Michel (Shelly) Denes – Fall Prevention: Assessment and Intervention Strategies to Care for High-Risk Fall Patients

Outline

Assessment of Multiple Dimensions of Balance, Mobility and Fall Risk

Three Classifications of Falls

• Accidental
• Unanticipated physiological falls
• Anticipated physiological falls

Balance Dysfunction and Falls: Contributing Factors

• The vestibular system
• Vision
• Somatosensory system
• Muscular strength and joint flexibility
• Endurance, fatigue and fitness level
• Cognition
• Posture

Risk Factors

• Intrinsic risk factors
• Extrinsic risk factors
• Methods for reducing risk factors
• Practical suggestions
• Home safety checklist
• Health and safety checklist
• Fall predictors

Balance, Mobility and Fall Risk Assessment Tools: Individualized Options

• Functional Reach Test
• Tinetti Balance Assessment Tool
• Berg Balance Scale
• Functional Gait Assessment
• The Timed Up and Go Test
• Three and Six Minute Walk Tests
• Full Evaluation of ROM, Flexibility, Muscle Strength and Tone

Effective Interventions to Improve Balance & Mobility and Reduce Fall Risk

Consequences of a Fall

• Physical consequences
• Social consequences
• Psychological consequences

Nutrition

• Strategies to Maintain and Restore Balance
  • Stability
  • Mobility

The Normal Gait Cycle

Gait Training When it Has Gone Awry

• Considerations for assistive devices and orthotics

Therapeutic Exercise

• Benefits & specifics for balance, ROM, strength and gait
• Equipment for clinics and home use
• Program design
• Safety reminders
• Home exercise program
• Environmental Modification/Home Evaluation

Post-Fall Assessment and Problem Solving Prevention

• Fall risk identification

Problem Solving After a Fall Occurs

• Investigation process
• Plan of action
• Corrective and preventative measures

Community-Based Care

• Develop community-based fall prevention programs for older adults

Overcoming Barriers to Effective Strategy Implementation

• Cognitive barriers
• Family barriers
• Facility staff/Caregiver barriers

Medicare and Documentation Considerations

Interactive Lab Time: Assessment Tools and Intervention Strategies in Practice