According to the Centers for Disease Control, one out of three people over the age of 65 fall each year.  Among older adults aged 65+, falls are the leading cause of accidental death, nonfatal injuries, and trauma-related hospitalizations.  People over the age of 75 have the highest rate of non-fatal fall episodes of all age groups.

Falls can result in cuts, scrapes, bruises, broken bones, head injuries, and/or death.  Even without an injury, a fall can cause an older adult to develop a fear of falling, which can be debilitating and cause a person to limit physical activity and social interaction to avoid the potential for falls.

Many falls occur in the home, so below are some tips to keep your home safe and to potentially prevent falls:

Entry

• If there are steps to enter/exit, make sure that:
  • There is a sturdy handrail
  • The steps are dry and clear of debris
  • A doormat may be a tripping hazard, so be careful when walking near it or remove it completely.

Kitchen

• To avoid being scalded, set your water heater to a maximum of 120 degrees.
• Rugs may be tripping hazards, you may want to remove them
• Keep the floor clean and dry to prevent slipping
• If possible, keep all frequently used items at a level where you won’t need to reach overhead or bend down
• Do not try to lift or move heavy pots full of hot food or liquid
• Keep the handles of pots and pans turned in so that no one accidently knocks cooking food off of the stove
• Keep cords short by gathering up the excess length with a zip-tie to prevent tripping on cords or knocking appliances onto oneself.

Bathroom

• If you have difficulty standing from the toilet, consider getting a commode chair.
• If you need assistance to maintain your balance while performing toileting tasks (undressing, cleaning yourself, dressing), install a sturdy grab bar.  Towel racks are not strong enough to hold a person’s body weight if they fall.
• If possible, use a step-in shower rather than a tub shower to decrease the risk of falling when you step over the edge.
• To avoid being scalded, set your water heater to a maximum of 120 degrees.
• Bathe using a shower chair and a shower hose to prevent slipping and falling.
• Install grab bars near the shower or tub to use when stepping in and out.
• Keep the floor clean and dry to prevent slipping.

Living Room

• Remove throw rugs, as they can be tripping hazards
• Do not allow cords to run across traffic areas
• Keep cords short by gathering up the excess length with a zip-tie to prevent tripping on them.
• Keep the floor clear of clutter to prevent falls.

Bedroom

• Use a nightlight to prevent falling during the evening, especially when getting up to use the bathroom.
• Consider using a bedside commode at night.
• Do not allow cords to run across traffic areas.
• Keep cords short by gathering up the excess length with a zip-tie to prevent tripping on them.
• Keep the floor clear of clutter to prevent falls.

Miscellaneous Safety Tips

• Keep in mind that though they can be good companions, small animals are a tripping hazard.
• Use nightlights in the hallways to prevent falling during the evening.
• Consider using a medical alert system so that if you ever need emergency assistance and cannot get to a phone, you will be able to call for help.
• Check in with a loved one regularly.
• Consult your physician regularly.
• Have your vision checked regularly.
• If you are feeling sick, dizzy, or unusual in any way, do not hesitate to call your doctor!
• Never be too proud to ask for help, whether it be to carry groceries, to help clean your house, to drive you around town, or any other activity you do not feel confident doing on your own.
• Seek out a community-based balance class for seniors
• If you are experiencing weakness, impaired balance, or are having difficulty getting around your home and the community, consider Physical Therapy to address these impairments.

According to the Centers for Disease Control, one out of three people over the age of 65 fall each year.  Among older adults aged 65 and over, falls are the leading cause of accidental death, nonfatal injuries, and trauma-related hospitalizations.  People over the age of 75 have the highest rate of non-fatal fall episodes of all age groups.  Falls are also a major reason that seniors find themselves no longer able to live independently.

Falls can result in cuts, scrapes, bruises, broken bones, head injuries, and/or death.  Even without an injury, a fall can cause an older adult to develop a fear of falling, which can be debilitating and cause a person to limit physical activity and social interaction to avoid the potential for falls.

Fortunately, many falls can be prevented with the help of a Physical Therapist.  Physical therapy is a health profession that strives to maximize a person’s mobility, functional ability, wellness, and quality of life.  A physical therapist is a medical professional who is licensed to assess and treat impairments, functional limitations, and disabilities in patients.

Physical Therapy for Fall Prevention

Many factors, both internal and external, can lead to an increased risk of falls.  A physical therapist will first perform an evaluation which will include a detailed history which includes medical history, history of the current problem, patient concerns, and patient goals.  The PT will then perform a physical assessment of a person’s balance, strength, sensation, proprioception (awareness of the body’s position in space), and functional mobility.  The PT will also consider external factors such as the patient’s home environment, footwear, and assistive devices.  Using this information, the physical therapist will develop a unique treatment program for the patient, which may include strength training, balance training, proprioceptive training, functional training, recommendation of appropriate footwear, prescription of an assistive device as appropriate, and a home safety evaluation.

Strength Training:  Many falls occur as the result of decreased strength.  Weak muscles at the front of the leg may prevent a person from lifting their toes to help their foot clear the floor while they walk.  If their toes drag, it can lead to a trip and fall.  Weak quadriceps and gluteal muscles can prevent a person from standing fully erect and the added effort to stand up can lead to a fall.  A physical therapist will determine which muscles are weak and develop a strengthening program that is individualized to each patient.  Exercises may include squats, knee extensions, hamstring curls, and calf raises.  These exercises will be performed during the PT session and as part of a home exercise program.

