Home' Community Care Review : CCR Jan-Feb 2015 Contents Brought to you in
association with the
Aged Care Channel
having the operation on the first affected
eye. Also people when they change
their spectacles need to take some time
to adjust to the new glasses and care
should be taken when walking with
bifocal or multifocal glasses down stairs.
Glasses should be cleaned regularly to
• It is important to change hazardous areas
in high risk populations, for example
the very frail or visually impaired. Many
elderly people should be encouraged
to remove loose rugs or carpets. There
should be bright effective lighting so
ageing eyes can see possible trip hazards.
• We know that some medications can lead
to a fall hence regular medication reviews
done collaboratively with pharmacists,
GPs and the client is important with an
emphasis on reducing, if possible, the
• Vitamin D and calcium supplementation
can reduce falls if the person is not
exposed to sunlight. Vitamin D is
important for good bone health. Take
people out into the sunshine if possible
every day to do some exercise outdoors.
• As we age our feet can change their
shape and develop painful bunions and
corns hence podiatry is a must for this
population. We need to encourage older
people to wear good supportive shoes that
decrease the risk of tripping and slipping.
• Syncope, which is a transient loss of
consciousness, for example fainting, is
common in the elderly and can be from
a drop in blood pressure (orthostatic
hypotension) to cardiac arrhythmias.
Good hydration is important especially
in hot weather and encourage clients to
decrease prolonged bed rest. They should
be encouraged to move from lying to
sitting and then to standing slowly to
adjust to the postural changes.
• Insertion of a pacemaker can reduce falls
in people with frequent falls associated
with carotid sinus hypersensitivity, a
condition which may result in changes in
heart rate and blood pressure.
Developing a plan
People in the community should be
encouraged to have a plan in the event of
a fall. It could be that they have a personal
alarm that can trigger an alert that they
have fallen or even a regular daily phone
call from a neighbour or family member.
This is particularly important if the person
lives alone, has cognitive impairment or
lives in a remote area.
We need to encourage people to tell their
carer, family member or doctor that they
have had a fall so the cause can be looked
at. It is particularly important if people are
on any blood thinners such as aspirin or
warfarin whereby a bleed could be fatal. n
Sharon Butler is the Better Balance
Leader for Anglican Retirement Villages
(ARV). Sharon appeared on the Aged
Care Channel's Minimising the Risk of Falls
in the Home program.
Falls risk factors
Footwear (e.g. high heels, slippers)
History of falls
Inappropriate glasses (e.g.
Hazards either inside or outside
Chronic medical conditions (e.g. Parkinson's, stroke,
Slippery, wet surfaces
Multiple medications especially those that affect the
central nervous system (e.g. psychoactive drugs)
Decreased muscle strength
Sensory problems (e.g. vision impairment,
Infections (e.g. chest infection & urinary tract infections)
Fear of falling
Slow reaction time
Tips: Falls prevention and your client
• Ask them regularly if they have had a fall and encourage them to tell you.
• Are they drinking fluids regularly? If they aren't then it may lead to a urinary tract
infection, which can lead to delirium.
• Are they eating well and holding a steady weight? If not then they may be losing
muscle definition, which can lead to reduced strength.
• Poor gait, mobility and strength can be addressed by a physiotherapist, who can
also give them a home program and check their walking aids.
• Have you noticed any change with their vision?
• Are the lights sufficient in their home and outside the home?
• Are there any home hazards that can be reduced, e.g. removal of rugs?
• Have you noticed any change in their cognition? If so, flag this to the supervisor,
GP or family; it may be due to a medical condition, e.g. delirium or true cognitive
• Observe a person's mobility especially if there has been a change in medication or
they have recently returned from hospital.
• Encourage people not to rush especially when going to the toilet and to wear good
supportive shoes or non-slip socks.
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