Category: Occupational Therapy

Home Hazards…Are they related to falls?

A 2018 study titled, The Potential to Reduce Falls and Avert Costs by Clinically Managing Fall Risk, by Judy A. Stevens, PhD and Robin Lee, PhD, MPH estimated the prevalence of seven fall risk factors and the effectiveness of seven evidence-based fall interventions.

Stevens & Lee defined a “fall risk factor as an attribute or characteristic of an individual that increases the likelihood of a fall occurring”. They go on to say that many fall risk factors are potentially modifiable (e.g. poor balance, mobility problems, impaired vision, and insufficient vitamin D). Contributing factors increase the chance of falls such as the side effects of medications and the presence of home hazards.

Lets take a focus on home hazards. Most of us feel our homes are the place we feel most safe and comfortable. But does that mean our home is truly “safe”. Here are some questions to ask your self to determine where your home sits on the safety spectrum and some techniques you can use to enhance safety.

Can you safely enter and exit your home? 
Do you have stationary chairs with arm rests that do not rock or glide? 
Does every room have a night light? 
Can you read your medication bottles? 
Can you enter and exit your shower or tub without a loss of balance?
Can you transfer to and from your toilet without difficulty? 
Do you have clear pathways throughout the home? 
Are your kitchen goods stored between the height of your knees and your shoulders? 
Are you able to retrieve items from under your bathroom sink with ease? 
Do you have throw rugs picked up? 
Do you know how to use your microwave correctly? 
Do you remember to turn off the stove or oven when finished? 
Are cords clear from being in the walkways? 
Do you know how to use your thermostat? 
Have you been free from falling in the last year?  
Do you take your medication on time consistently? 
Is there a table next to your bed for a light and to set items on? 
Is your carpet and flooring free from tears and ripples? 

Home Safety Strategies:

  1. Remove all scatter rugs, repair frayed carpet, tape or tack down loose carpet edges.
  2. Arrange furniture to allow adequate space for safe walking between and within all rooms.
  3. When using oxygen, do not smoke or use an open flame.
  4. Do not overload circuits – unplug appliances when not in use.
  5. Wear close-fitting sleeves to prevent spills and burns that could happen with loose, long sleeves.
  6. Clean up spills immediately.
  7. Use a step stool or reacher to reach high shelves – do not stand on chairs or stools.
  8. Place safety strips or a non-skid mat in bathtub/shower and install grab bars – do not use soap dishes or towel racks for support when sitting or standing.
  9. Keep closet doors and drawers closed to prevent bruises or tripping.
  10. Keep walking aids within reach and keep a nightlight on or flashlight within reach of your bed.

If you are interested in having an occupational therapist conduct a home safety assessment in your home please contact our office at (970) 204-4331. And keep in mind, most insurance plans cover the visit.

The Potential to Reduce Falls and Avert Costs by Clinically Managing Fall Risk Judy A. Stevens, PhD,1 Robin Lee, PhD, MPH2

Pelvic Dysfunction & Aging

Thank you to Guest Blogger and CSU Graduate, Hailey Jungerman.

Although many believe that it is a natural part of ageing, “age doesn’t cause urinary incontinence, age-related changes may predispose an individual” (Garvey 14). Not only is it not a normal part of ageing, but “more than 50 percent of older Americans struggle with incontinence” (Reinberg). It is important to understand that bladder and bowel incontinence is an issue that can go beyond just toileting. As owner Krista Covell-Pierson OTR/L, BCB-PMD points out in her article Are You Addressing Incontinence at Home? An OT’s Guide, “Unaddressed incontinence can lead to the following additional problems: depression, social withdrawal, anxiety, fatigue, increased fall risk, restricted sexual activity, increased expenses for supplies, higher risk of infection, and skin irritation.” All of these things can lead to reduced participation in activities of daily living.

So, how can OT help address incontinence? “Occupational therapists provide a comprehensive approach that looks beyond musculoskeletal skills deficits and recognizes the need for changes in performance patterns, such as habits and routines, while also considering the context and activity demands related to the problem. Additionally, occupational therapy practitioners have the background and training to understand the related distress and provide support for the psychosocial aspects of these disorders” (Neuman et al.).

Krista Covell-Pierson OTR/L explained to me what a normal plan to manage
incontinence would look like. The evaluation will touch on bowel and bladder health. Krista says it is important to look at both as the bladder can affect the bowel and vice versa. The therapist will discuss with the patient about their diet, toileting and leave the patient with incontinence reading material and a voiding diary. From there the rest of the sessions are working on finding the issue and working on the pelvic floor muscles. The therapist will work as an investigator to solve the problem. They will recommend small changes to see if that is helping, and work in stages as to not be overwhelming for the patient. If needed, the therapist can also use a
biofeedback machine to better understand what the pelvic floor muscles are doing and to get patients working them. Though the internal biofeedback is not required, Krista said there is about an 87% rate of improvement over those that do not do the biofeedback.

Incontinence is a serious issue that can lead to a decline in quality of life. It is the number one reason why people put a loved one in an assisted living community as it is draining on the patient as well as any caregivers. Getting the issue resolved can improve the quality of life and keep our loved ones home for longer. If you have any questions regarding incontinence our owner Krista Covell-Pierson is a great resource as she is Board Certified in Biofeedback.

Please call Covell Care and Rehabilitation at (970) 204-4331 to get more information or an appointment scheduled with us to address incontinence.


