The First Step Falls prevention starts with you

Transcription

1 The First Step Falls prevention starts with you A booklet for older adults living in Kingston, Frontenac and Lennox & Addington

2 Find out if you re at risk of falling and take action to reduce your risks. Disclaimer: This material is intended to provide you with general information. It does not take the place of assessment, information or services provided by a health care professional. Acknowledgments: KFL&A Public Health wishes to acknowledge the efforts of staff, students, and community partners who contributed to the 2014 review and revision of this booklet. A special thanks to the following individuals for their contributions: Anne Chiarelli, RN - Canadian National Institute for the Blind Mary Lou Boudreau, MSc OT (Ret) Nancy Willis, C. Ped (C) - Computer Engineered Orthotics

3 Introduction Injuries from falls have been identified as the leading cause of hospital admissions due to injury in Ontario. As we age, we are particularly at risk of having a fall. One in every three people over the age of 65 will have a fall each year. A fall can cause an injury that might seriously impair your ability to live independently. Forty percent of all nursing home admissions can be directly related to a fall. The good news is that most falls are predictable and preventable! Do you know what is putting you at risk for a fall? Research shows that there are many risk factors linked to falls. Many of these risks can be reduced through awareness and simple lifestyle changes. This booklet will help you to see what is putting you at risk, and what you can do to reduce your risks and prevent a fall. Take your First Step to Prevent Yourself from Falling 1. Answer the Falls Risk Questions on pages 2 and For each question answered Yes, go to the corresponding page listed beside the question. 3. Put a check mark beside every item that applies to you. 4. Complete the My Plan to Prevent Falls on page See pages 24 and 25 for a list of organizations that provide community programs and services for older adults in Kingston, Frontenac, and Lennox & Addington. Take control now to stay on your feet! Page 1

4 Your Falls Risk Checklist Do you: Circle Yes or No If yes, go to page: 1. Ever feel dizzy? Yes No 4 - Dizziness 2. Take three or more medications? Yes No 5 - Medication Concerns 3. Ever have more than one drink of alcohol per day? Yes No 6 and 7 - Problems with Alcohol 4. Have foot problems? Yes No 8 - Foot Problems 5. Have weak muscles or stiff joints? Yes No 9 - Weak Muscles and Stiff Joints 6. Have to rush to the bathroom? Yes No 10 - Bladder and Bowel Control 7. Have vision or hearing difficulties? Yes No 11 and 12 - Vision and Hearing Difficulties 8. Have trouble sleeping? Yes No 13 - Sleep Difficulties Page 2

5 Your Falls Risk Checklist Do you: Circle Yes or No If yes, go to page: 9. Experience difficulty with concentrating? 10. Neglect to regularly check for safety hazards in and around the home? 11. Walk in places that are uneven, slippery or icy? Yes No 14 and 15 - Concentration Difficulties Yes No 16 and 17 - Indoor Hazards Yes No 18 - Outdoor Hazards 12. Experience shortness of breath? Yes No 19 - Shortness of Breath 13. Have difficulty keeping your balance? Yes No 20 and 21 - Balance Difficulties 14. Have frequent slips, trips, near falls or falls? Yes No Please read the complete booklet and speak to your health care provider*. 15. Notice a recent, unexpected change in your ability to function? Yes No Speak to your health care provider*. You may be eligible for a referral to the Regional Geriatric Program. Call or * In this publication the term health care provider refers to a doctor or nurse practitioner. Page 3

6 Dizziness What causes dizziness What you can do Where to get help Medication side effects Low or high blood pressure Inner ear problems Poor nutrition and eating habits (e.g., not eating enough or often enough) Dehydration Getting up too quickly from a chair or bed Discuss your symptoms with your health care provider and have your inner ear checked. Also discuss any medications you re taking that could be causing dizziness. Have your blood pressure checked regularly in both sitting and standing positions. Eat regularly. Canada s Food Guide recommends eating three meals and two snacks per day from a variety of food groups. Include protein rich foods like meat, fish, eggs, nut butters or cheese with your meals and snacks. Stay hydrated. Drink fluids throughout the day 9 cups for women and 12 cups for men. Sit down immediately if feeling dizzy. Sit on the side of your bed for a few minutes before standing up. Talk to your health care provider about a referral to Providence Care Physiotherapy Outpatient Services Vestibular Rehabilitation Program or call , ext for information. Call KFL&A Public Health s Diala-Dietitian line for information on nutrition at or , ext Contact Eat Right Ontario to speak to a registered dietitian at or visit Page 4

