Category: Support System

The Fear of Falling

Guest blogger Colorado State University and Covell Care Intern, Hailey Jungerman.

Falling can cause major issues for older adults. Injuries can range from an ankle sprain to a traumatic brain injury. These injuries can lead to high direct medical costs and indirect medical costs. Not only that, but it can lead to an increase in fall risk factors.

“Fear of falling often develops after experiencing a fall” (Tomita et al.).The same study shows that even one fall can lead to developing fear. There is a vicious circle that is associated with the fear of falling that can be hard to break without intervention. “Fear of falling is associated with negative physical and psychosocial health outcomes, including depression and
activity restriction” (Lee, Oh and Hong 2018). Once an older adult obtains this fear, the less likely they are willing to participate in activities such as exercise or even leaving their house. This can lead to weakened muscles and depression. Which in turn are more risk factors for older adults.

A team of therapists including occupational and physical therapists can help to overcome the fear of falling. Occupational therapists can assess the home for safety, both occupational and physical therapists can do a fall risk assessment on the client, and both can create a plan to address risk factors. They can suggest home modifications, address risk factors around the house, see how the patient gets around their home, and giving the patient exercises to build strength and work on balance. As the American Occupational Therapy Association’s page says, “Identifying environmental factors that contribute to falls and implementing the occupational therapy strategies to ameliorate these elements can improve safety and reduce health care costs while enhancing the participation of older adults in those communities.”

In order to keep older adults independent, it is important to have them assessed to find their risk factors. Each individual is unique, and so are their needs. Therapists working together can help to improve the quality of life by addressing fall risk in our loved ones.

For more information on Home Safety or Fall Risk Assessments call Covell Care & Rehabilitation at 970.204.4331.

Citations:
Lee, Seonhye, et al. “Comparison of Factors Associated with Fear of Falling between Older Adults with and without a Fall History.” International Journal of Environmental Research
and Public Health, vol. 15, no. 5, May 2018, p. 982., doi:10.3390/ijerph15050982.
Tomita, Yoshihito, et al. “Prevalence of Fear of Falling and Associated Factors among Japanese Community-Dwelling Older Adults.” Medicine, vol. 97, no. 4, Jan. 2018, doi:10.1097/md.0000000000009721.
Toto, Pamela. “Occupational Therapy and Prevention of Falls.” Aota.org, American
Occupational Therapy Association, 2017, www.aota.org/About-Occupational-Therapy/Professionals/PA/Facts/Fall-Prevention.aspx.

Wellness & Mobile Practitioners

Guest blogger, Colorado State University Graduate and Covell Care Intern, Hailey Jungerman.

Being a mobile practitioner there are a number of health factors to keep in mind. You are constantly on the go, but not being active in the sense of physical activity requirements. There is also a high chance that you are eating in between appointments while in the car. On top of that you may also be stressing about making it to your next appointment on time if one runs over, or there is traffic. All of these, and I am sure you know, and many more are stressors. All these can also pose serious health problems. Chronic stress can cause issues such as high blood pressure, racing heart, weakened immune system, depression, headaches and so many more (Pietrangelo and Watson). They also state that “Chronic stress is also a factor in behaviors such a overeating or not eating enough, alcohol or drug abuse, and social withdrawal.”

Symptoms of chronic stress include (Pietrangelo and Watson):

  • irritability
  • anxiety
  • depression
  • headaches
  • Insomnia

If you are experiencing any of these, it is important to know how to relieve stress. Stress management techniques vary. Some can be more effective than others. It will depend on you and what you are comfortable with. Many of them have health benefits beyond just relieving stress.

Some evidence based stress management techniques include (Darviri and Varvogli):

  • Progressive Muscle Relaxation: leads to a decrease in stress and anxiety as well as decreased blood pressure, heart rate, and decreased headaches.
  • Mindfulness-based Stress Reduction: positive impact on mood, stress and anxiety reduction.
  • Guided Imagery: can help in stress reduction, pain management, preventing relapse of smoking, and treatment of depression.

These are just a few strategies that could help to reduce your stress. It is important to find something that you enjoy and that works for you. Listening to books on tape, podcasts, or light music while you are driving are great ways to relieve stress in between appointments. Finding time to workout, take your dog for a walk, or making time for hobbies are other great ways to find a work-life balance and reduce stress. Ask Covell Care about our employee stress management!


