Falls and Getting up from the floor

Transcription

1 Falls and Getting up from the floor Information for amputee patients Amputee Department

2 The aim of this leaflet is to give you information about falls and getting up from the floor. Falls are very common among amputees, especially in the early stages of rehabilitation, before receiving your prosthetic limb. Some research suggests that in the first year after amputation, over half of amputees fall. This can have devastating effects on the residual limb (stump), your mobility and your confidence. Reasons for falling There are many, varied reasons why you may fall. Some of the common causes are described below. Phantom sensations Many amputees experience phantom sensations: they feel that they still have a limb where there is not one. You are particularly at risk of this at night, when drowsy, as you may wake up and attempt to stand, forgetting you have had an amputation. Balance It is likely that your balance will be affected by the loss of a limb, whether you wear a prosthesis or not. When you are not wearing a prosthesis you will not be able to correct your balance by putting your foot down. When wearing a prosthesis you lose the normal sensation of your foot on the ground, therefore your balance can be poor when standing or walking. This can improve with time. Diabetes Many amputees have diabetes, which can have an effect on their eyesight and sensation (feeling) in their legs. This can lead to falls, as hazards may not be seen and uneven surfaces may not be felt underfoot. Muscle Weakness If you have been unwell for a long time, your muscles may have weakened. This may affect your balance. Exercises from your Physiotherapist will help. If you are unsure about which exercises to do, then ask your Physiotherapist for advice.

3 Vascular Disease Similar to diabetes, people with vascular disease may have problems with sensation in their limbs, as the blood flow may be poor. This may lead to less awareness of surfaces underfoot and therefore increase the chance of falling. Environmental Factors Many amputees fall due to tripping or slipping. Hazards such as rugs, cables, door thresholds, and magazines left lying on the floor, can get in the way. Also, poor arrangement of furniture can make transferring difficult and dangerous. In hospital, wet bathroom or shower floors are also fall hazards. Taking risks Sometimes, when people are transferring from one place to another, they may take risks. These commonly include: leaving a large gap from their wheelchair to the bed, or not putting the brakes on their wheelchair. How to prevent falls Most falls are preventable. Use common sense: Always apply the brakes on your wheelchair before transferring. Ensure you are as close as possible to the surface you are transferring to. Always remove footplates/stump rests. If advised to by your therapist, take the side off your wheelchair this will help you to transfer safely. Ensure your wheelchair is easily accessible at night. Correct position Incorrect position

4 Correct way to do a toilet transfer: Initially you may need somebody to help or supervise your transfers. Your Physiotherapist or Occupational Therapist will advise you when you are safe to do this on your own. Before discharge from hospital, an Occupational Therapist will assess your house. They may give advice on removing rugs, lowering door thresholds or how to arrange furniture to ensure safe transfers. It is common for amputees to fall at night. Often they wake up drowsy, need the toilet, and forget that they are missing a limb. When they attempt to stand, they may lose their balance and fall over. There is no way to prevent this, but it is important to be aware that it does happen. Do not take unnecessary risks. This is when many people fall, and it can delay rehabilitation by months if the stump is damaged.

5 What to do if you fall at home Don t panic! Take a few moments to regain your composure and calm down. If you are injured and feel you cannot get up off the floor, then try to remember: If you wear a pendant alarm or have a pull cord, use these to call for assistance. Keep telephones on low surfaces. If you think you are injured, do not hesitate to call for an ambulance. Pull a cushion off your sofa or chair and put it underneath you so that you are not sitting on a hard floor. After you fall you should always check your residual limb (stump) for damage. If seriously injured, you may need to go to Accident and Emergency, or your GP. You should monitor your stump for a few days it may take this long for problems to arise after the fall. What to do if you fall in hospital There are emergency buzzers or pull cords in the wards and the bathrooms to call for help. Use these and staff will assist you up from the floor, and medical staff will assess you for any injuries. Getting up from the floor Method 1 1. Stay calm and ensure you are not hurt. 2. Bring yourself up into a sitting position. 3. When sitting, shuffle your self to a footstool or step. 4. Ensure the footstool or step is beside a sofa, solid chair, bed or your wheelchair. 5. Place both hands on the step, bend your knees and lift your body up on to the step.

6 6. Place your hands up onto the sofa/chair/bed and lift your body up on to the surface. Getting up from the floor Method 2 (only if wearing your prosthesis) 1. Stay calm and ensure you are not hurt. 2. Roll on to the side of your strongest leg and prop yourself up with your hands. 3. Roll towards your strongest leg and push yourself on to your hands and knees.

7 4. Place your hands on a chair/sofa/bed and put the foot of your strongest leg flat on the floor. 5. Push yourself into standing, keeping both hands on the surface for support. 6. Turn around and sit down on the chair/sofa/bed.

8 Useful Contact Numbers Ninewells Hospital Telephone: Physiotherapy Gym, East Block Extension: Occupational Therapy Extension: This leaflet has been developed by the Physiotherapists in the Amputee Therapy Gym and reviewed by other members of the multidisciplinary team and patients. Developed: 03/2015 Review: 03/2017 LN0465