7 Medication Concerns What causes medication concerns What you can do Where to get help Taking several medications. This may increase the risk of drug interactions that can cause side effects such as dizziness or drowsiness. Taking non-prescription medications, herbal supplements or alcohol with prescription medications. Using someone else s medication. Not understanding why you are taking certain medications or when and how to take them. Your health care provider not being aware of all the medications or supplements you are taking or side effects you may have experienced. Taking expired medication. Ask your pharmacist about potential medication side effects or drug interactions before taking a new medication. Use the same pharmacy if possible. Review your medications with your health care provider every six months or whenever a medication is added or stopped. Keep an updated list of your medications in your wallet, purse or on your fridge. Never take someone else s medication. Consider using a pill organizer. Take unused or expired medication to the pharmacy for proper disposal. Talk to your health care provider or pharmacist. Order your free personal medication record, My MedRec, by calling or visit www. knowledgeisthebestmedicine.org. Your local pharmacist may also have copies available. Book your FREE MedsCheck personal medication review. Ask your pharmacist or call to book an appointment. Page 5

8 Problems with Alcohol What causes problems with alcohol What you can do Where to get help Drinking more than what is recommended in Canada s Low- Risk Alcohol Drinking Guidelines. Taking medication and drinking alcohol. Drinking alcohol on an empty stomach. Using alcohol to cope with emotional problems or physical pain. Using alcohol to help you sleep. Do not exceed Canada s Low- Risk Alcohol Drinking Guidelines. Measure your drinks (see graphic on page 7). Avoid mixing alcohol with medication(s). Eat food when drinking alcohol and have a glass of water between drinks. Talk to your health care provider if you are using alcohol to cope with emotional problems. Page 6 Talk to your health care provider. Contact Frontenac Community Mental Health and Addictions Services for support groups and counselling at , ext or visit Contact Lennox & Addington Addiction and Community Mental Health Services for support groups and counselling at , or visit Contact Hospice Kingston s Grief and Bereavement Program at , L&A Hospice at for grief support or the Victorian Order of Nurses (VON) at Contact the Canadian Centre on Substance Abuse for information about Canada s Low-Risk Alcohol Drinking Guidelines at

9 Canada s Low-Risk Alcohol Drinking Guidelines Drinking alcohol is a personal choice. Older adults should not exceed Canada s Low-Risk Alcohol Drinking Guidelines (LRADG). Women: no more than two drinks per day or 10 drinks per week. Men: no more than three drinks per day or 15 drinks per week. Both men and women should plan to have non-drinking days each week to avoid developing a habit. Our bodies process alcohol more slowly as we age and may become more sensitive to alcohol. This increases the risk for falls and may worsen some health issues. In addition, many older people have multiple prescription medications that can interact with alcohol. It is recommended that you do not drink alcohol if you are taking medications. For more information on the LRADG, visit Page 7

10 Foot Problems What causes foot problems What you can do Where to get help Wearing poorly fitted, nonsupportive or worn out shoes. Wearing shoes with sticky or slippery soles, with loose or undone laces, or with heels that are high and narrow. Swollen feet. Untreated calluses, bunions, corns, untrimmed or ingrown toenails. Health conditions such as diabetes and poor circulation. Muscle imbalances or poor posture. Wear proper-fitting, supportive shoes that have a good tread. Always ensure that laces are tied. If wearing heels, ensure they are broad based with a good tread. Elevate legs and feet when swollen. See a foot care specialist for foot care, including regular toenail trimming if unable to do yourself. Ask a foot care specialist or physiotherapist about exercises you can do to increase strength and improve flexibility in your legs and feet. If you wear slippers at home, ensure that they fit, are comfortable, have a good tread, and enclose around the heel. Wear loose socks or stockings as knee highs can cut off circulation in your legs. Page 8 Talk to your health care provider or see a foot care specialist. Consult the Yellow Pages for a chiropodist, podiatrist, physiotherapist or occupational therapist. Talk to your health care provider about a referral to Providence Care Physiotherapy Outpatient Services, or call , ext for information. Call the Canadian Diabetes Association to speak to a diabetes educator if your foot problems are related to diabetes at or For properly fitted shoes, consult the Yellow Pages for a pedorthist, or certified shoe fitter, or visit a comfort shoe store.

