Falls « The Professional Geriatric Care Manager’s Blog

The Most Dangerous Room in the House

September 2, 2011 at 10:30 am | Posted in Deborah Varisco, GCM | Leave a comment
Tags: Falls, Help, Life, Personal, Prevention, Safety, Tips

As we age, the incidence of sustaining an injury in the home increases, especially after age 85. The higher rate of injury is the result of decreased mobility, decreasing eyesight and decreased strength. Studies show that most of these injuries occur in the bathroom, around the tub or shower, and more than half near the toilet. Many emergency room visits are the result of injuries sustained in the bathroom, and a large percent of these have to be hospitalized.

Women have a higher rate of bathroom injury than men. The most dangerous activity for both men and women, though, is bathing or showering. Injuries can occur either getting out of the bathtub or shower, or getting into the tub or shower. A large percent seem to be suffered while getting out of the shower. Another large percentage of injuries occurring in the bathroom are related to getting on or off the toilet.

Injuries in the bathroom can be the result of slipping, tripping, or fainting. The head and neck make up the greatest percent of bodily injuries, followed by the lower torso, the upper torso, and the leg and foot. The least amount of injuries are to the arm or hand. Injuries in the bathroom can never be totally eliminated, but they can be reduced by the installation of grab bars by the toilet or shower. Other helpful hints to prevent injuries in the bathroom are to place nonslip mats in the bath or shower, to prevent slipping; remove throw rugs in the bathroom, to prevent tripping; and installing a shower chair or bath benches, which assist an individual to get into the tub itself.

There are many agencies which will also come into your home and provide an assessment and offer suggestions on how to make your bathroom and home safer. At Distinctive Care Geriatric Care Management, part of the client’s assessment evaluation involves assessing the individuals living environment and performing a home safety evaluation. The client’s individualized care plan will include suggestions on ways to make their living environment safer. Included in the care plan may also be the recommendation to have an evaluation from a home safety specialist such as Back Home Safely, with Gregg Frank, 973-489-7790. So watch your step while in the bathroom.

Distinctive Care Geriatric Care Management serves Bergen, Passaic, Rockland and Orange County with nurses licensed in New Jersey and New York. We help families dealing with various issues related to their elderly loved ones and would be happy to discuss any concerns you may have related to long term care. Please contact us in our Ridgewood Office at 201-587-5283 to schedule a consultation.

Falling…Up?

June 1, 2011 at 10:30 am | Posted in Joanne Jordan, Office Manager | Leave a comment
Tags: Aging, Caregiver, Eldercare, Falls, Help, Life, Tips

According to the American Academy of Family Physicians, falls are the leading cause of injury-related visits to emergency departments in the United States and the primary cause of accidental deaths in persons over age 65. Falls account for 70 percent of accidental deaths in persons 75 years of age and older.

Risk factors for falls in the elderly include increasing age, medication use, cognitive impairment and sensory deficits. Here at Distinctive Care, our R.N. geriatric care managers try to identify these risk factors and implement changes to minimize these risks wherever possible. We conduct a comprehensive assessment of each new client. Among the many components of the assessment is a 130-point safety checklist of the home, which includes looking for things like loose throw rugs, as well as a complete medical history and review of all medications which can increase fall risk.

Clients are often unaware of little changes that can be made to improve the safety of their living environment. After all, in many cases, their furnishings have been in place for years, and they’ve never had a problem. But they fail to realize how increasing age and increasing fall risk go hand in hand. It helps to have a trained eye review the living environment to identify potential pitfalls.

Tips to Prevent Falls

March 11, 2010 at 5:50 pm | Posted in Lori Habersaat, GCM | Leave a comment
Tags: exercise, Falls, Health, Prevention

The following information was taken from the December 2009 Harvard Men’s Health Watch-

To keep your feet and prevent falls, combine prudent behavior with exercises to promote strength, balance, and flexibility And consider these tips:

Review your medications with your doctors; avoid pills that may make you groggy, dizzy, or that drop your blood pressure when you stand up.
If you drink, do so responsibly.
Wear flat shoes with wide, thin soles. Don’t wear loose or untied shoes or slippers.
Beware of ice, snow, and uneven surfaces. Use a walking stick if you need help.
Check your vision.
Store things you need on low, easy to reach shelves. Never stand on a chair to reach overhead items.
Consider a vitamin D supplement. A 2004 study reported that this supplement reduces the risk of falling by 22%; 800 iu a day may be best. And remember that a good intake of calcium will act with vitamin D to help keep your bones strong, perhaps giving you a margin of safety if you fall.
Keep your house safe. Good lighting, especially at night, is crucial. Avoid clutter, exposed electrical wires and telephone cords, loose area rugs, and slippery floor wax. Place non-slip mats in tubs and showers, and consider installing grab bars in your bathroom. Be sure your stairs have sturdy handrails and non-slip treads.

