Category: Therapy

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.

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

Is your bowel or bladder controlling you???

People of all ages live with bowel and/or bladder issues. Bowel and bladder dysfunction arise for various reasons: childbirth, prostate issues, a recent surgery, cancer treatment, lack of pelvic floor strength, the food & drink a person consumes and the list goes on.

There is even a thought that incontinence is just a normal part of aging. I am here to tell you that is not the case. Whether you suffer from stress or urge bladder incontinence, bowel incontinence or mix…You can take back your life and make changes NOW!

It is good to understand what a healthy bowel and bladder look like.

  • The average bladder can hold 2 cups of urine before needing to be emptied.
  • We should urinate 6-8 times in 24 hours, and have a bowel movement 3x/day-3x/week. As we age we may need to go more because our bladder shrinks but should not need to go more than every 2 hours.
  • Urine should flow out easily without straining and should come out in a steady stream.
  • An urge is the sensation you feel as the bladder stretches and fills. It does not always mean your bladder is full and urges should be controlled.
  • Your bladder should be completely emptied when you use the toilet.
  • Void positioning: knees higher than hips, lean forward and put elbows on your knees, bulge out your abdomen and straighten your spine (squatting position).
  • Holding your bladder for an excessive time (more than 4 hours) is NOT healthy for your bladder.
  • Don’t go to the bathroom “just in case” or more than every 2 hours.
  • Drink 6-8 glasses of water everyday unless your physician advises otherwise. When your urine is dark and has a foul odor, you may not be taking in enough fluid.
  • Avoid food and drink irritants. Limit alcohol! Alcohol actually increases urine production and also makes it difficult for the brain to coordinate the bladder control.
  • Too much sugar and/or fatty foods, a sedentary lifestyle, medications, ignoring the need to have a BM are all potential causes of constipation.
  • Avoid constipation by having a balanced diet of fiber. Gradually increase fiber intake to 25-35 grams per day.

Did you get all of that? Follow these bladder/bowel guidelines and see if anything changes.

Have questions about irritants or fiber? Join Covell Care for an intimate presentation on on this topic 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 & to RSVP: (970) 541-4173. https://www.mbkseniorliving.com/senior-living/co/loveland/hillcrest-of-loveland/

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/