Each year, more than 1.8 million people over age 65 are treated in hospital emergency rooms for injuries associated with, among other things, stairs, bathtubs, furniture, and rugs/carpeting.  Thousands of these injuries are related to falls.  In fact, one in every three adults age 65 and older and almost half of people over the age of 80 falls at least once during a calendar year. Because falls can cause moderate to severe injuries, such as hip fractures and head traumas, and can even increase the risk of early death it is very important to identify the risk factors that can lead up to the fall. 

So, exactly who is at risk of falling?

The easy answer is everyone.  But there are specific reasons that can increase your risk.  Below is a list of the most common ones:

• Being 80 years old or older
• Leg muscle weakness
• Difficulty with balance or walking
• Vision problems (cataracts, macular degeneration, wearing bifocals)
• Medical conditions that limit your ability to get around, such as Parkinson disease, stroke, or diabetes
• Conditions that cause confusion, such as dementia and Alzheimer disease
• Depression
• Taking more than 4 medications at the same time or psychoactive medications (such as sedatives or antidepressants)
• Using a cane or other walking device
• Home hazards (throw rugs, pets underfoot)
• Low blood pressure

The more risk factors you have, the greater your risk.  20 to 30% of people who fall suffer moderate to severe injuries such as lacerations, hip fractures, or head traumas, usually occurring within the home. These injuries can make it hard to get around or live independently, and, in some cases, can even increase the risk of early death. 

Once people have experienced a fall, even if they are not injured, they develop a fear of falling again.  This fear may cause them to limit their activities, leading to reduced mobility and loss of physical fitness, which in turn increases their actual risk of falling again.  

Fortunately, the good news is that, for the most part, falls can be largely prevented!  For example, simple modifications to the interior of your house can cut your risk of falling by almost 50%!

How can you prevent falls?

By following these few simple steps and precautions, your risk of suffering from a fall will greatly be reduced, allowing you to maintain your independence.

Exercise regularly.  Specific strengthening exercises that focus on leg and “core” muscles used in maintaining posture are extremely important.  Balance training has also been shown to be an important part of fall prevention.  Whether you decide to join that Tai Chi class or need more guidance from a trained professional, such as a physical therapist, the key is to keep moving!

Review your medications.   Ask your primary care doctor or pharmacist to go over both your prescription and over-the counter medicines, especially if you receive prescription medications from different doctors.  A simple check can prevent the possibility of medications interacting with each other and causing dizziness or drowsiness.

Have your eyes checked by an eye doctor at least once a year.  You may be wearing the wrong glasses or have a condition like glaucoma that limits your vision.

Make your home safer.  About 50% of all falls happen at home.  By reducing tripping hazards (such as throw rugs), adding grab bars and railings in the bathroom, and improving the lighting in your home you are moving in the right direction to make your home safer and lower your chances of falling!

With the obvious benefits of avoiding a fall, why wouldn’t you do everything you can to prevent one?  So, don’t wait any longer; pick up that throw rug, replace those old light bulbs and start exercising!

Acknowledgements: American Physical Therapy Association’s Move Forward, Centers for Disease Control and Prevention, Home Safety Council

Karen Krzywda, MSPT, OCS is a physical therapist and owner of Head to Toe Physical Therapy in Lewiston and Topsham.  She has over 14 years of experience treating people in the outpatient setting.  For more information call 725-4400.

We all want the best for the senior loved ones in our lives. For many seniors, living independent lives at home is their main desire. Seniors are able to do so provided they are physically and mentally able to care for themselves. Sometimes, depending on their situations, seniors need help and guidance from friends and relatives, or from even caregivers who can facilitate the potential of seniors living home alone for as long as possible.

The key to seniors maintaining independent lifestyles depends on many factors and most importantly their safety in doing so. With that being said, it should be noted that one of the most common dangers older seniors face is falling. In fact, research shows that injuries and subsequent complications due to falls are the leading causes of death in seniors who are 65 and older. Furthermore, one out of three seniors in this age group fall each year. While not every tumble guarantees an injury, these statistics should prompt you and your senior loved ones to make every effort to prevent falls occurring within their homes.

The first place to evaluate is the bathroom. While this is the smallest room in the house, bathrooms potentially offer the most opportunities for falls to occur. Bathtub edges may be hard to step over for some seniors. Once in the shower or tub, wet surfaces can cause seniors to slip. Some seniors may not be able to stand steadily while bathing. Others may have trouble sitting down on toilets or standing up again after using them. Wet floors after showers or baths and even bath mats can cause seniors to slip and fall.

