Preventing Falls Among Older Adults

1. Preventing Falls Among Older Adults WHAM

2. WHAM • What risks are observed on scene? • How can we keep from coming back? • Action to take to prevent future injuries • Materials/messages to leave behind

3. Falls Among Older Adults An older adult dies every hour because of a fall Greatest cause of injury and injury hospitalizations in US and Washington State Those who fall are 2-3 times more likely to fall again Falls are a major threat to the health and independence of older adults

4. Chronic health conditions Physical & functional impairments Medication & alcohol use Environmental hazards Older Adult Fall Risk Factors Fall risk increases with the number of risk factors present

5. ABCs of Why Older Adults Fall (usually more than one risk factor is present) • Age, Ambulatory status, Assistive device use (or need): Age > 65, 75, or 85? Able to stand up from a chair without using their arms? (indicative of lower extremity strength/joint function); Able to stand, walk 8-10 feet, turn around and sit down without assistance of another person? • Balance: Self assessment of balance correlates with objective balance assessment Can patient stand on 1 foot for 10 seconds without any type of support? Vision and hearing status intact? (vision +/or hearing deficits weaken balance) • Chronic Conditions & Cognition: More than 3 chronic conditions? (arthritis, diabetes, hypertension, etc); also dementia • Drugs: Medication (prescription + OTC) and/or alcohol usage in previous 1-24 hrs? Cardiovascular, antidepressant & major tranquilizer meds increase fall risk • Environment & Exercise Level: Lighting status, tripping obstacles /hazards in or outside home? (includes pets, steps, ladders) Regular exercise/physical activity 2-3 times/week? • Footwear & Flooring: Did type (or lack) of footwear and flooring cause slipping or tripping?

6. What risks are observed on scene? You are on-scene with a 78-year old female who was found on the floor by a neighbor. She is uninjured and only needs help to a chair. She says she accidentally tripped and “didn’t have the strength to get herself up.”

7. How can we keep from coming back?

8. Action to take to prevent further injuries Make appropriate recommendations based on your observations: • Remove or secure loose rugs • Recommend a handrail that extends the length of the stairs • Advise patient to wear sturdy shoes with non-slip soles (not athletic shoes) • Encourage patient to talk to healthcare provider about: • prescription drug review • strength, balance and flexibility exercises • vision screening • falls risk assessment

9. Materials to leave behind • Utilize WHAM folder from rig • CDC “Check for Safety” booklet • CDC “What You Can Do To Prevent Falls” booklet • Washington Poison Center “Prevention & Treatment Guide” for older adults • “Dial 2-1-1” (local referrals for assistance) • Medical history form to post on fridge, if available from your department

10. Further info on Older Adult Falls • Join the Pierce County Falls Prevention Coalition (253-627-5144) • Links: CDC Senior Falls Prevention Toolkit--www.cdc.gov/ncipc/duip/fallsmaterial.htm NorthWest Orthopaedic Institute-- www.nwoi.org

11. WHAM developed by:Central Pierce Fire & RescueCity of DuPont Fire DepartmentGig Harbor Fire & Medic OneSafe Kids Pierce CountyTacoma-Pierce County Health Dept. Technical Assistance from:NorthWest Orthopaedic Institute Funding from:West Region EMS & Trauma Care Council