Fall Prevention: Assessment and Intervention Strategies to Care for High-Risk Fall Patients – Michel Janet (Shelly) Denes

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Falls and subsequent injuries are an ongoing issue in healthcare and we as clinicians need to know how to intervene to not only treat falls, but also to prevent them before they happen.

During this course you will get the most up-to-date, clinically-relevant evaluation and treatment techniques for improving balance in geriatric and neurologically impaired individuals. A key focus is on learning to select and use the most appropriate tools for assessing balance/risk of falls and evaluating function. You will examine the relationship between cognition, the sensory system and all the musculo-skeletal aspects that impact on balance and fall risk. This will improve your clinical skills in assessment of high-risk fall patients. Providing appropriate pre-(minimizing the risks) and post-fall interventions is very critical to FALL PREVENTION.

OUTLINE

Assessment of Multiple Dimensions of Balance, Mobility and Fall Risk

Three Classifications of Falls

• Accidental
• Unanticipated physiological falls
• Anticipated physiological falls

Balance Dysfunction and Falls: Contributing Factors

• The vestibular system
• Vision
• Somatosensory system
• Muscular strength and joint flexibility
• Endurance, fatigue and fitness level
• Cognition
• Posture

Risk Factors

• Intrinsic risk factors
• Extrinsic risk factors
• Methods for reducing risk factors
• Practical suggestions
• Home safety checklist
• Health and safety checklist
• Fall predictors

Balance, Mobility and Fall Risk Assessment Tools: Individualized Options

• Functional Reach Test
• Tinetti Balance Assessment Tool
• Berg Balance Scale
• Functional Gait Assessment
• The Timed Up and Go Test
• Three and Six Minute Walk Tests
• Full Evaluation of ROM, Flexibility, Muscle Strength and Tone

Effective Interventions to Improve Balance & Mobility and Reduce Fall Risk

Consequences of a Fall

• Physical consequences
• Social consequences
• Psychological consequences

Nutrition

• Strategies to Maintain and Restore Balance
  • Stability
  • Mobility

The Normal Gait Cycle

Gait Training When it Has Gone Awry

• Considerations for assistive devices and orthotics

Therapeutic Exercise

• Benefits & specifics for balance, ROM, strength and gait
• Equipment for clinics and home use
• Program design
• Safety reminders
• Home exercise program
• Environmental Modification/Home Evaluation

Post-Fall Assessment and Problem Solving Prevention

• Fall risk identification

Problem Solving After a Fall Occurs

• Investigation process
• Plan of action
• Corrective and preventative measures

Community-Based Care

• Develop community-based fall prevention programs for older adults

Overcoming Barriers to Effective Strategy Implementation

• Cognitive barriers
• Family barriers
• Facility staff/Caregiver barriers

Medicare and Documentation Considerations

Interactive Lab Time: Assessment Tools and Intervention Strategies in Practice

OBJECTIVES

1. Identify the most challenging fall predictors to be able to put in place a fall prevention plan.
2. Explore current evidence-based therapeutics and research in movement strategies for geriatric and neurologically impaired individuals.
3. Determine the most effective evaluation techniques for the highest risk populations you see in practice.
4. Choose the best strategies for fall prevention based on individualized assessment.
5. Incorporate the most appropriate functional balance testing tools for specific settings.
6. Differentiate between various types of therapeutic interventions, including: gait training, exercise, assistive devices and orthotics as appropriate.
7. Develop a comprehensive balance training and fall risk reduction program for individuals with balance dysfunction.