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Overview
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A fall occurs when there is an
unintentional change in position resulting in landing on the
floor or ground. It is often the result of cumulative
risk from both physiological and environmental factors.
Physiological factors include normal aging and the presence
of acute or chronic conditions. Environmental factors refer
to unsafe surroundings and any events that can trigger
a fall, such as improper use of walking aids.
Though fall can happen to
anyone, it is more vulnerable to the sick persons and the elders.
The risk of being seriously
injured in a fall also increases with age. Among
people 65 years and older, falls are the leading cause of
injuries and deaths.
Besides causing physical harm, injuries from falls can also
result in
psychological problems which lead
to a loss of confidence in
independent mobility and increasing dependency on others.
Preventing falls begins
with identifying the risks.
While it is difficult to change
some physiological risk factors, it is important that
caregivers understand how these factors can contribute to
the risk. In contrast, it is easier to control the
environmental factors to eliminate or reduce the risk of
fall.
Who is at
Risk?
Anyone with the following
conditions has a higher risk of fall:
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Poor general health with a
chronic disease
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Muscular weakness
particularly of the lower limbs
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Decreased sensation in
extremities such as stroke
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Gait and balance disorders
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On medications such as
anti-hypertensive and sedative
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Urinary frequency or diarrhea
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Measures to Prevent
Fall at Home
As we
know that fall occurs due to various factors, it is important to identify the potential causes so that
appropriate measures
can be
implemented. Below are interventions to prevent
fall at home; some of these measures may be relevant to your care plan:
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Identify the risk factors that may
contribute to fall. Alert all
caregivers about the person's risk of falling and define interventions
you have implemented.
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Provide a safe environment at home.
For examples, keep the path
from the bed to the bathroom clear of clutter to prevent falls
during the night. If you
spills, clean up as soon as they happen to prevent slips.
To learn more on safe home environment, please refer to
Room Safety Measures.
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Medications
often cause fatigue or confusion which increases the risk of
fall. These medicines include blood pressure pills,
heart medicines, diuretics, muscle relaxants, and
sleeping pills. Reinforce the need to rest in bed after
taking such medicines. If you find
that your care recipient is extremely 'sleepy' after medications,
inform your doctor. He may want to review the dosages.
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Ensure that
the person wears clothes that
fit properly. Pants that are too long can cause him to trip.
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If the person has frequent urge to
eliminate, scheduled toileting routine will
prevent him from rushing to the toilet., hence reducing the risk
of fall.
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Provide
the person with a
call signal such as a bell if he is not well to move about.
Encourage him to request for assistance whenever needed.
Place his commonly used items within easy access.
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To prevent
postural hypotension which causes giddiness, especially if
the person is taking a blood pressure medication, instruct him to change positions
slowly e.g. lying to sitting, and sitting to standing. A good
practice is to sit on the edge
of a bed or chair for a few minutes before rising. This is
also helpful to avoid loss of balance.
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Instruct
the person to ambulate in well-lit areas and to use handrails if
needed.
When necessary, accompany him during ambulation.
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Provide
the person with nonskid footwear. Replace slippers that have
stretched out of shape and are too loose. Do not allow
the person to walk in socks or stockings.
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Provide ambulatory
aids if the person is weak or unsteady on feet. Consult your
occupational therapist or physiotherapist on the appropriate aids or
equipment that would assist the person at home. Learn and reinforce the correct use of mobility aids and
ambulation techniques
to the person.
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Do not rush
the person. Allow adequate time for him to
complete his task.
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Encourage
the person to perform active range-of-motion exercises to improve
muscles flexibility and coordination. This would reduce
his risk of falls as they help to improve his strength and
balancing. However, please seek professional advice prior
to commencing any exercises.
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Ask your
doctor for a referral to an occupational therapist who can help
you devise other ways to prevent falls in your home.
Alternatively, you can engage a physiotherapy and occupational
therapist to conduct a comprehensive fall risks assessment at
your home. Click
here for a list
of therapists home visit in Singapore that may
also provide fall risk assessment at your home.
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