Balance Training:  Many older adults experience impaired balance for a variety of reasons including certain medications, vestibular issues such as vertigo, low blood pressure, or neurological conditions.  While physical therapy may not necessarily cure the cause of the dizziness, it can help improve a patient’s balance and teach a patient to become desensitized to any exaggerated feelings of dizziness that the patient may be experiencing.

Balance activities during a PT session may include standing with a narrow base of support, sitting and standing on unstable surfaces, sitting and standing activities with the eyes closed or with head movements, stepping over and around obstacles, walking on a line or balance beam, and education in alternative movement patterns.

For vestibular issues such as vertigo or Meniere’s disease, there are physical therapists that specialize in vestibular rehabilitation.

Proprioceptive Training:  Proprioception is a person’s ability to determine his or her body’s position in space.  Proprioceptive training activities are similar to balance activities and serve to stimulate the receptors in the joints that are responsible for proprioception.  These include standing on unstable surfaces such as foam cushions or wobble boards, performing balance and movement activities with one’s eyes closed, and replicating joint positions with one’s eyes closed.

Functional Training:  Functional training with a physical therapist includes activities such as getting into and out of bed, standing from a variety of surfaces, safely sitting with control, getting into and out of a vehicle, stair and curb training, and walking in a safe and efficient manner.  Many falls occur during these transitional movements, so performing them safely and in a controlled manner will help reduce the risk of falls.  The physical therapist will have the patient practice these tasks in a controlled clinic environment, then generalize the skills to the patient’s home and community.

Appropriate Footwear:  A physical therapist will take a person’s footwear into consideration if they have a history of falls.  Proper footwear is not too heavy, not excessively worn, fits correctly, can be laced or fastened easily, and offers appropriate support.  Shoes that are slick on the bottom or that have heels should not be worn by someone who is at risk of falling.

Assistive Devices:  If necessary, a physical therapist will recommend an appropriate assistive device to help with a patient’s balance.  These devices include canes, walkers, foot and ankle braces.  A PT will also help train patients how to use these devices safely and correctly.

Home Safety Evaluation:  A physical therapist may be able to come to a patient’s home to perform a safety evaluation.  This evaluation would include identifying and eliminating tripping hazards, recommending installation of grab bars if necessary, and recommending equipment such as a commode or shower chair.

Unfortunately, there are some factors that a PT is unable to change.  Loss of sensation from diabetes or neuropathy cannot be directly treated by a PT, but the patient can be taught compensatory strategies along with the treatment described above.  A PT cannot address medication side effects, but can communicate to a patient’s physician that the prescribed medication may be contributing to the risk of falls.  Incontinence can lead to falls and may be treatable by a physical therapist depending on the cause, but it is also an issue that needs a physician’s expertise.  Impaired vision can also lead to an increased risk of falls, so those at risk should have their vision checked regularly and make sure that their prescription is appropriate.

Many falls in older adults can be predicted and prevented.  Physical therapy treatment can help remediate several risk factors for falling to ensure that our seniors are able to live longer, safer, and more active lives.

Today’s seniors are busier than ever!  With advances in healthcare and disease prevention, seniors are healthier and are able to lead longer, more active lives.  However, injuries, illness, or the effects of aging can impair a senior’s ability to lead the type of life desired.

If a senior’s activity level is limited by deconditioning after an illness, pain from osteoarthritis, a history of falls, vestibular problems, weakness, or any other medical condition, it would be prudent to seek the assistance of a physical therapist.  Physical therapy is a health profession that aims to remediate impairments and functional limitations.  Physical therapy also strives to maximize a person’s mobility, functional ability, wellness, and quality of life.

After an injury, illness, or general deconditioning, a physical therapist can help to halt or reverse functional decline by helping seniors move in an efficient, less painful manner.  To help seniors maintain active lifestyles, a physical therapist will determine an individualized treatment plan for each patient after performing a thorough assessment.

The physical therapist would work with the patient to determine measureable, relevant goals to encourage compliance and to make physical therapy sessions more meaningful.  For example, if a senior desires a return to playing golf, the physical therapist can help him or her practice walking on grassy terrain, maintain balance while swinging a club, and squat to pick up a ball or tee with proper body mechanics.

Physical therapy treatment plans may incorporate manual therapy techniques, stretching, therapeutic exercise, balance training, functional mobility training, gait training, and caregiver training.  If necessary, a physical therapist may also recommend appropriate assistive devices such as canes or walkers for patients to help them move as safely as possible.  Patient education regarding one’s condition, injury prevention, proper body mechanics, appropriate recreational activities, and general health and wellness is also a vital part of physical therapy intervention.  To ensure continued progress and consistency, a physical therapist will often prescribe an individualized home exercise program.

Many physical therapists offer community based educational and fitness classes.  Often, these classes can be found at senior centers, assisted living facilities, or offered by the city in which one lives.  These classes are aimed at active seniors to help them remain active, educated, and safe.  Physical therapists are often familiar with numerous community-based fitness and recreational programs and can make appropriate recommendations based on a person’s preferences and abilities.

With the guidance of a physical therapist, seniors can assume or continue a fitness program that would be most beneficial for them, whether it be walking, swimming, cycling, dancing, golfing, Tai Chi, or anything else of interest.