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SPRING into Action! WINter by Preventing SOMEmer FALLs all Year Around!

By Michelle Fritsch posted 10-05-2018 10:44

  


Pharmacists can help prevent falls! One of the most common mechanisms of injury in the senior adult population is falling. Falls are the leading cause of both fatal and nonfatal injuries among adults age 65 and over. For example, 30%-50% of falls in this population result in minor injuries, and an estimated 10% of all falls in seniors cause major injuries. It is important to note that older adults who fall, even if not injured, develop a fear of falling. This causes them to limit their activities and reduce their physical fitness. In return, loss of physical activity will lead to increased risk of falls and fall related injuries. Therefore, it is imperative that we optimize prevention strategies to minimize falls. Regular physical activity is one way to minimize risk of falls in older adults. However for older adults, exercise can seem like a daunting task and many may not be familiar with the best options for their age and physical abilities. Thankfully, there’s been some supported successful exercise options to try all year long!

Tai Chi is a great exercise for older adults because it does not put a lot of stress on the muscle. It is a form of exercise that involves a series of movements, which are performed in a slow, organized manner. In addition, the exercise involves combining movements with slow and controlled breathing. Tai Chi exercises are recommended to prevent falls as it improves balance, improves mobility and increases leg strength. Tai Chi may also improve memory and cognition because a lot of the moves are in a repetitive sequence. It has been shown that Tai Chi decreases falls and improves balance and mobility when practiced for at least 50 hours over time. Research findings also support Tai Chi as an effective means of decreasing fall rates in older adults by over 30% after initiating Tai Chi three times per week for almost two months. Tai Chi is known for being a versatile option for older adults because no equipment is needed for this exercise, it can be done indoors or outdoors, and it can be done individually or in group classes.

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For the more adventurous, water aerobics is another effective exercise. This activity involves performing exercises in a shallow pool. Water aerobics is great for senior adults, especially those with arthritis, as it is gentle on the joints. An added benefit to this exercise is that individuals have no risk of falling while exercising as opposed to land exercises.

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Going back to basics, one of the simplest and easiest forms of exercise for anyone is walking. Older adults can maintain adequate levels of strength, endurance and coordination by engaging in at least 30 minutes of walking per day. In addition to walking, there are a number of exercises that can be incorporated to strengthen hips, thighs, feet, and other important areas. Local senior centers and community centers often offer instruction in these types of exercises.

As pharmacists, we often have the most consistent patient interaction compared to our other healthcare providers. This one-on-one time with our aging patients is a great opportunity to address fall risk prevention. It is always important to start with a full medication history, making sure to assess any over-the-counter culprits that could increase your patient’s fall risk. But don’t stop there! Use this time to talk to your patients about participating in evidence-based fall prevention programs to keep them on their feet. As pharmacists we can assist our patients in finding a best suited fall prevention program in their area based on our patient’s mobility, independence, interests and goals.

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Know the resources in your area. If you know a patient is struggling with falls or you find evidence of falls risk, a physical therapist has the greatest skill set to minimize those physical risks. An occupational therapist can guide home modifications to minimize risks.

The Centers of Disease Control provides many useful free resources we can use in practice. You can find those at www.cdc.gov/STEADI. The American Society of Consultant Pharmacists with the National Council on Aging published a toolkit especially for pharmacists who want to diminish falls risk: www.ascp.com/fallstoolkit.

The National Council of Aging (NCOA) is a great resource for pharmacists to reference about fall prevention programs. Every September the NCAO has a Fall Prevention Awareness Day to promote awareness on innovative tips and tools about how to prevent fall-related injuries among older adults. It is highly recommended to check out this resource to get more information about exercise prevention programs. Also make sure to mark your calendars for next year’s Fall Prevention Awareness Day, which is also first day of fall 2019! Helpful resources can be found in the National Council of Aging (NCOA) website: https://www.ncoa.org/healthy-aging/falls-prevention/

Have you had a successful experience with getting an older adult active to prevent falls? Would you like to offer feedback or ask a question? Please share your thoughts below.

 

Wintana Stefanos, Pharm.D.

Brittney Champagne, Pharm.D.

Assisted by Deanna Rattray, Pharm.D. and Michelle Fritsch, Pharm.D.

 

References:

  1. YMCA of western North Carolina. Falls Prevention. Accessed October 2018.
  2. National Council on Aging (NCOA). NCOA. https://www.ncoa.org/. Accessed October 1, 2018.
  3. Choi JH, Moon JS, Song R. Effects of Sun-style Tai Chi exercise on physical fitness and fall prevention in fall prone older adults. Journal of Advanced Nursing. Jul 2005; 51(2):150-157.
  4. Rose DJ, Hernandez D. The Role of Exercise in Fall Prevention for Older Adults. Clinics in Geriatric Medicine. 2010;26(4):607-631. doi:10.1016/j.cger.2010.07.003.

 

Picture References:

  1. https://www.phillyvoice.com/tai-chi-class-martial-arts-class-center-city-independence-live-market-059991/
  2. http://3.bp.blogspot.com/-b4moklVWFn4/Tx63EZvoG4I/AAAAAAAAInE/2Uol4gligWE/s1600/senior-aqua-water-aerobic-exercises.jpg
  3. http://files.modernmedicine.com/alfresco_images/HealthCare/2017/06/13/6160c2ab-7c7c-4cf9-93a6-c497a79315ce/elderlypatients.png
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