Inner Ear Problems and Risk for Falls

July 10, 2009 at 10:00 am | Posted in Sophia Heftler, GCM | Leave a comment
Tags: Ears, Falls, Johns Hopkins, Prevention, Study

69 million adults over the age of forty are up to 12 times more likely to suffer a serious fall because of inner ear dysfunction that affects their balance and makes them dizzy. A Johns Hopkins study of this subject found that approximately 22 million of these adults had no idea of their vulnerability as they have had no previous incidents of vestibular disorders, dizziness or sudden falls to suggest they had any problem.

The study revealed that those people who were asymptomatic were six times more likely to suffer a fatal fall than those who had a healthy sense of balance and those who were symptomatic increased their risk 12 times.

Each year more than 1.5 million visits to the emergency room in the United States occur related to falls. Falls are among the leading cause of death in the elderly with an estimated 13,000 senior deaths occuring per year.

“Vestibular imbalances need to be taken seriously because falls can be fatal and injuries can be painful, leading to long hospital stays and resulting in significant loss in quality of life ” says Lloyd B. Minor, MD from Johns Hopkins University School of Medicine in the study published in the May 2009 Archives of Internal Medicine. He says that recent government reports estimate that fatal falls cost the US Medicare program nearly 1 billion dollars in hospital charges and those with broken bones cost an additional 19 billion dollars.

This study found that 85% of men and women over the age of 80 had an imbalance problem and people with diabetes are 70% more likely to suffer from vestibular damage. The study revealed that balance testing should be part of basic primary care and that all physicians should be screening and monitoring their patients for vestibular dysfunction so that preventative measures can be taken to prevent falls.

Dr Minor added that physical rehabilitation exercise programs can help people with vestibular dysfunction. Balance and walking exercising can be used to train the brain to compensate for inner-ear deficits and dizziness.

Preventative steps can be taken in the home to reduce the risk of falls such as installing guard rails along stairs and hallways where a fall might occur, ensuring that lighting is adequate and removing throw rugs.

You can go to the Johns Hopkins Center for Hearing and Balance site to view a short video about this study.

Distinctive Care Geriatric Care Management completes a fall risk assessment and 130 point home safety evaluation as part of their initial assessment. To learn more about the assessment process, call our Ridgewood, NJ office at (201) 857-5283.

Fall Prevention for All

December 20, 2008 at 10:14 am | Posted in Sophia Heftler, GCM | Leave a comment
Tags: Falls, Home, Prevention, Safety, Tips

Although this blog usually deals with elder care issues and yesterday we focused on falls and the elderly, the tips I’m going to provide you with today are useful for people of any age.

Some common causes of falls in and around the home include the following:

Slippery floors
Poor lighting
Electrical cords in pathways
Loose scatter rugs
Raised thresholds
Clutter

For those of you caring for an elder the following age-related factors could increase the risk for falls:

Problems with balance
Slow reflexes
Poor eyesight
Use of certain medications including cardiac, antidepressant and pain medication

Below you will find a list of precautions that can be easily implemented whether providing elder care for a loved one or ensuring your own safety.

Outside your house:

Ensure that concrete steps and walkways are in good repair. Paint the edges of outdoor steps with light reflective paint or apply light reflective tape to the edges. This is particularly important if any of the steps are narrow, or higher, or lower than the rest.
Keep outdoor walkways clear and well-lit, ensure that all outdoor lighting is working and replace burned out bulbs.
Clear snow and ice from entrances and sidewalks. Have rock salt available during the winter months.