11 Weak Muscles and Stiff Joints What causes weak muscles and stiff joints Lack of physical activity, including sitting for long periods of time. Muscle imbalances or poor posture. Conditions affecting the muscles and joints such as arthritis. Acute or prolonged illness. Overexertion or improper form during physical activity. Improper use of mobility aids. Unresolved injuries or pain. What you can do Talk to your health care provider about muscle or joint pain, or if you are planning to become physically active. Be active. See page 27 for the Canadian Physical Activity Guidelines for adults over 65. Avoid sitting for long periods of time. For example, if watching T.V., get up and move around during commercials. If you use mobility aids, make sure they are fitted properly and that you know how to use them correctly. Where to get help Talk to your health care provider about a referral to Providence Care Physiotherapy Outpatient Services, or call , ext for information. Call KFL&A Public Health s Living Well Phone Line at , ext for information on free physical activity programs. See pages 24 and 25 for local community organizations who provide fitness programs for older adults. Call the VON at for information on their free exercise and falls prevention programs. Call The Arthritis Society at or Talk to your health care provider if you think you need a mobility aid. Page 9

12 Bladder and Bowel Control What causes changes in bladder and bowel control Weakness of muscles controlling urine flow Changes in your normal eating and drinking routine Medications Infections Prostate problems Constipation Caffeine and alcohol consumption Inadequate fluid intake Difficulty getting to the bathroom on time What you can do Talk to your health care provider about any changes in bladder or bowel control or habits, and any symptoms you may be experiencing. Kegel exercises may be recommended to strengthen the muscles that control urine flow. Limit or avoid beverages that contain caffeine like coffee, tea or cola. Go to the bathroom before going to bed. Eat adequate servings of vegetables and fruit, whole grains and legumes according to Canada s Food Guide. Be active on a regular basis. Drink enough fluids so that your urine is light yellow in colour. Where to get help Talk to your health care provider. Call the Canadian Continence Foundation at or Call KFL&A Public Health s Diala-Dietitian line at or , ext to speak to a registered dietitian. Call Eat Right Ontario at to speak to a registered dietitian or visit Consult the Yellow Pages under pharmacies or hospital equipment and supplies for incontinence products, or call 211. Page 10

13 Vision Difficulties What causes vision difficulties Age-related diseases of the eye such as cataracts and glaucoma Diseases that affect eyesight, such as diabetes and stroke Medications Dirty or scratched eye glasses Sensitivity to glare Prescription for glasses that needs to be changed Getting used to wearing bifocals Poor or low lighting What you can do Have vision checked annually. Clean glasses regularly using a soft cloth and keep glasses in good repair. Wear sunglasses to reduce glare. Give your eyes time to adjust to changes in light (e.g., going indoors on a sunny day). Maintain a clutter-free environment free of tripping hazards. Ensure good lighting throughout your home. Use colour contrast on stairs. Remove reading glasses when walking. Maintain good diabetic control. Where to get help Talk to your health care provider or optometrist to arrange for an eye exam covered by OHIP if you are over 65. Contact the Canadian National Institute for the Blind at , or visit Page 11

14 Hearing Difficulties What causes hearing difficulties Foreign objects or wax build up in ears Dirty or old batteries in hearing aids Hearing aids that are no longer appropriate for the degree of your hearing loss Inner ear problems Infections Conditions such as tinnitus (ringing in the ears) or Ménière s disease Excessive exposure to loud noise What you can do Visit your health care provider to have your ears checked for foreign objects or wax build up. Talk to your health care provider if you experience a decrease in your hearing. Learn the proper care for your hearing aid and check batteries regularly. Limit your exposure to loud noise or wear protective equipment. Where to get help Talk to your health care provider. Call the Canadian Hearing Society at or TTY , or info@chs.ca. Government funding for hearing aids and devices may be available through the Ministry of Health Assistive Devices Program (ADP). Ask your health care provider or call ADP at Page 12

