The importance of physical activity

When it comes to falls prevention, physical activity is key.

“When seniors are inactive and sedentary, they are more likely to decondition. It’s one of the risk factors [for falls]: poor activity tolerance, weakness, pain,” says Sara, a physiotherapist in Sunnybrook’s Geriatric Day Hospital, an interdisciplinary outpatient therapy program that provides care for seniors to help them continue to live at home safely.

Sara says stay-at-home orders during the pandemic made it difficult for many seniors to maintain a level of physical activity.

“A lot of seniors have had serious deconditioning from staying home, being sedentary,” she says. “Reduced interactions in the community as they stopped going out to run errands or socialize has had an impact on their mobility, function and overall mental wellbeing.”

Belinda Wagner is a physiotherapist and the team lead for Sunnybrook’s Emergency Department One team, a health professionals team that provides support to patients (most of whom are 70+) who don’t need to stay in hospital, but would benefit from community services. The team ensures discharged patients are well-connected and supported in the community to hopefully prevent a return to hospital. She says physical activity doesn’t mean older adults need to start an intense gym routine, but movement is critical.

“The bottom line is the more you move, the more you’re up and exercising, [the better]. Walks around the block, mall walks, getting up periodically. It can be an exercise program, but functional movement first and foremost is the focus,” she says.

Make a plan

With the cold weather arriving, sidewalks will become slippery, the temperature will drop and older adults may be hesitant about heading outdoors. While it might be more difficult to get outside, Kellen, an Occupational Therapist and Project Manager for Senior Friendly and Quality at Sunnybrook, says making a plan with family members can help.

“Make a plan for how you’re going to stay active this winter,” he says, adding he encourages family members to have this conversation with the seniors in their life. “If family members are involved in making a plan, they can check in and see how that plan is going.”

Another aspect to planning is ensuring the home environment is as safe as possible. Through Sunnybrook’s Specialized Geriatric Services, an outreach team can go into a senior’s home to not only assess home safety (i.e. fall or tripping hazards), but to complete a Comprehensive Geriatric Safety Assessment.

“I feel like most seniors would benefit from a home safety assessment, just to have a look at their environment, how they move within their home, see if they do things safely and to make sure they have adequate gait aides such as canes or walkers,” says Sara. Those assessments can be completed through Sunnybrook’s Specialized Geriatric Services with a physician’s referral. Individuals can also self-refer through Home and Community Care Support Services.

Make use of mobility aids

One way to reduce the risk of falls is to use mobility aids such as canes or walkers, which can provide additional stability and support.

Kellen says if you (or a family member) need to hold a wall when walking or are unstable without support, it could be time to discuss using a mobility aid.

“Some of those signs are indicators that someone might need a bit more support, and the risk of falls is greater if you can’t support yourself. If you’re looking for other things to help you, especially things that aren’t designed to support you while you move, you have a greater risk of falling,” he says.

There may be some reluctance to use mobility aids, but Belinda says they are an important tool to keep older adults safe, active and healthy.

“You’re keeping your independence, you’re keeping your ability to do everything as much on your own, to keep safe and to keep moving,” she says.

Kellen suggests speaking to your family physician or contacting home care for a connection to an occupational therapist or physiotherapist to explore whether a mobility aid is a good option for yourself or a family member. For all people, including older adults, remaining active and exercising throughout the winter is important and can actually reduce the risk of falls.

“It’s how do I stay active and moving in a safe way that’s supported and where there’s a plan.”

You can reach Home and Community Care for general inquiries or to make a referral at 310-222—no area code required.

You can reach Sunnybrook’s Geriatric Day Hospital at 416-480-6888

The post How to support and prioritize falls prevention in everyday life appeared first on Your Health Matters.

Why does cancer or cancer treatment put me at a greater risk for a fall?

Cancer, and its treatments, increases the risk of sustaining a fall. Research has found that falls occur in 30-50 per cent of people with cancer over the age of 65.

