Better Balance for Fall Prevention Get Strong and Get Going Reducing the Risk of Falls 1
2
Contents Better Balance for Fall Prevention............................... 4 Safety Check................................................................................................ 6 Your Environment................................................................................ 8 Healthy Habits........................................................................................... 9 Physical Activity and Balance Exercises............ 12 Exercises Build Your Balance and Strength 1. Walking Group......................................................................... 14 2. Balance and Strength Exercises.................................... 14 3. Exercises in the Armchair..................................................19
References ................................................................................................ 27
3
Better Balance for Fall Prevention Each year we focus on fall prevention by providing advice and resources. This booklet provides important information about effective and achievable falls prevention strategies. We hope that this will contribute to helping you live safely.
Understanding the Risk of Falls Falls in older adults are serious. Broken bones can be slow to heal and can take a long period of recovery. Falls can also have a lasting impact on your confidence due to an ongoing fear of falling. The old saying ‘use it or lose it’ is especially true in helping to prevent falls. So we want to do everything we can to help you stay fit, healthy and safe from falls.
4
The best way to prevent falls is by staying active, looking after yourself and maintaining safety around the home. Reducing your risk of falling and injury will allow you to continue to participate in activities that you value and enjoy, enabling you to live the life you choose. Evidence suggests that there are several factors that increase the risk of falls for older adults. The environment, footwear, decreased muscle strength and balance, medications and reduced vision can all contribute to a fall.
5
Safety Check This Safety Checklist can assist to identify areas where changes could be made to prevent falls.
Safety Checklist Access in and around your room
Yes
No
N/A
Yes
No
N/A
Yes
No
N/A
Do you feel safe and steady on your feet when going through your door? If you get up at night, are you able to turn on lights so you can see your way clearly? Can you easily reach the items in your room which you use every day, without needing to reach above your head or below your knees? Around the home Are you able to easily get up from your chair when in the dining and lounge room? Bathroom and toilet Do you feel safe and confident with the level of support and assistance in and around the shower? Can you easily reach soaps and shampoos whilst showering without over reaching or bending?
6
Bedroom
Yes
No
N/A
Do you feel safe and steady on your feet when walking from your bedroom to the toilet – especially at night time? Is your bed easy to get up and out of? Are you confident using the electric bed adjustment system? Do you have a nightlight or bedside table light which can be turned on easily when needed during the night? Is there anything in your room or environment that may be a falls risk to you?
If you answer ‘no’ to any of these questions it is recommended your Team arrange a reassessment.
7
Your Environment Removing Hazards We have systems and processes to monitor, remove or minimise hazards in order to prevent falls.
Minor or Major Modifications Around the Home Our Allied Health Team can advise you on the types of modifications that will keep you safer, and support you to be as independent as possible. Simple modifications already included are the grab rails in your bathroom or along the hallways.
Prescription of Assistive Equipment Your Allied Health Team can prescribe all sorts of handy equipment to improve your independence and safety. People are often amazed by the variety of helpful gadgets and technologies to help with everyday activities like getting out of bed, showering, dressing, and moving around the home, garden and community.
Lighting Good lighting throughout your home, both inside and outside, is important for preventing falls. Outdoor sensor lighting can help you see clearly after dark. Nightlights or a bedside table light that can be reached from bed can be used to ensure that you can see properly when going to the toilet at night.
8
Healthy Habits Regular Health Check Up Conditions including diabetes, Parkinson’s disease, dementia and arthritis can cause you to feel unsteady and increase your risk of falling. Having regular check-ups with your health professional will assist to you to know how to manage these conditions and continue to move safely.
Nutrition Eating a healthy diet is important to fuel your body and to keep your muscles and bones working properly. A balanced diet consists of foods from the five food groups (fruit, vegetables, meats, dairy and cereals/grains), and drinking plenty of water. Your Medical Practitioner may prescribe vitamins and minerals, in particular Vitamin D and calcium.
Medicines Some medicines can make you feel dizzy and drowsy, and increase your risk of falling. If you take multiple medicines, or use medicines to sleep, a medication review with the pharmacist may be worthwhile.
9
Footwear and Foot Health Wearing correctly fitted, firm and supportive shoes can assist to prevent falls. Here are some things to look for. Firm heel counter
Fastening firm and adjustable Smooth lining Uppers of soft breathable material
Flexible at forefoot Low heel Deep and wide toe box
Stable synthetic sole
(Sutherland Podiatry, 2020)
Ensuring your feet are healthy and that conditions such as bunions, corns and calluses are treated can also be a positive step towards falls prevention. Regular check-ups with a podiatrist can be a useful way to monitor foot health and gain advice on suitable footwear.