15 Sleep Difficulties What causes sleep difficulties What you can do Where to get help Sleep apnea, a condition that causes breathing to temporarily stop and can cause excessive snoring Medications, including sleeping pills Alcohol misuse Aches and pains Grief, depression, stress or anxiety Poor sleeping environment Lack of physical activity or being active too close to bedtime Napping in the late afternoon or early evening Needing to go to the bathroom frequently Eating a heavy meal before bedtime Discuss a sleep apnea assessment with your health care provider. Avoid food and drinks with caffeine before going to bed. Avoid drinking alcohol before bed. Go to bed and wake up at the same time every day. Keep bedroom cool and quiet, and ensure that your mattress is firm and comfortable. Practise relaxation techniques such as meditation or deep breathing. Consider a grief support group, therapy or counselling. Use pillows to prop you up in bed to assist breathing. Incorporate physical activity into the earlier part of your day. Talk to your health care provider. Contact Hospice Kingston s Grief and Bereavement Program at , L&A Hospice at for grief support or the VON at Page 13

16 Concentration Difficulties What causes concentration difficulties Medication(s) Poor nutrition and dehydration Cognitive and physical problems such as delirium, dementia and stroke Thyroid or other hormonal imbalances Grief, depression and anxiety Chronic or acute pain Lack of regular physical activity Not keeping mentally active Lack of sleep What you can do Talk to your health care provider about any symptoms you are experiencing that could be affecting your concentration, such as changes in sleep patterns, loss of appetite or feelings of sadness. Eat regularly to prevent weakness and feeling sluggish. Canada s Food Guide recommends eating three meals and two snacks per day from a variety of food groups. Include protein-rich foods like meat, fish, eggs, nut butters or cheese with your meals and snacks. What you can do Stay hydrated. Drink fluids throughout the day 9 cups for women and 12 cups for men. Stay active both physically and mentally. Write down activities that need to be done during the day. Post a list on the fridge or near your phone, write in a day planner or use a calendar with large spaces. Try mental aerobics such as crossword puzzles or word searches, or take a class to learn a new skill. Page 14

17 Concentration Difficulties Where to get help Talk to your health care provider. Call KFL&A Public Health s Diala-Dietitian line for information on nutrition at or , ext Call Eat Right Ontario at to speak to a registered dietitian or visit Where to get help Contact Hospice Kingston s Grief and Bereavement Program at , L&A Hospice at for grief support or the VON at If struggling with mental health issues, you may be eligible for a referral to Seniors Mental Health at Providence Care. Call for information. Page 15

18 Indoor Hazards What causes hazards in and around the home Inadequate or poor lighting Clutter such as electrical cords, books, shoes, etc. Loose carpets and scatter rugs Wet or slippery floors Slippery bath tubs that do not have a good quality bath mat Lack of handrails in bath tub and bathroom Chairs and toilet seats that are too low or difficult to get up from Lack of sturdy handrails on stairs Pets What causes hazards in and around the home Poor furniture arrangement Standing on furniture to reach objects Wearing clothes that are too long Rushing or inattentiveness What you can do Ensure adequate lighting around your home. Use non-glare bulbs that are 100 watts or greater. Use a night light. Ensure loose electrical cords are tucked away and keep entrances, hallways, stairs and walking paths clear of clutter. Remove scatter rugs and tack down loose carpets. Wipe up spills promptly and use non-slip wax on floors. Use a good quality, non-slip bath mat in the bath tub. Consider installing handrails in the bath tub and beside the toilet. Page 16

19 Indoor Hazards What you can do Where to get help Where to get help Ensure that all stairs have a sturdy hand rail. Know where your pet is when moving around your home. Consider a raised toilet seat. Arrange your furniture to allow for clear walking paths. Store items on shelves where you can reach them. Consider using a long-handled reacher available at medical supply stores. Wear clothes that fit and do not drape around your feet. Plan ahead, be alert, and don t rush. Have a friend or family member walk through your home with you to identify potential falls hazards. Take action to reduce those hazards. Canada Mortgage & Housing provides financial assistance to people with low income to pay for adaptations to their homes. Call March of Dimes Canada Home and Vehicle Modification Program helps facilitate safe, independent living for adults with physical disabilities. Call Veterans Affairs Canada offers benefits to qualified veterans and their dependents. Call Page 17 Canadian Red Cross has medical equipment available to rent. Call Have an occupational therapist assess your home for safety. See the Yellow Pages under occupational therapists or ask your health care provider about a referral. Home safety services are also available from: South East Community Care Access Centre at or The Arthritis Society at or Kingston Community Health Centre at Check the Yellow Pages under Home Health Services or Hospital Equipment and Supplies for safety equipment for your home.