Works Cited :
Darviri, Christina and Liza Varvogli. “Stress Management Techniques: evidence-based procedures that reduce stress and promote health.” Health Science Journal (2011): 74-89.
Pietrangelo, Ann and Stephanie Watson “The Effects of Stress on Your Body.” 5 June Health Line. 30 April 2019.

Dementia Awareness

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

In America, one in ten people over the age of sixty five has Alzheimer’s dementia.  Two thirds of these people are women. In 2000, 4 million people in America were diagnosed with dementia.  By 2012, nearly 4.5 million people were diagnosed with this disease. With a rapid increase of people diagnosed with dementia it is important to notice the early signs and receive treatment.

Early signs of dementia include: Increased confusion, memory problems, reduced concentration, personality or behavior changes, apathy, and loss of ability to do everyday tasks. These symptoms can come on suddenly or gradually. Unfortunately, these signs can often be mistaken or overlooked. If you or someone you know is showing any of these signs it is important to seek a doctor and get a medical diagnoses.

If you are caring for a patient of dementia it is important to keep a positive mindset, remember body language and attitude communicate your feelings more than words do! Dementia can be tough for both the patient and the caregiver, so it is important to be clear when relying messages to the patient and to also ask clear and answerable questions.  Conducting activities are easier when performed in steps, this helps instruct the patient with dementia and to avoid frustration for the caregiver.

This being said, frustrations will still occur.  When the going gets tough for the dementia
patient try changing the subject or even the environment.  It is important to remember to connect with the person on a feelings level. This means when making suggestions state what feeling you are sensing from them.  This could be done by saying, “I know you are feeling sad today, maybe a walk would make you feel better?” Doing this will help make a connection and improve communication.  Being diagnosed or having someone you care for be diagnosed with dementia is not easy, catching warning signs early could help with treatment and the caregiving process.

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.

Senior Driving: Warning Signs

The winter months are a season that all drivers give thought to cautious driving when weather changes and also seems to be a time when older drivers question if they should even go out on the roads. It is hard for families to truly understand when their loved one is at risk for an accident, when to reach out for expert help or if driving should even be an option.

It is a good idea to keep in mind the many warning signs that driving is a concern. If one warning sign is present that person may benefit from further discussion on driving with their physician, participation in a driving program or worse case scenario stop driving. AAA has many resources to support this decision and senior drivers (https://seniordriving.aaa.com/). Below is a list of warning signs to keep in mind when making a decision on next steps of a loved one’s driving ability.

  • The senior driver has been issued two or more traffic tickets or warnings in the past two years. Tickets can predict greatest risk for collision.
  • The senior driver has been involved in two or more collisions or “near-misses” in the past two years. Rear-end crashes, parking lot fender-benders and side collisions while turning across traffic rank as the most common mishaps for drivers with diminishing skills, depth perception or reaction time.
  • Does the senior driver confuse the gas and brake pedals or have difficulty working them? Drivers who lift their legs to move from the accelerator to the brake, rather than keeping a heel on the floor and pressing with the toes, may be signaling waning leg strength.
  • Does the senior driver seem to ignore or miss stop signs and other traffic signals? Perhaps the driver is inattentive or cannot spot the signs in a crowded, constantly moving visual field.
  • Does the senior driver weave between or straddle lanes? Signaling incorrectly or not at all when changing lanes can be particularly dangerous, especially if the driver fails to check mirrors or blind spots.
  • Do other senior drivers honk or pass frequently, even when the traffic stream is moving relatively slowly? This may indicate difficulty keeping pace with fast-changing conditions.
  • Does the senior driver get lost or disoriented easily, even in familiar places? This could indicate problems with working memory or early cognitive decline.
  • Does the driver have a history of falls? If yes, they are 40% more likely to be involved in a crash.
  • Has there been a new diagnosis? Note ‘red flag’ diagnosis: sleep apnea, dementia, MS, Parkinson’s, diabetes.

Take this list as a guide in your next conversation or car ride with a loved one. Please contact our office with specific questions on Covell Care’s driving rehabilitation program.

Please join Covell Care for an intimate presentation on driving rehabilitation and bossy bladder March 7th 11:30-1:15 (includes lunch!), next week at The Hillcrest of Loveland, 535 Douglas Ave, Loveland, CO 80537. Contact the Hillcrest with questions: (970) 541-4173. https://www.mbkseniorliving.com/senior-living/co/loveland/hillcrest-of-loveland/