Inside your house:

Remove all clutter from your home
Keep telephone and electrical cords out of pathways.
Tack down rugs and glue loose vinyl flooring so they lie flat. Remove scatter rugs or attach non-slip backing or tape to them.
Be sure that carpets are frimly attached to the stairs.
Do not stand on chairs to reach for things, use a sturdy step stools with hand rail. Store frequently used items items where they can be reached easily.
Have a lamp or light switch that you can easily reach without getting out of bed.
Use nightlights in the bedroom, bathroom and hallways.
Keep a flashlight with fresh batteries in each room.
Have light switches at both ends of halls and stairs.
Install handrails on both sides of the stairs.
Turn on the lights when entering the house.

In the bathroom:

Install grab bars in the shower, tub and toilet areas.
Use nonslip adhesive strips or a mat in the the shower or tub.
Consider sitting on a bench or stool in the shower.
Use an elevated toilet seat or commode.

When walking:

Use all helping devices such as canes or walkers as directed by your healthcare provider.
Wear nonslip, low-heeled shoes that fit snugly. Don’t walk around in stocking feet.

Other things to remember:

Review medications with your doctor or pharmacist. Some drugs including over-the-counter medications can make you drowsy, dizzy and unsteady.
Discuss safe amounts of alcohol intake with your doctor.
Have your hearing and eyesight tested. Inner ear conditions can interfere with your balance and vision problems can make it difficult to see potential fall hazards.
Exercise regularly to improve muscle flexibility, strength and balance. Speak to your healthcare provider about which exercises are safe for you.
If you feel dizzy or light-headed sit down or stay seated until your head clears. Change positions from laying down to sitting to standing slowly to avoid unsteadiness.

The care managers at Distinctive Care Geriatric Care Management always perform a home safety assessment to identify potential fall risks in the home and develop interventions to reduce the risk. Each Client is also assessed for their potential risk for falls.

Distinctive Care is centrally located in Bergen County and provided care management services in Bergen, Passaic and Essex County and the surrounding areas and in New York we currently service Rockland, Westchester and Orange County.

If you have any questions about this topic or anything else related to elder care please contact our Administrator, Mark Heftler at 201-857-5283.

Fall Prevention

December 18, 2008 at 3:36 pm | Posted in Mark Heftler, Admin | Leave a comment
Tags: Falls, Prevention, Safety, Tips

The Center for Disease Control states that falls are the leading cause of injury deaths amongst older adults, a scary fact when coupled with research data that claims more than one third of adults 65 and older fall each year. According to the most recent census, 13% of New Jersey’s population are age 65 and older. With a population climbing over 8,725,000 people, that comes to a whopping 1,134,250 residents. That means upwards of 380,000 elderly adults will fall yearly in New Jersey alone.

While not all falls are preventable, a fact which Sophia Heftler, RN, CALA, Geriatric Care Manager, fully recognizes, there are a number of steps that can be taken to make environments safer and people stronger, the two best ways to stave off a fall. Distinctive Care Geriatric Care Management, located in Bergen County, New Jersey, has developed this comprehensive list to promote fall prevention and help families make positive changes.

• Exercise Regularly: performing exercises and activities that increase balance and strength are the most helpful; consider joining a Tai Chi or Yoga program.

• Eye Checkups: have your eyes checked at least once a year by an eye doctor.

• Medicine Review: have your medications reviewed by your doctor or pharmacist to reduce interactions and side affects; make sure both prescription and over the counter medications are taken into consideration!

• Improve Lighting: making sure that your home is well lit is essential to fall avoidance; instal night-lights to ensure safety at night.

• Reduce Hazards: it’s important to bring in outside help to perform in-home assessments, which are crucial for fall prevention; risk reduction devices, such as tub grab bars, toilet assist bars, shower chairs, wall grab bars, rug slips and carpet tape should be installed to provide for ease of movement and safety.

Falls are one of the biggest threats to independence in later life. According to the Center for Disease Control, fall-related injuries for seniors cost over $19 billion dollars annually, and that number will reach $43.8 billion dollars by the year 2020. By following Distinctive Care’s simple fall prevention guidelines, Bergen County can do its part to fight the nationwide averages and keep our older adults independent!

References:

Center for Disease Control: http://www.cdc.gov/ncipc/factsheets/adultfalls.htm

U.S. Census Bureau: http://quickfacts.census.gov/qfd/states/34000.html

Senior Journal.com: http://www.seniorjournal.com/NEWS/Aging/2008/20080923-SenMikulskiWinsAgain.htm Seattle

Post-Intelligencer: http://seattlepi.nwsource.com/local/379540_falls18.html