Eyesight Changes in your eyesight often occur as you age. It is important to have regular eyesight checks to monitor vision changes and seek treatment when needed. If you are not able to see properly, you may not see the raised edge of a footpath, or the edge of a step, which could cause you to trip and fall. 10
You Choose Falls can be prevented by making careful choices about which activities are safe for you to do. Consider your capabilities and what you are going to need to do to complete the task, before you start. A little planning can make all the difference. Your Team will support you and may offer alternatives to meet your needs safely. If you’re not sure that you can do something safely, don’t take the risk – just ask your Team to assist.
Personal Monitoring System A personal alarm or monitoring system can give you confidence that you will be able to get help when you need it. There are several types of buzzers, call bells and monitoring systems available. These may be worn around your neck or on your wrist or attached by cord to a wall plug, and with the push of a button can contact your Care Team. Some devices also have an automatic movement detection feature and will alert the Team if you are at risk.
11
Physical Activity and Balance Exercises Balance is a complex skill that requires coordination between our brain and the information we receive from our sensory systems. Good balance is often taken for granted. As we age it may start to seem harder to step from a footpath onto grass, getting out of bed without stumbling or get up from a chair quickly to answer the phone. Research has shown that engaging in regular exercise is important for your health. Exercises that focus on balance and strength are vital to prevent falls and should be included in your daily routine. The next section of this booklet provides some basic exercises that can assist you to improve these two areas.
12
Precaution Only perform these exercises if you’re able to do so safely and after you have been assessed by your Allied Health Team. Our Allied Health Professionals, such as a physiotherapist or exercise physiologist can also advise about whether a walking aid such as a walking stick would be appropriate. If you experience any of the following during the exercises you should cease exercise and tell your Care Team: •
Chest pain
•
Dizziness
•
Severe shortness of breath
•
Significant change in muscle and joint pain
•
Any other severe symptoms
You may experience some muscle soreness at first, or if you do a lot of the exercises. This is a natural process that allows muscles to repair and rebuild to be stronger. This feeling is completely normally and may peak up to 48 hours after. The more regularly you exercise the less likely you will experience muscle soreness. You should also ensure that you exercise in an area that is level and clear of any hazards or obstructions. Please refer to your lifestyle calendar for scheduled exercise sessions.
13
Exercises Build Your Balance and Strength All programs are closely supervised and individually upgraded.
1. Walking Group The homes walking program provides a structured and tailored walking program that is safe and right for your level of mobility. The program will build on your mobility level while having fun and meeting people.
2. Balance and Strength Exercises Sit to Stand The sit to stand exercise helps with getting up and down from a chair, a toilet or in and out of a car.
14
•
Move to the front of the chair. Lean your body forward, with your nose over your toes, and stand up slowly. Keep your knees slightly apart.
•
Lower yourself back down into the chair, trying to control your descent to the chair.
•
Repeat 5-10 times up to three times a day.
•
To make this exercise harder, cross your arms in front of your chest or hold them out in front of you at shoulder height.
Heel to Toe Stance and Tandem Walk The tandem walk challenges your static and dynamic balance by narrowing your base of support. This helps you keep balance when you have to walk through a narrow space or turning on the spot. •
With fingertips on the top of the kitchen bench to help balance, stand heel-to-toe, bend your knees slightly and keep still for up to ten seconds, repeat up to three times a day. Keep your support on straight leg.
•
If you feel confident you can vary the exercise by walking slowly, placing your heel to touch the toe of the other foot along the kitchen bench, repeat 10 steps up to three times a day.
15
Standing Knee Raise The knee raise strengthens the muscles of the hips, it helps with climbing stairs and getting in and out of cars and buses.
16
•
With fingertips on something solid like the kitchen bench to help balance, lift a knee to hip level and hold it up to five seconds.
•
Repeat with the other leg.
•
Repeat 5 to 10 times each side, up to three times a day.
Side Leg Raises/Sideways Walking The side leg raise improves your stability when you have to take weight on one leg and helps you step sideways to avoid tripping. •
With fingertips on something solid such as the kitchen bench to help balance, stand on one leg and raise the other sideways, holding it up for five seconds whilst keeping your supporting leg straight.
•
If you feel confident you can vary the exercise by extending to walking sideways, with slow steps alongside a bench or table.
•
Repeat 5 to 10 times each side up to three times a day.
17
Heel Raises
18
•
Stand with feet shoulder width apart. Hold onto a wall or bench to help with balance if needed.
•
Slowly rise up onto your toes, making sure your body moves straight upwards.
•
Lower your heels to the floor to return to your start position.
