Fall Prevention for the Elderly

According to the Centers for Disease Control and Prevention, more than one third of elderly persons over 65 years old fall every year in the United States (CDC). In 2005 about 1.8 million older adults were treated in emergency rooms for nonfatal injuries from falls and more than 433,000 of these patients were hospitalized (CDC). In fact the leading cause of injury deaths in the elderly are a result of falls.  

Due to this high prevalence of cases, it does not come as a surprise that falling is a major concern reported by elderly adults.  According to a study published in Physical and Occupational Therapy in Geriatrics, older adults fear falling because of fear of social embarrassment, getting hurt, and fear of losing their independence. So while physical injury is major concern, many older adults also fear the psychological effects of falling. A fall can result in feeling of inadequacy and embarassment. This fear can also lead to avoidance of everyday activities in hopes of preventing a fall. This abandonment of everyday activities can affect the individual's quality of life and their feeling of independence. 

So what, if anything, can be done about this fear of falling? Well for several years now occupational therapists have been working with elderly patients in programs designed to prevent falls. These occupational therapists address the patient’s fear of falling and ways that it could be prevented. According to the study, the most common fears regarding falls were fear of physical injury, the feeling of falling, becoming an invalid, losing one’s independence and being institutionalized, a long lie and being unable to reach someone once they have fallen, and being confined to a wheelchair or being unable to walk (ibid).  This study could shed light to some of the assistive tools that occupational therapists could suggest to calm their client’s fears of falling and tools that could even help to prevent future falls. 

 One promising tool may in fact be a popular video game that many children play.  According to the article Wii-habituation 'could prevent elderly from falls' published in CNN health, researchers at the University of Aberdeen in Sweden are studying to see if the popular video gaming system the Wii-fit can improve balance in elderly individuals.

http://www.cnn.com/2009/HEALTH/02/11/wii.fit.elderly/index.html

If this does prove to be successful numerous occupational therapists could help develop treatment plans using the gaming system to help improve an elderly patient’s balance as well as confidence. Other assistive devices such as medical alarms are becoming popular. These alarms can be worn around the person’s neck and can allow the older adult to call for help with the touch of a button. This can help to calm the fear that many older adults have of falling and not being able to contact anyone. This can help to boost the older adult’s confidence and chance of getting medical assistance much faster in the case of a fall. Hopefully more can be done in this field to prevent the number of falls suffered from elderly adults. 

CDC. Falls among older adults: An overview. Retrieved 28 February 2009, from http://www.cdc.gov/HomeandRecreationalSafety/Falls/adultfalls.html

Lorie, A. (2009). Wii-habilitation could prevent elderly from falls. Retrieved Febrauary 28, 2009, from http://www.cnn.com/2009/HEALTH/02/11/wii.fit.elderly/index.html

Tischer, L., Hobson, S. (2005). Fear of falling: A qualitative study among community-dwelling older adults. Physical and Occupational Therapy in Geriatrics, 23, 37-53. 

Can Alzheimer's Disease Affect the Safety of the Road?

A recent study conducted by the University of Iowa indicates that people with early Alzheimer’s disease can show impairments in their driving ability compared to people without the disease. (http://www.usatoday.com/news/health/2009-02-09-alzheimers-driving_N.htm) The study observed 40 older adults diagnosed with early Alzheimer’s and compared them to a group of 115 older adult drivers without the disorder.

During a road test, the Alzheimer’s subjects showed an

average of 42 mistakes while the subjects without the disease showed an average of 33 mistakes. The most common of these mistakes was lane violations, which was about 50% higher in the Alzheimer’s subjects. This study helps to bring light to the potential danger that the Alzheimer population faces when driving. While many older adults in the early stages of the disease may show very little cognitive impairment, they may in fact manifest impairments in their abilities to drive safely.

This raises the question. Should people with Alzheimer’s disease be driving? People diagnosed with other neurological disorders such as epilepsy must follow a strict set of rules in order to drive, which can include obtaining a doctor’s note stating that they are fit to drive safely. Similar rules could be applied to people with Alzheimer’s disease to improve their safety on the road.

In combination with these laws, occupational therapy can help to improve the safety of this population on the road. One emerging area of occupational therapy is looking to help elderly patients modify their driving to ensure safety on the road. According to the Alzheimer’s Association, as many as 5 million Americans currently have the disease. Occupational therapists could greatly help this population by identifying their specific needs. Perhaps new tools and warning devices can be made for these patients. For example, sensors that could identify the driver of the cars that may be in their blind spot when switching lanes. With these added measures, the safety of these drivers as well as others on the road could be greatly improved.

Marcus, B. M. (2009). Early Alzheimer's can erode erode driving skills. Retrieved 28 February 2009, from http://www.usatoday.com/news/health/2009-02-09-alzheimers-driving_N.htm