How physiotherapy can prevent falls in the elderly

The facts:
“Accidental falls resulted in 1,530 deaths among people aged 75 or over in 2012. This is a fourfold increase from the 2002 figure of 365. Women accounted for 57 per cent of these deaths.”
- Australian Bureau of Statistics, 2012.

Compared to younger age groups there is a much higher rate of death from accidental falls in the 75 years and over population, and particularly for people aged 80 years and over.

While these statistics are sad but true there are many ways falls can be prevented. Physiotherapists, who understand human movement and function innately, are well qualified health professionals to work with the elderly to prevent falls.

The consequences of falling include loss of confidence, admission to residential care, injuries and pain and reduced quality of life. Furthermore, one in 10 falls results in a hip fracture and 25% of those who fracture a hip pass away within six months of the injury. Falls prevention is key, not only for the individual but for the community - significant financial costs such as hospital admissions and community health care also come about from such unfortunate events.

There are multiple “risk factors” of falls, but no single risk factor is the cause of all falls. The greater number of risk factors the individual is exposed to, the greater probability of a fall.

Risk Factors include:

• Lack of knowledge about risk factors
• Disease Processes
• Lack of physical exercise
• Medications
• Environmental Hazards

How Physiotherapy can help?
There are many ways a physiotherapist or another health professional can assist with Fall Prevention Strategies. The best approach involves using multiple strategies such as, health promotion, exercise prescription, environmental modification clinical assessment and injury minimisation.

Education is a great starting point. Physios can assisting the elderly to understand how to prevent falls through increasing safety around the home, physical activity, appropriate diet and footwear.

Exercise interventions have been heavily researched in recent years and it has been proven that even the very frail and elderly derive measurable benefits from regular exercise.  These positive outcomes can be achieved through exercise groups or individual physiotherapist-prescribed programs of balance training, walking, aerobic or hydrotherapy and resistance training for maintaining bone density.

Environmental safety in the home requires assessment visits and can result in modifications to the home. Usual hazards include inadequate lighting; dangerous floor surfaces, such as rugs or worn carpets, electrical cords, inappropriate foot wear, general clutter and wet areas.

Other considerations in the home include stairs without hand rails or worn and uneven steps, furniture that may not be able to support leaning or is too low, also including areas such as the bathroom where the toilet may be too low, there are no hand rails and slippery baths or showers.

A Clinical Assessment is a simple task undertaken by a physiotherapist.  Tools that have been proven to be fair predictors of falls such as Timed Up & Go, Functional Reach Test or Berg Balance Test are included in this. Following a Clinical Assessment, your physio will be able to generate a management plan and exercise program suitable to the individuals needs.

Injury minimisation also involves referral to the individual’s GP for review of prescribed medication and vision as well as referrals to other service providers who can assist with devices such as personal alarms, sensor mats and hip protectors etc.
In the unfortunate instance that a fall does occur, physiotherapy can support the individual in injury management and rehabilitation.

Physiotherapy is a versatile field and may be able to prevent a fall of someone you love, so if you have questions on how you can help, speak to your local Back In Motion physiotherapist.

Sophie Motteram - Physiotherapist, Back In Motion Campbelltown

Resources:
Physiotherapy Clinical Studies 200, 2004, Manual 2, Issues of Aging. University of South Australia
Australian Bureau of Statistics media release: Death from heart disease continue to fall