20 Outdoor Hazards What causes hazards outdoors What you can do Where to get help Snow, ice patches, and wet leaves Fallen branches Cracked sidewalks, uneven ground and curbs Poor or lack of outdoor lighting Improper footwear for weather conditions Carrying too many items or items that are too heavy Getting on and off buses Not keeping mobility aids in good condition Avoid walking on snow, ice patches or wet leaves. Watch for uneven ground, fallen branches, potholes, and curbs. Install automatic or timed lighting outside of your home. Wear proper fitting shoes with good treads that are appropriate for the weather conditions. Avoid carrying heavy items. Keep mobility aids clean and in good condition. In icy weather, keep hands free for balance. Sprinkle salt or non-clumping kitty litter ahead of you if you must walk in icy conditions. Consider investing in a pair of good quality ice grippers. Call your municipal office to report a damaged sidewalk or other falls hazards. Describe the location, what the hazard is, and if you ve fallen as a result of the hazard. Use a delivery service or a portable folding cart if possible to transport heavy items. Page 18

21 Shortness of Breath What causes shortness of breath Smoking Lack of physical activity Obesity Poor air quality Lung infections or chronic diseases such as asthma, bronchitis, and emphysema Allergies Heart problems such as congestive heart failure What you can do Talk with your health care provider about shortness of breath. Be prepared to discuss when it happens and how it limits your activities. Get your annual flu shot and the one-time only pneumonia vaccine to prevent severe respiratory infections. Cut down on or quit smoking. Support is available. Limit time spent in areas with poor air quality, both indoor and outdoor. Seek immediate medical attention if your shortness of breath is accompanied by chest pain, fainting or nausea as these can be a sign of a heart attack. Where to get help Talk to your health care provider about your symptoms and ask about a referral to Providence Care Physiotherapy Outpatient Services Respiratory Rehabilitation Program. Call , ext Call the Lung Health Information Line for information about respiratory health and lung diseases at LUNG (5864). The Tobacco Information Line offers information, support, and resources for those who want to quit smoking. Call or , ext Call the Lung Association Ontario Kingston and the Thousand Islands Branch at Page 19

22 Balance Difficulties What causes balance difficulties Alcohol or medication misuse Poor vision Inner ear problems Lack of physical activity Improper footwear Poor nutrition or eating habits (e.g., not eating enough or often enough) Dehydration Medical conditions that affect the muscles, nerves or senses Lack of sleep Not using mobility aids correctly Diabetes Getting up too quickly from a sitting or lying down position What you can do Talk to your health care provider about your symptoms. Get vision and hearing checked annually. Limit alcohol consumption. Be physically active on a regular basis and do exercises that improve balance. Try a group fitness class, Tai Chi or ask a physiotherapist for balance exercises you can do at home. Eat regularly. Canada s Food Guide recommends eating three meals and two snacks per day from a variety of food groups. Include protein-rich foods like meat, fish, eggs, nut butters or cheese with your meals and snacks. Stay hydrated. Drink fluids throughout the day 9 cups for women and 12 cups for men. What you can do Wear proper fitting footwear. Get adequate sleep (see page 13 if sleep is an issue). Know how to use mobility aids correctly and keep them in good condition. Get up slowly and pause for a few seconds before moving. Page 20

23 Balance Difficulties Where to get help Where to get help Where to get help Talk to your health care provider. Talk to your health care provider about a referral to Providence Care Physiotherapy Outpatient Services and the Vestibular Rehabilitation Program or call , ext for information. Call your Community Care Access Centre at or for community rehabilitation services in your home. Call KFL&A Public Health s Diala-Dietitian line at or , ext to speak to a registered dietitian. Call Eat Right Ontario at to speak to a registered dietitian or visit Government funding for mobility aids (e.g., canes, walkers) may be available through the Ministry of Health Assistive Devices Program (ADP). Ask your health care provider or call ADP at Call the Canadian Diabetes Association at or for information on diabetes or for support. Call KFL&A Public Health s Living Well Phone Line at , ext for information on free physical activity programs. See pages 24 and 25 for local community organizations who provide fitness programs for older adults. Page 21

