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1 Volume 2 Summer 2015 Firelands Regional Medical Center s S.P.O.T. REPORT Your quarterly guide to new information, insights, and events from Speech, Physical, & Occupational Therapies at Firelands Regional Medical Center. READY, STEADI, GO! The Centers for Disease Control and Prevention (CDC) has developed the STEADI program. STEADI, which stands for Stopping Elderly Accidents, Deaths, and Injuries, is a compilation of educational materials and tools to be used by health care providers. These tools will enable health care providers with a three-part approach to 1) better identify individuals with low, moderate, or high risk for falls; 2) better identify risk factors contributing to an individual s potential for falls; and 3) offer effective interventions to address and prevent falls. p. 2 Inside this issue: Occupational Therapy Corner STEADI helps health care providers to simply and efficiently assess an individual s confidence level regarding their own mobility. Health care providers will also review medications that may be impacting an individual s fall risk and may suggest reducing the dosage, switching to another medication with fewer side effects, and/or discontinuing medications that increase fall risks. STEADI also encourages health care providers to recommend that individuals take Vitamin D and calcium supplements of at least 800 IU/day. The CDC continues to provide additional materials and tools to support health care providers in the use of STEADI. (Adapted from p. 3 p. 4 p. 5 Physical Therapy Corner Speech Therapy Corner Clinician Spotlight Karly Westfall, PTA, CPT

2 INSIGHTS ON EYESIGHT Contributed by Heather Smith, MOT, OTR/L Low vision disorder is an umbrella term that encompasses multiple visual deficits affecting almost 135 million people worldwide. These conditions may include the following: glaucoma, age-related macular degeneration, diabetic retinopathy, and cataracts. Most of these conditions are preventable through regular eye exams, consistent use of appropriate eye protection, and proper nutrition. It is important to monitor visual health because low vision disorders can significantly impact an individual s overall quality of life. Individuals suffering from visual deficits may experience a variety of symptoms, including loss of central vision, loss of peripheral vision, blurred vision, generalized haze, extreme sensitivity to light, and/or night blindness. Some warning signs of low vision may include difficulty completing the following tasks: reading, cooking, recognizing faces, and/or identifying traffic signs and signals. If a person is experiencing vision difficulties, it is important to seek care from an eye care professional. He or she will conduct an eye examination and low vision examination, will discuss conventional treatment methods (such as glasses, contact lenses, medication, or surgery), and provide training and education regarding adaptive visual devices, support groups, compensatory strategies, and vision rehabilitation services. Individuals diagnosed with low vision disorders are at risk for multiple concerns regarding balance impairment. Vision and balance work cooperatively. As we age, we increasingly rely on this partnership to offset concerns of weakness, decreased righting reactions, and peripheral nerve damage, etc. When an individual experiences decreased depth perception, decreased contrast sensitivity, and decreased visual field, he or she becomes more likely to misjudge his or her steps and less likely to recognize tripping hazards. When these visual impairments are combined with poor balance, there is an increased risk for falls. Education is the best way to prevent falls caused by low vision. Many people are often unaware that they have low vision or how significantly low vision may impact their balance. Vision rehabilitation professionals, ( continued on p.5) ( continued on p.5) (Vision, continued from p.2 ) including occupational therapists, will teach people with low vision to prevent falls during daily activities and will recommend compensatory strategies such as the following: increased room and/or task lighting, decreased clutter (particularly near walkways), use of magnifying lenses, and/or use of contrasting colors for increased awareness and discrimination. There are many resources that clinicians and individuals living with low vision disorders may access for further information. Two such resources include 2

3 THE FACTS OF FALLS Contributed by Karly Westfall, LPTA, NASM-CPT Falls and the risk of falls among the elderly population are often overlooked or superseded by more important medical ailments. But at what cost can we continue to overlook the alarming statistics of falls related to decreased quality of life and mortality? Falls are the leading cause of injury among the 65+ population. Every 13 seconds, an older adult is treated in a hospital emergency department for fall-related injuries. We must establish an open dialogue regarding fall risks by addressing the following underlying causes and concerns of falls: potential prescription medication interactions, poor vision, weakness in the core and legs, decreased and unsafe mobility, decreased daily activity and exercise, and unsafe home set-up. Physical therapy can address balance deficits, vertigo, and weakness in the core and lower extremities. We can challenge a patient s stability limits through static or dynamic exercises. Through the use of different surfaces, supports, and balance perturbations, we can work to improve balance and increase confidence in mobility. This will not only decrease fall risk but will also assist in easing an individual s fear of falling. Firelands Regional Medical Center s Physical and Occupational Therapy Departments will provide monthly education workshops in conjunction with Community Outreach. We seek to educate the community regarding identification and prevention of fall risks. We will be utilizing the CDC s STEADI program to screen and identify individuals with fall risks. Individuals that are found to be in the fall risk category will be referred to their physician for further intervention. Please contact Firelands Regional Medical Center s Physical & Occupational Therapy Departments at to pre-register. If 5,000 health care providers adopt STEADI over a 5-year period, as many as: * 6.3 million more patients could be screened; * 1.4 million more falls could be prevented; and * $3.6 billion more in direct medical costs could be saved. (Adapted from 3

