Fall Prevention Programs at The Therapy Center
Falls are one of the most common geriatric syndromes threatening the independence of older persons. Between 30 and 40 percent of community-dwelling adults older than 65 years fall each year, and the rates are higher for nursing home residents. Falls are associated with increased morbidity, mortality, and nursing home placement. Most falls have multiple causes. Risk factors for falls include muscle weakness, a history of falls, use of four or more prescription medications, use of an assistive device, arthritis, depression, age older than 80 years, and impairments in gait, balance, cognition, vision, and activities of daily living. Physicians and Physical Therapists caring for older patients should ask about any falls that have occurred in the past year. Assessment should include evaluating the circumstances of the fall and a complete history and physical examination, looking for potential risk factors. The most effective fall prevention strategies are multifactorial interventions targeting identified risk factors, exercises for muscle strengthening combined with balance training, and withdrawal of psychotropic medication. Home hazard assessment and modification by a health professional also is helpful. Between 20 and 30 percent of older adults who fall suffer serious injuries such as hip fractures and head trauma. Recovery from falls often is complicated by poor quality of life caused by restricted mobility, functional decline, and increased risk for nursing home placement. Self-imposed functional limitations due to the fear of falling can cause post-fall anxiety syndrome. This can lead to depression, feelings of helplessness, and social isolation.