24 Talking to your Health Care Provider Slipping, tripping, and falling are not a normal part of aging. Most falls are predictable and preventable. Know your risks and take action to prevent a fall. One of the ways to reduce your risk is to talk to your primary health care provider whether that s your doctor or nurse practitioner about any symptoms you may be experiencing, or concerns you have. To ensure that you have a beneficial appointment with your health care provider, try the following: Speak up for yourself and be proactive. If a treatment is not working, or if you re experiencing side effects or symptoms, tell your health care provider. Ask for referrals and resources if needed (e.g., brochures). List your concerns on a piece of paper before your appointment and be as clear as possible when talking to your health care provider about them. If you think you ll need more time for discussion, tell the receptionist when you call to make your appointment. Keep a diary of medications and concerns, and bring this with you to your appointment. If you are unclear about your medical treatment plan (e.g., tests, medications), ask that it be written down for you or re-stated. Take a family member, friend or translator with you if needed. Page 22

25 My Plan to Prevent Falls (Review periodically) An example of a falls prevention plan: My greatest risk(s): Getting in and out of the bath tub. I will: I have: Resources I might use: talk to my health care provider about an occupational therapist coming to my home to assess my bath tub and bathroom, purchase a good quality, non-slip bath mat, and install a handrail in the tub. talked to my doctor and have a referral for an occupational therapist to come to my home and look at my bath tub and bathroom, and purchased a good quality non-slip bath mat for the tub. My health care provider Occupational therapist Family member or friend Staff at home health stores Page 23

26 Community Resources for Older Adults There are many community organizations throughout Kingston, Frontenac, and Lennox & Addington that provide programs and services for older adults, such as: health services, counselling, recreation and social activities, home help, physical activity, transportation, meals, and medical alarms or security checks. Talk to your health care provider. Contact local community organizations (see page 24 and 25) or call 211 for information on the programs and services that are offered in your area. 211 is a free, confidential helpline that provides information about Ontario s community and social services. Information is available 24 hours a day, 7 days a week. Dial 211 or visit The Arthritis Society or Canadian Diabetes Association or City of Kingston Recreation & Leisure Services , ext KFL&A Public Health Living Well Phone Line , ext Kingston Community Health Centre YMCA of Kingston Kingston Gets Active , ext Page 24

27 Kingston Military Community Sports Centre Land O Lakes Community Services Loyalist Township Recreation Services Department Taoist Tai Chi Society Town of Greater Napanee Recreation Department VON Smart Program Lennox & Addington Seniors Outreach Services Northern Frontenac Community Services Osteoporosis Canada Seniors Association Kingston Region Southern Frontenac Community Services Page 25

28 What to Do if You Fall - Plan of Action 1. Rest. Falling is a shock. 2. Think about your next move. 3. Are you hurt or unable to get up? Plan One - Comfort plan (if you are unable to get up from the floor) 1. Attract attention Use your medical or personal alarm. Try to shuffle to the phone. Bang on the wall or floor or use a stick to wave at the window. Shout for help. 2. Keep warm Use bedding, coat or tablecloth to cover your feet and legs. 3. Keep moving This helps to relieve pressure areas. Keep your feet and hands moving to help circulation. 4. Bladder control If your bladder lets go while on the floor - move away from the damp area. Trauma Prevention Council, Central West Ontario Senior Falls Prevention Project. Used with permission. Plan Two - Get up from the floor Roll onto your side and push up into sitting position. Turn onto your hands and knees and crawl to the nearest suitable furniture like a bed, chair, or sturdy stool. Place your hands on the surface. Place one foot flat on the floor. Lean forward and push up onto the forward leg and into standing position. Sit. Rest. Seek medical attention even if you think you are uninjured. Page 26

29 Page 27

30 Notes Page 28

31 Adapted with permission from: The Burnaby Coalition to Prevent Falls, Simon Fraser Health Region - July 2002 Revised and reprinted December 2014

32 To request copies of this booklet or to provide comments or suggestions, call KFL&A Public Health at or , ext