October 2008

Anne-Marie Barry, Physical Therapist

Preventing Falls
• Try not to move too quickly – think about what you are doing
• When walking – think about the heel hitting the ground first
• Do not pivot your body over your feet when turning. Make a U turn or Clock turn in confined areas
• Never lean too far forward over your feet
• If freezing or shuffling try to come to a complete stop
• Do not carry many items when walking
• Avoid walking backwards
• When attempting to sit, turn all the way around and feel the chair with your legs, use hands to lower yourself. Never slide sideways into a chair. Use visual cues like colorful tape on the floor in front of the chair and on the arms.

Falls can happen when getting up from a chair and turning in a small place.
Avoid shoes with lots of tread or cushioning.

Walking
Walking is like being on “auto-pilot” but if our “auto-pilot” isn’t working efficiently we have problems like festinating (speed-walking) or freezing and we need to concentrate. It’s not a good idea to multi-task.
When you experience freezing don’t fight it. Some suggestions to get going again are to divert your attention by raising an arm, taking a step out to   the side, and having your carepartner touch you.

What to do if you fall
• Stay calm, check to see if there is an injury
• Plan a strategy to get up, find a supportive piece of furniture to help
• Activate an emergency signaling system

Practice getting up from the floor.
If you fall outside and you’re not injured, try to crawl to something that you can use to haul yourself up.

Postural tips
• Avoid chairs without arms and a good back support
• Avoid recliners since they contribute to the rounding of the head, neck and shoulders. If using a recliner, raise the foot rest, stretch out and recline!
• Avoid low soft sofas and chairs
• Height of chairs should allow hips and knees to be level
• Keep your chin parallel to the floor
• Avoid crossing of legs
• Keep head, shoulders and hips in line with each other
• Use a lumbar roll in the low back
• Computer screen and TV should be at eye level
• When reading, support elbows on pillow so that you can look directly at the pages. Avoid reading in bed, or sit up in bed to read.
• Do not sit for more than 30 minutes. Get up and move around, get a glass of water, etc.
• Take naps lying down.

Is your home safe?
Outside
• Do steps have handrails?
Is walkway in good condition and well lighted?
• Are there any garden tools lying around?
Inside
• Are carpets laying flat?
• Are area rugs non skid and secured to the floor?
• Are areas clear of wires and clutter?
• Is your favorite chair easy to get in/out of?
• Do you have night lights turned on?
• Are items in cabinets within easy reach?
• Are stairs well lit, and with handrails?
• Do you have grab bars in the shower/near the toilet?
• Do you have a non-skid surface in the shower/tub?

When are assisted devices needed?
• There is no specific answer to this question, but ask yourself, could and would you do more if you felt safer?

If you find that you are avoiding things like going shopping or having a shower, then consider aids to help you do that activity.

Moving around in bed
Flannel sheets make it harder to move around in bed.
Avoid too many bedclothes – a light down comforter is better than heavy blankets.
Practice rolling out of bed when you’re feeling your best.

Getting in and out of the tub
There is a tub bench that you place with 2 legs in the tub and 2 on the floor. Requires a hand held shower.

Commode – Can be very handy to use as
1) a commode
2) light weight toilet seat
3) shower chair
If using a toilet seat riser it is recommended that you use the kind that bolts securely to the toilet.

Eating – If it’s difficult to hold knives and forks, find cutlery with larger handles or make handles larger by slipping a cushion from ladies’ hair rollers over the handle

Walking assistance devices
Selecting a walker is personal because it’s important to take into consideration where and how it will be used. You may need a couple – one   for indoor use and one for outside. A physical therapist can help you choose which one is the most suitable for you.
For short distances, a transport chair can be handy as it’s lighter than a regular wheelchair because it doesn’t have the large back wheels.

These are links to a some of the things we talked about:
UStep walker – www.ustep.com
Equipment website so you can see what’s available –  www.sammonspreston.com
such as the super pole system and the bed hoist
Recommended – www.patientslikeme.com

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