Fall Prevention Archives - LDOT - O.T.SERVICES INC.

Best Practices in Fall Prevention

Best Practices in Fall Prevention

Best Practices in Fall Prevention – When you want to make a change for your health, you want to know about best practices. Best practices are strong recommendations that clinicians (doctors, occupational therapists, etc.) use to provide their patients with an effective intervention (treatment or modification).

The clinicians base these recommendations on evidence in the clinical unbiased literature.  Evidence found that the intervention improved the health outcome, and the conclusion is that the benefits outweigh the harm.

This is a big deal. The evidence is what should guide all good practice. It is why you buy a car with safety ratings that are independently researched, and not just the word of the company that is trying to sell you a car.

Fall Prevention is a big thing. Here are a few startling statistics:

  • 1 in 3 older adults in Canada fall each year (over 65)
  • 50% of falls which resulted in hospital admissions occurred in those 65 and older
  • Falls cause more than 90% of hip fractures in seniors and 20% die within a year of the fracture

(Public Health Agency of Canada, Report on Seniors’ Falls in Canada, 2005)

So, when our team at LDOT Services were looking at Best Practices for Fall Prevention; we looked at the literature and found what the American and British Geriatric Society recommended as best practice.

With respect to ‘Assessment’ – the following is recommended:

A multifactorial fall risk assessment should be performed by clinicians with appropriate skills and training, (Occupational Therapists have this training) including a focused history, physical examination, functional assessment (watching clients actually do things) and an assessment of their environment.

With respect to ‘interventions’ or ‘treatment’ – the following should be “Best Practice”.

  • Assessment should include identifying hazards in the home, making recommendations to eliminate the hazards, and providing options to promote the safe performance of daily activities
  • Adaptation or modification of the home environment based on the assessment criteria above
  • Exercise, particularly balance, strength, and gait training

More importantly – the following was NOT recommended in that there was fair evidence found that the intervention is ineffective, or that harm outweighs benefits.

  • Education should not be provided as a single intervention to reduce falls in older persons living in the community

Other evidence that was strong was that vitamin D supplements should be taken by persons proven to have insufficient vitamin D intake. The only way to know whether this is an issue is to consult a doctor – and this is our recommendation.

Our practice is best practice. We provide a multi factorial assessment. We provide recommendations to eliminate hazards within the home and provide options to promote the safe performance of daily activities.

We can provide a list of vetted contracting companies that specialize in home adaptations.

We can work with the contractors to ensure you get what you need to make the living safer, and avoid what may put you in harm’s way.

We provide in home and pool exercise programs though our team of Occupational Therapy Assistants. And by using Occupational Therapy Assistants we ensure these programs are accessible and financially feasible for the participants. For information on these programs or any of our Occupational Services; please contact us directly; you will reach a live knowledge representative at either our  Hamilton Office: 905-481-1122 or our Toronto Office: 416-907-6287.

Alternatively, you can email us directly anytime and one of our helpful representatives will respond very quickly.

 

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Happy Holidays – Is your house visitable?

Happy Holidays – Is your house visitable?

At the recent National Institute of Aging conference held in Toronto, I was a speaker representing OSOT and the Home Modifications Canada Steering Group. The afternoon session was lead by a presentation by Jamie Shipley, a knowledge transfer consultant with the Canada Mortgage and Housing Corporation. He and I have done presentations together before about accessibility for seniors wishing to Age in Place.

Lesya Dyk

At the recent National Institute of Aging conference held in Toronto, I was a speaker representing OSOT and the Home Modifications Canada Steering Group. The afternoon session was lead by a presentation by Jamie Shipley, a knowledge transfer consultant with the Canada Mortgage and Housing Corporation. He and I have done presentations together before about accessibility for seniors wishing to Age in Place.

He asked that the members in the audience raise their hand if they were a “caregiver”. A few members of the audience raised their hands….

Then he asked how many of the audience help their family members (change in definition), and a significantly larger number of hands were raised.

Then, he asked that all the people who had their hands up, to keep their hands up, if those family members who needed care, were coming to their house over the holidays… and most of the hands went down…

The truth is, that most of us live in homes that are not “visitable” – what is visitable?

Visitable is now a term that encompasses adaptability, accessibility and inclusivity – it means that a home can be visited by almost anyone with no major impediments to access into the home or to the bathroom. Accessible is a concept that we as OT’s are more familiar with, but the drawback to this concept is that the issue is that it denotes that disability must exist. But age is not a disability – it is a normal life stage, and we in Canada are at the brink of a crisis….