•
Repeat 5 to 10 times, up to three times a day.
•
To make this exercise harder, stand on one leg and slowly rise up onto your toes. Hold onto a bench if needed.
3. Exercises in the Armchair Chest Stretch This stretch is good for posture. •
Sit upright and away from the back of the chair. Pull your shoulders back and down. Extend your arms out to the side.
•
Gently push your chest forward and up until you feel a stretch across your chest.
Hold for 5 to 10 seconds and repeat 5 times.
19
Upper-Body Twist This stretch will develop and maintain flexibility in the upper back. •
Sit upright with your feet flat on the floor, cross your arms and reach for your shoulders.
•
Without moving your hips, turn your upper body to the left as far as is comfortable. Hold for 5 seconds.
•
Repeat on the right side.
Do 5 times on each side.
20
Hip Marching This exercise will strengthen hips and thighs, and improve flexibility. •
Sit upright and do not lean on the back of the chair. Hold on to the sides of the chair.
•
Lift your left leg with your knee bent as far as is comfortable. Place your foot down with control.
•
Repeat with the opposite leg.
Do 5 lifts with each leg.
21
Ankle Stretch This stretch will improve ankle flexibility and lower the risk of developing a blood clot. •
Sit upright, hold on to the side of the chair and straighten your left leg with your foot off the floor.
•
With your leg straight and raised, point your toes away from you.
•
Point your toes back towards you.
Try 2 sets of 5 stretches with each foot.
22
Arm Raises This exercise builds shoulder strength. •
Sit upright with your arms by your sides.
•
With palms forwards, raise both arms out and to the side, and up as far as is comfortable.
•
Return to the starting position.
Keep your shoulders down and arms straight throughout. Breathe out as you raise your arms and breathe in as you lower them. Repeat 5 times.
23
Neck Rotation This stretch is good for improving neck mobility and flexibility. •
Sit upright with your shoulders down. Look straight ahead.
•
Slowly turn your head towards your left shoulder as far as is comfortable. Hold for 5 seconds and return to the starting position.
•
Repeat on the right.
Do 3 rotations on each side.
24
Neck Stretch This stretch is good for loosening tight neck muscles. •
Sitting upright, look straight ahead and hold your left shoulder down with your right hand.
•
Slowly tilt your head to the right while holding your shoulder down.
•
Repeat on the opposite side.
Hold each stretch for 5 seconds and repeat 3 times on each side.
25
Please remember, if you do have a fall, even if you are unhurt, make sure that you tell your Care Team that you have fallen.
26
References Australian Government: Department of Health, 2015. The Five Food Groups. [Online] Available at: https://www.eatforhealth.gov.au/food-essentials/five-foodgroups [Accessed 25 September 2020]. Clemson, L. & Sherrington, C., 2013. Staying Active and on your feet. [Online] Available at: https://www.activeandhealthy.nsw.gov.au/assets/Uploads/StayingActive-A4-Oct2018-web.pdf [Accessed 25 September 2020]. Pharmacy Programs Administrator, 2018. MedsCheck and Diabetes MedsCheck. [Online] Available at: https://www.ppaonline.com.au/programs/medicationmanagement-programs/medscheck-and-diabetes-medscheck [Accessed 25 September 2020]. Sutherland Podiatry, 2020. The Ideal Shore. [Online] Available at: https://sutherlandpodiatry.com.au/wp-content/uploads/2016/06/falls-shoe.jpg [Accessed 25 September 2020]. Waldron, N., Hill, A.-M. & Barker, A., 2012. Falls Prevention in Older Adults: Assessment and Management. Australian Family Physcian, 41(12), pp. 930- 935. NSW Government Active and Healthy (2022) www.activeandhealthy.nsw.gov.au Injury Matters Prevention to Recovery (2022) https://www.injurymatters.org.au/informationhub/ programresources/category/stay-on-your-feet/ The NSW Fall Prevention and Healthy Ageing Network (2022) https://fallsnetwork.neura.edu.au/thenetwork/
27
MyTeam is all about you and the way you wish to live your life. Residents, families and consistent team members are all partners in MyTeam. Our relationship-based approach means that personal care is delivered by a smaller number of carers who get to know each resident’s choices and preferences. MyTeam can assist with your mobility and falls prevention by: • Ensuring that you participate in exercise activities of your choice; these may be scheduled or individual, • Referring you to the physiotherapy team for expert review and advice, • Sharing information that ensures the whole team knows how best to support you, • Creating a better and safer environment in your room and in common areas. BaptistCare’s MyTeam approach is all about improving quality of life.
www.baptistcare.org.au 28
02112