrist or ophthalmologist for an eye exam.
   To investigate fall factors fully, there a lot of important questions to consider. These are some of the ones I commonly start with: What were you doing when you fell? Have you fallen like this before or was this the first time? Have you started any new medications lately? When is the last time you had an eye exam?
5. My fifth tip is to instill confidence in your patients regarding getting up from a fall if one takes place. Many times you may hear, “I am terrified of falling. I will not be able to get up.” And so I preemptively train patients and caregivers on how to safely get up from a fall.
   Although there are many ways to prevent falls, under some circumstances it may not be preventable. If you provide skilled education to patients and caregivers on how to get up from a fall independently they can improve confidence and self-efficacy which directly impacts fall risk. This helps reduce the fear of falling and allows individuals to feel more confident with their ability to prevent a fall by knowing what to do if it occurs.

I hope after reading this article you can take away new tools to add to your fall prevention toolkit! As physical and occupational therapists we have the gift of skill that can enhance our patients’ lives by making them stronger, safer, and more independent during their day to day lives to keep them on their feet and prevent them from falling!