According to statistics provided by the CMHC, by 2038, 24% of all Canadians will be seniors 65+, and 35% will be 55+. And to bring it back to today – a full third of Canadians now over 65 have some form of disability.

With all of us marching into this ageing cohort – where will we all live? There are no more Long Term Facilities that the province is building, and homes, townhomes and condominiums are being built all over without thought or incentive to making them spaces where we can easily and safely age…..

Many designers, architects, and contractors are now promoting “Inclusive or Universal Design Principles”. These include:

  • Equality
  • Flexibility
  • Simple and Intuitive
  • Easily perceived
  • Tolerance for error
  • Minimal effort
  • Size and space considerations for function

And where do we fit in? Well, Universal Design is not universal, and an OT has the knowledge skills and training to help a person function in their environments. The other issue, is that OT’s have their eye on function – and the client, and the future… This unique perspective is now being understood and valued.

To focus the lens just a bit more – Fall Prevention has been identified as the most important issue that we face and will be facing in healthcare when it comes to our ageing population. ( Tilak Dutta, PEng, Toronto Rehab)

According to Centre for Disease Control published study:

  • In 2012–2013, 55% of all unintentional injury deaths among adults aged 65 and over were due to falls.
  • From 2000 through 2013, the age-adjusted fall injury death rate among adults aged 65 and over nearly doubled from 29.6 per 100,000 to 56.7 per 100,000.
  • Falls cause more accidental deaths than all other causes COMBINED.
  • Over 3/4 of all falls occur in or near the home

And then, when we think about Dementia…

  • Dementia – mostly associated with confusion, reduced short term memory, reduced ability for new learning and later, motor coordination and visual perception difficulties
  • Alzheimer’s Dementia is most common seen in the elderly population
  • 20% over 80 years old have some form of dementia
  • Persons with Dementia who fall have 3 times the risk of death within one year than their counterparts without dementia

In order to prevent falls, the risks and risk factors need to be understood. As OT’s we can assess this, and provide a solution to meet the challenge. If it is low vision – then contrasting colours should be used. If it is reduced strength, then exercise may be indicated. If the issue is balance – is the underlying cause cardiac or neurological, or a change in medication? And what transfers are affected – how do we keep our clients from falls?

Best Practice…

Based on recommendations from the American Geriatric Society and British Geriatric Society (2010) updated in 2016 in: “Clinical practice Guideline: Prevention of Falls in Older Persons’, the summary of recommendations include:

“a home environment assessment carried out by a health care professional should be included in a multifactorial assessment and intervention for older persons who have fallen or who have risk factors for falling”

Although it does not specify Occupational Therapy, it is clear that this work is in our realm. We have the ability to assess the person, their environment, and their occupation, and make recommendations that make sense for our clients now, and in the future.

As we approach the Holiday Season, we the Board who serve OSOT on your behalf wish you all a safe, and happy holiday season, and a prosperous and healthy 2017.

As you begin to gather up your family and friends, start thinking of your own homes, your own spaces….your future selves and your own careers. This my colleagues, is where all our futures lie.

Home is where people want to age , they are happier and it is cheaper….

Prof. Barry Trentham,
O.T. Reg. (Ont) UofT

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Fall Prevention – In–Home Safety to Address Ageing in Place

Fall Prevention – In–Home Safety to Address Ageing in Place

fall-preventionFall Prevention – Ageing in place – Staying put – Accessible at Home – Inclusive Space,  all are phrases that are being used to address the issue, no – crisis, that is facing us here in Canada.

With the population ageing, the last baby boomers hitting 55 years, with no further long term care facilities being built in the province of Ontario, ageing Ontarians and their caregivers are faced with the reality that to stay healthy, one must learn to live safely at home . Why? According to CDC published study:

  • In 2012–2013, 55% of all unintentional injury deaths among adults aged 65 and over were due to falls.
  • From 2000 through 2013, the age-adjusted fall injury death rate among adults aged 65 and over nearly doubled from 29.6 per 100,000 to 56.7 per 100,000.
  • Falls cause more accidental deaths than all other causes COMBINED.
  • Over 3/4 of all falls occur in or near the home

So while everybody talks about accessibility, for our ageing population, the concern is really Fall Prevention.

How can we help? We provide:

  • No hassle solution
  • A flat rate for initial screening assessment
  • After that, pay for only the services that you want
  • Well trained , experienced and supervised Occupational Therapists
  • A number of solutions depending on client individual needs and budget
  • Able to provide a list of vetted contractors that specialize in accessibility solutions

As regulated health professionals, we do not pay or accept referral fees – our recommendations are in your best interest, not ours

Want more information? Please contact info@LDOT.ca or call our office directly.

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