Comfort Keepers offers these ideas and solutions for safety in the bathroom:

Bathtubs and Showers
Install grab bars in proper places to aid in safe entry and exit of tubs and showers. Consider replacing a bathtub with a walk-in shower for seniors who have trouble stepping over high bathtub sides. Non-skid mats or decal applications should be applied on the floors of showers and tubs to help prevent slipping while bathing. Seniors who have trouble standing to bathe should use sturdy shower chairs made specifically for this purpose. Make sure soap, shampoos, towels and other bathing necessities are within easy reach.

Toilets and Floors
Seniors who have trouble sitting and standing up can have raised toilet seats installed to make this process easier. Grab bars should be installed for additional support. Make sure the toilet paper dispenser is easily accessible. Use a bathmat for the bathroom floor just outside the shower or tub to prevent slipping on slick floors after bathing. Place a non-skid material between the bathroom floor to prevent the mat from sliding or creasing.

While none of these safety features guarantees a no-fall zone, they certainly add layers of protection and aid for seniors at risk for falling. Your local home improvement store or durable medical equipment company carries safety devices made for specific purposes, and to ensure the safest results these items should be used instead of homemade devices. Another crucial element is installing safety aids properly and also teaching your loved ones how to use them. The discussion may be a bit hard to broach but the end result fosters safe, independent living for seniors in their own homes for as long as possible.

Parkview is Leading the Way with its Electronic Medical Records (EMR)Program

President Barack Obama has a clear vision of what he foresees as the future of health care in the United States.  And, in 2009, with the creation of the U.S. American Recovery and Reinvestment Act, the President set the bar high setting in motion a lofty goal:  every hospital and doctor’s office in America must computerize its medical information, creating a nationwide electronic medical record system (EMR).  Every patient’s records, files, data must be transferred from paper to integrated technology (IT) via an electronic database. The goal is to save billions of dollars and thousands of lives that are lost each year to waste and mistakes.  And the President backed his verbal pledge with a $787 billion federal stimulus package promise.

The money is aimed at stimulating interest and action.  Hospitals and doctors that adhere to the President’s goal using IT to fix system problems will be rewarded with stimulus money.  They will be given access to the $50 billion kitty over the next five years, starting with $19 billion which will be available to cooperating entities in 2011.  What’s more, medical groups and hospitals that lag behind and don’t install effective IT will face stiff punishment:  starting in 2015, they will see a 1 percent cut in Medicare payouts and the punishment grows to 3 percent come 2017.

Leading the way toward achieving the President’s vision here in Maine?  Parkview Adventist Medical Center.  The 55-bed acute care facility in Brunswick, which didn’t even have e-mail a decade ago, is grabbing national and global headlines with its IT division.  The department’s forward thinking, no-nonsense approach has garnered major awards and attention and has put the Maine Street hospital in line for receiving $700,000 in stimulus funds for implementing an EMR in the practices of its affiliated physicians.  “The hospital is pretty much paperless”, says Bill McQuaid, CIO and Assistant VP at Parkview.  Nurses are communicating and documenting patient information electronically, doctors are using computerized physician order entry, and pharmacy, radiology and labs are all electronic.

“Through advanced clinical committees, Parkview updates and improves clinical applications to provide better functionality for users and enhanced care for patients,” McQuaid proffers. “This evidence-based medicine wouldn’t be possible without integrating its computerized systems to analyze the data, which in the end, could wind up saving Parkview (and its patients) millions.”

“One of the biggest challenges I had was trying to get all these different things to talk together,” McQuaid said.    So, Parkview turned its attention to finding a vendor that could bring the whole system together electronically.  They found their match in the company Meditech.  “We picked them because they were truly one of the few vendors out there that had a solution for every aspect of the hospital.” 

McQuaid appreciated Meditech’s approach: they offered the same product to hospitals of all sizes. “The product they offered me as a 55-bed hospital is the same as a 1,000-bed hospital.  I don’t want reduced functionality.  What you have to build is no different if you’re two beds or a thousand beds.”  And McQuaid and his team, a six-person IT department, are now achieving even greater success:  sharing data with other facilities, including physician practices in the Brunswick area, larger hospitals and Maine’s Regional Information Exchange for EMR’s.   “We are leading the way and couldn’t be happier with how smoothly our system is working,” McQuaid admits.  “Yes, we are ahead of the pack.  And, yes, we plan to continue to be in the lead.”

When you begin to think about staying safely and comfortably in your own home, it’s not easy to think of everything. Here’s a very comprehensive home safety assessment list that you can download and print. It’s a great reminder of what you should look for in your own home, when you’re visiting senior family members, or even as you consider downsizing or moving to a different location. There’s even a section at the end with special considerations for persons living with Alzheimer’s or dementia.