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THE ROLE OF THE PHYSICAL THERAPIST IN A FALLS
PROGRAM
Melinda Jaeger, PT Empira
Rehab SpecialistAging Services of Minnesota Live From 350 South Conference Call
November 3, 2010
EVALUATE
• Strength/ROM• Balance• Mobility• Pain• W/C Positioning
New Admissions Significant Change /Decline
Post Fall
PT_FALL_RISK_ASSESSMENT.xlsx
Significant Change/Decline• Struggle with sit →stand- referral for LE strengthening
• Signs of pain- referral for modalities, nonpharmacologic approach
• Loss of balance with reaching or during gait• C/O dizziness- referral for vestibular eval
• Poor w/c positioning- referral for core strengthening, proper w/c fit
• ↓ Endurance• ↓ ADL functionElders with dementia or cognition impairments can
benefit from therapy intervention.
COMMUNICATE
Systems in place to convey information from PT evaluation and or treatment to nursing assignment sheets.
EDUCATE
Raise awareness of Fall Risks in the facility• Staff, families and residents aware of proper
footwear• Measure and mark correct bed heights• Anti-rollback or auto-lock brakes on w/c
PARTICIPATEMember of falls committee
• Balance and falls expert• Skilled in Root Cause Analysis • Astute in recognizing patterns in the recurrent
faller
How to allocate time to participate with current time/ productivity constraints?
• Run an effective meeting• Assess time management
ADVOCATE
The therapist should advocate Fall Prevention• Involve NAR in last PT Rx to incorporate reaching,
standing, and balance in ADLs• Refer to TR after therapy D/C to maintain balance skills by
offering standing or reaching opportunities in TR activities• Emphasis on balance and ankle strengthening on
restorative nursing referrals
Why the focus on balance not exercise or walking programs?
“Balance Exercise Reduces Risk of Falling”
Journal of the American Geriatrics Society, December 2008
Strength training alone may not effectively reduce falls since impaired balance is a stronger risk factor for falls than poor muscle strength.
Walking programs did not appear to have much effect in preventing falls.
The greatest effect in preventing falls were seen with exercises that challenged balance.
ANKLES are the ANCHOR for Balance
• Rock Ankle Exercise Board • Use seated for ankle strengthening and ROM
TRANSFER POLE
ENCOURAGESTANDING and Safe Transfers
The therapist is a key team member in your falls program
GOOD LUCK ON YOUR EFFORTSTO STOP FALLS
I welcome any questions you may have as you continue your goal towards fall
reduction
Contact informationMelinda Jaeger, PTEmpiraEmail: [email protected]: 612-816-5231