4 COGNITION CONVERSATION Contributed by Jennifer S. Papineau, MS, CCC-SLP Speech and Language Pathology plays a vital role in addressing cognition as it relates to falls and home safety. A speech-language pathologist can be instrumental in assisting family members and caretakers in determining if a loved one has the complex cognitive skills needed to be at home alone. An individual s memory and problem-solving capabilities are two primary skills that must be working effectively for maximum safety and independent functioning in the home environment. Memory is the ability to retrieve previously stored information. Intact problemsolving capabilities allow an individual to make decisions based on any given information and an immediate need. If your loved one is suffering from deficient memory, he or she may be unable to recall physical safety guidelines being taught during physical and occupational therapies, including proper use of a walker or cane, the clearance of possible obstructions from Falls are the leading cause of injury among the 65+ population. Every 13 seconds, an older adult is treated in a hospital emergency department for fallrelated injuries. walkways, and the notion of energy conservation. He or she may have a disorganized medication management system or may demonstrate a complete inability to accurately recall medication schedules and dosages. Confusion regarding compensatory safety strategies and medication administration can contribute to increased falls and related injuries. For an individual to remain independent at home, he or she must be able to differentiate between emergent and non-emergent situations. In the case of non-emergencies, an individual needs to know when it is unsafe to complete tasks alone and who to contact for assistance. In the case of emergencies, an elderly individual must be able to easily access a telephone or medical alert system. Family members and caregivers must determine how well their loved ones perform these tasks and not proceed on their word alone. Observing loved ones as they complete tasks of daily living is the best way to see if their memory and problem-solving skills are working effectively. Please contact Firelands Regional Medical Center s Speech Therapy Department at for more information regarding cognition evaluation and treatment. 4

5 Clinician Spotlight Karly Westfall, LPTA, NASM-CPT I am a licensed physical therapist assistant and certified personal trainer who has been providing services at Firelands Regional Medical Center for eight years. I earned my degree from Lorain County Community College and currently reside in Wakeman, OH. My family is my greatest priority and I take pride in my duties as a wife and as a mother of an active toddler. I provide physical therapy services for a wide variety of medical diagnoses across the orthopedic and neurological spectrum. I am generally performing in an outpatient setting in Huron or Norwalk but I also provide services in our acute care and inpatient rehabilitation settings. I very much enjoy the challenge of problem solving individualized treatment programs for patients presenting with balance and strength impairments. I am involved in community outreach and perform speaking engagements on the importance of maintaining adequate balance and participating in daily exercise and other active activities. I am passionate about community education on exercise and the significant positive impact it can have on our daily lives. I intend to work with Firelands Regional Medical Center s Community Outreach Department for continued development of our Balance and Falls program. I hope to be involved in additional community measures to promote the benefits of exercise and physical therapy. I would also love to return to teaching exercise classes. I hold certification as a NASM-Certified Personal Trainer and have been trained in the McKenzie Method for treatment of back and neck pain. I have also taken multiple continuing education courses in the areas of balance, Neuromuscular Re-education, and sports medicine. I am currently involved in launching the Firelands Regional Medical Center s Balance and Falls program to assist in decreasing fall risks among the elderly population. I am working in conjunction with the Physical and Occupational Therapy departments and with Community Outreach to introduce a monthly education workshop series and exercise program. (vision, continued ) including occupational therapists, will teach people with low vision to prevent falls during daily activities and will recommend compensatory strategies such as the following: increased room and/or task lighting, decreased clutter (particularly near walkways), use of magnifying lenses, and/or use of contrasting colors for increased awareness and discrimination. There are many resources that clinicians and individuals living with low vision disorders may access for further information. Two such resources include Prevent Blindness America ( org) and the National Eye Institute ( which will provide information on eye health and treatments for vision disorders. 5

6 Firelands Regional Medical Center s Physical & Occupational Therapy Departments to offer community screenings and workshops regarding balance and fall risks. WHERE! Mobility Education Workshops Firelands Regional Medical Center South Campus Community Resource Room Tuesday, August 11, 2015 Low Vision & How to Prevent Falls DATES! Tuesday, September 16, 2015 Medications That Can Affect Balance Tuesday, October 13, 2015 Home Modifications & General Safety For Those with Impaired Balance Tuesday, November 10, 2015 Exercising Your Balance TIME! 11am-12pm **Pre-registration is required by calling ** 1111 Hayes Avenue Sandusky, OH 44870