Citations:
Covell-Pierson, Krista. “Are You Addressing Incontinence at Home? An OT’s Guide.” 2018 National Patient Safety Goals: Communication | MedBridge Blog, Medbridge, 20 Apr. 2018, www.medbridgeeducation.com/blog/2018/04/addressing-incontinence-home-ots-guide/. Garvey, Kathleen A. “Toileting: Making the Most of Our Time in the Bathroom.” MiOTA Conference. 12 Oct. 2015, www.miota.org.
Neumann, B & Tries, J & Plummer, M. (2009). The role of OT in the treatment of incontinence and pelvic floor disorders. OT Practice. 14. 10-1318.
Reinberg, Steven. “Over Half of Seniors Plagued by Incontinence: CDC.” Consumer HealthDay, HealthDay, 25 June 2014.

Sacroiliac Belt

Guest Blogger: Colorado State University Graduate and Covell Care Intern, Garrett Masterson.

The sacroiliac (SI) joint is a very important joint in the human body. There are two SI joints which are located where your sacrum, the lower portion of your spine, and pelvis meet. This joint is very important, as it supports the entire upper body’s weight. If your ligaments or muscles around the SI joint are too weak and/or do not provide enough support, the joints will become destabilized. This can result in abnormal stretching of the joint/muscles/ligaments, arthritis, inflammation, stress and other pains.

A sacroiliac belt is a belt device that’s purpose is to help stabilize the SI joint. This device is worn securely around the hips. The belt compresses against the SI joint, acting as the ligaments and muscles in the area to help provide support. The belt also helps with realigning the pelvis to its proper angles, thereby helping to reduce the destabilization. Wearing one of these
sacroiliac belts can also provide your body with some relief and aid to allow the body to potentially heal and repair the affected muscles and ligaments that are required to have a healthy sacroiliac joint. This relief could also come in the form of reduced inflammation and lessened
pain which is commonly felt in the lower back.

If you are having concerns of SI joint pain and would like to hear more information about a sacroiliac belt, please do not hesitate to contact us at Covell Care. We would love to help you out! (970) 204-4331

Preventing Falls

Blog provided by JaNae Gregg, University of Northern Colorado Student and Covell Care Intern.

Top 5 Ways to Prevent Falls

Aging into later life can bring many concerns, one of the biggest concerns with aging is falling.  The CDC estimates that 1 in 3 seniors will fall at least once a year. One of the biggest predictors of having a fall is already having a previous fall.  This can be worrisome not only for the person involved, but also the families. To prevent something as serious as a fall from happening the first time, it is important to review 5 steps that have been proven to help prevent falls.

One of the first steps in preventing a fall is reviewing medications, certain medications have been linked to increasing falls in seniors.  Such medications include: sedatives and tranquilizers, antipsychotics, nighttime drugs, over-the-counter medication, medications that cause drowsiness.  If these medications are taken, it is important to review them with a doctor to assess the amount of risk of falling involved.

Checking blood pressure while sitting and standing is the second important step in fall prevention.  A substantial drop in blood pressure when a person stands up or changes position is known as postural.  Drops in blood pressure is common for older adults, especially for those who are taking medicine to lower blood pressure.  Blood pressure treatment has in fact been linked to some of the most serious falls in older adults.

The third step in preventing a fall involves a balance evaluation.  If you or someone who know has noticed difficulty with walking or standing should seek an evaluation by a doctor.  These evaluations are covered by Medicare and can be very useful in preventing a fall from occuring. Strength and balance exercises may be recommended to insure this.  Along with these exercises, taking a daily walk can be very helpful in improving balance.

A home safety assessment may be one of the most important parts to preventing a fall.  A set up of a home and placement of furniture and other household items can easily set a person up for a bad fall.  Having a home healthcare agency to have an Occupational Therapist come and evaluate the home for possible falls is an easy way to prevent something serious from happening.  

The final step in fall prevent consists of getting enough Vitamin D.  Taking 1,000 IU per day will help insure that a person is getting the recommended amount of Vitamin D.  A deficiency in Vitamin D can lead to fragile bones and may cause a fall.

Trying Natural Alternatives: Acupuncture

Blog provided by JaNae Gregg, University of Northern Colorado Student and Covell Care Intern.

Keeping our bodies filled with energy and balance are two important keys to a healthy lifestyle.  Acupuncture is a healthy and natural way to cure physical or mental ailments.  This practice first began more 2,500 years ago in China and since has been used to diagnose, treat, and improve general health.  The main effectiveness of acupuncture comes from modifying the flow of energy in the body.

When acupuncture is performed, the patients can either lay face up or face down (depending on which points need to be used).  Then a single use disposable needle is inserted.  When the needle is inserted it can cause a sting or tingling sensation at first, then the needle remains there for five to thirty minutes.  While the needle remains in place the patient may feel a dull ache, but the treatment is relatively painless.   By placing the needles into certain points it brings the energy flow back into proper balance.

The best part of acupuncture is that it is all natural!  There are little to none side effects, it can be combined with other treatments, it can control various types of pain, and helps patients stay off medication.  Acute problems can be cured from eight to twelve sessions, while chronic may take one to two sessions a month for several months.

There are many misconceptions about natural remedies, but medications, surgeries, or other treatments haven’t worked for you, then give acupuncture a chance.  It has been known to not only cure illnesses, but to also prevent future medical problems from arising.  Using acupuncture can be the start of a new way to healthier and natural lifestyle.

The Benefits of Acupuncture

  1. Muscle spasms and pain
  2. Chronic back problems and pain
  3. Headaches and migraines
  4. Neck pain
  5. Osteoarthritis
  6. Knee pain
  7. Allergies
  8. Digestive problems
  9. Mood and depression
  10. Sleep problems
  11. High and low blood pressure
  12. Nausea
  13. Reduce risk of stroke
  14. Facial pain
  15. Vascular dementia