Various chemotherapy medicines affect physical functioning and can cause vision changes, nerve issues (that can cause decreased sensation in your feet), muscle weakness and loss. There’s also a risk of osteoporosis. Both chemotherapy and radiation cause fatigue, which puts you at higher risk for a fall.

After cancer surgery you might feel fatigue or dizzy, and you may have muscle weakness or loss.

Anti-nausea and pain medications can cause drowsiness and sedation, increasing the risk of falls.

Is a fall something serious? Why?

According to the Public Health Agency of Canada, falls are the leading cause of injury among older adults in Canada:

• 20-30% of seniors experience at least one fall each year
• 95% of all hip fractures are due to a fall
• 50% of all falls causing hospitalization happen at home

Falls can also cause head injuries, hand and arm fractures, all of which can affect an individual’s ability to manage their day-to-day activities.

What can I do to reduce my risk of falling?

• Wear footwear that has good support, low/no heels and a good tread, even inside your home. Avoid wearing stocking/sock feet or going barefoot.
• Inspect your home for falls risks. Ensure that your home is well lit, inside and out. Use night lights. Ensure you have a handrail for use on all stairs. Keep your home tidy and remove any clutter that might cause you to trip — cords, boxes, pet toys. Consider removing all area rugs as they pose a falls risk. If they are not removed, ensure they are well secured with either non-skid backing or double-sided tape. Clear outdoor walkways of leaves, snow and ice.
• Many medications used to treat common health issues like sleep problems, anxiety, depression, blood pressure, pain, arthritis, bladder control, colds and dementia can affect your balance. Talk with your doctor and pharmacist about side effects of your medication, including all prescription medications, over-the-counter medicines and herbal products. Have a medication review with your pharmacist. Make sure you are taking your medications as prescribed. Consider the use of a medication dosette or a blister pack.
• Consider the use of assistive devices. Canes, walkers and rollaters can provide support for people with balance issues or weakness in their legs. Ensure that the rubber tip on the cane is not cracked or worn down. If using a cane outdoors in the winter, use an ice tip for the end of the cane to grip ice and snow. Other equipment that can help prevent falls, particularly in the bathroom which is a common spot for falls, include grab bars, bath chairs, hand-held showers, non-slip tub mats and raised toilet seats. Consider the use of an emergency response system, which will help you and your family feel more secure about being home alone.

What should I do if I do fall? 

Stay calm and don’t rush to get up off the floor. Ensure that you are not injured before trying to get up or letting others help you up. If you aren’t injured and can get up, roll onto your side and slowly push up so that you are on your hands and knees. Crawl to a sturdy chair. By grabbing the seat of the chair and bringing one foot forward with your knee bent and foot flat on the ground, slowly push up from the kneeling position, rise, and turn your body to sit in the chair.

If you cannot get up, shout for help. Call 911 if your phone is nearby. Use an Emergency Response System.

Now that I hear all this, I’m scared I’m going to fall. Should I just reduce my activity and stay home and stay put?

No! Being inactive actually can increase your risk for falls.

• Exercise: Cardiovascular and resistance exercises can help increase muscular strength, flexibility and power, and can also improve balance.
• Consider a Home Safety Assessment with an Occupational Therapist. The therapist can identify areas in your home where falls risks exist and can provide recommendations to reduce your risk of falling. Take to your care team.
• Falls Prevention Clinics in the community. The Sunnybrook Falls Prevention Program involves consultation with a geriatrician and a physiotherapist to assess people over the age of 65 who are having falls or are at risk of falling. This six-week group exercise program is designed to improve strength, balance and gait, and is run by a registered physiotherapist. Education sessions include information about home safety, home exercises and safe medication practices.
• Have regular medical appointments with your physician. Talk to your doctor about any drowsiness, dizziness, blurred vision, unsteadiness or falls you have experienced.

Find more information about falls prevention:

8 winter safety tips for pedestrians

8 tips to prevent falls at home

The post Cancer treatment increases risk of falling. Here’s help. appeared first on Your Health Matters.