September is National Falls Prevention month! At least one out of every three adults over the age of 65 falls each year, resulting in almost 2 million older adults ending up in an emergency room. Out of those 2 million, 15,000 die from their injuries. That equals 1 death every 35 minutes as a direct result of a fall. With the help of Pemi-Baker Community Health’s therapy practitioners, older adults can take steps to reduce fall risk and safely increase their involvement in activities they value.
What Causes Falls?
Falls result from personal, environmental, and activity-based factors. Personal factors include such things as illness, behaviors, capabilities, medications, and fear of falling. Environmental factors are those outside of the older adult, such as hazards in the home, the stability of the shoes he or she wears, and the availability and use of mobility devices like canes or walkers. Finally, specific activities can place someone at risk for a fall when the demands of the activity exceed his or her abilities. For example, when someone who has poor balance stands on top of a step stool to reach into a cabinet, fall risk increases. “It is the interaction of these factors that typically leads to a fall,” says Pam Hixon, Occupational Therapist at Pemi-Baker Community Health.
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How Occupational Therapy Can Help
The role of occupational therapy in fall prevention has been widely and increasingly recognized. “Occupational therapy practitioners consider how the individual functions in his or her day-to-day environment,” says Hixon. “They actively involve the client in the fall prevention process to better understand individual fall risk factors and intervention priorities. Teaching clients how to identify and solve problems is an important part of the occupational therapy process.”
Occupational therapy practitioners working in home health have a unique opportunity to understand factors that increase fall risk. They usually start creating a fall prevention plan by discussing the older adult’s typical and desired daily activities. To understand a client’s capabilities, the practitioner might ask the client to perform some typical activities, such as climbing stairs or getting in and out of the bathtub.
To make activities safer and easier, the practitioner might suggest new ways to do things or recommend the 
use of adaptive equipment. They will help clients select which assistive devices would be most appropriate- walkers vs canes for example. The practitioner also helps to identify and address hazards in the home such as loose rugs, stairways cluttered with items and slippery tubs and showers. They can also help procure items such as grab bars, tub seats, raised toilet seats…all of which increase safety.
How Physical Therapy Can Help
Preventing falls is key, but reducing the chance of injury in the case of a fall is also extremely important. Screening for osteoporosis through a painless bone density test can be very helpful. Older adults who have low bone mass are at greater risk for a fracture if a fall occurs. Osteoporosis can be managed medically with a physician’s help, and physical therapy practitioners can help clients who have osteoporosis build bone mass through activity, thus increasing their ability to engage in day-to-day activities more easily.
When you first meet your physical therapist, he or she will assess your balance. If it is impaired due to visual, inner ear or muscular reasons, your physical therapist will give you exercises to safely challenge and improve your balance. For those with very high fall-risk factors, doing exercises waist to chest deep in Pemi-Baker’s warm therapy pool creates a very safe setting for a client to be in control, without the risk of falling. On land or in the water, physical therapy will help improve your mobility, and provide an important boost to your confidence when walking so you can minimize your risk of falling and enjoy your normal everyday activities.
Accessing Occupational or Physical Therapy
Older adults can access therapy services for fall prevention in various settings, such as acute care hospitals, rehabilitation centers, outpatient clinics, and in the home via home health services. Pemi-Baker Community Health offers services in the home as well as at their facility on 101 Boulder Point Road in Plymouth, NH.
If you are concerned about falling, or have had a fall recently, talk to your Primary Care Physician (PCP) about getting a referral to see an Occupational or Physical Therapist with Pemi-Baker Community Health. With over 50 years of experience, serving clients from 20+ towns in central and northern New Hampshire, Pemi-Baker Community Health is committed to creating healthier communities. Services include at-home healthcare (VNA), hospice and palliative care and on-site physical, occupational and aquatic therapy at their Boulder Point Facility.
To contact us please call: 603-536-2232 or email: info@pbhha.org
~Anna Swanson
Being part of a hospice team gives you the profound privilege of bringing comfort, peace and care to patients, caregivers, and their families during their transitional journey.
etcetera. With the ongoing pandemic, things aren’t that clean, direct, or explicit. The notion of a “new normal” brings with it the possibility that there may be some patterns of living we might not be able to recover. We are enduring a prolonged time of “not yet”. It is an experience of anticipatory grief on a global scale. It’s a hard place to be, and it may be awhile before we have any answers.
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comfortable at the end of their lives. Fewer people have heard of palliative care, and they may have no idea what it is. The truth is that 
often, board-certified in Hospice and Palliative Medicine. Additionally, the team generally includes a palliative care nurse, a social worker, a chaplain or someone who can help with spiritual support if the patient requests it, plus a patient navigator or someone who can coordinate the process. PBCH and NANA work collaboratively with 
