Why are residents still falling down? Because we’re helping them too much!

By Susan Saldibar

Why are residents still falling down? Because we’re helping them too much!

And this has nothing to do with “freedom to fall,” although that’s a great concept.

The folks at Aegis Therapies, a Senior Housing Forum partner, have been doing a lot of research about falls, which has helped identify some of the underlying reasons our residents continue to fall. They even created a committee to study falls in greater depth.

Knowing they might fall, they try to do things anyway. Don’t we all?

It turns out, in many cases, falls are precipitated by a non-routine movement, usually doing something that caregivers normally do for them (more on that in a minute). Two movements were noted:

  • Reaching vertically, above their shoulders, outside their base of support

  • Reaching laterally, and stepping outside their base of support

And what do we do when we reach, awkwardly, out of range? Come on, we’ve all done it. We tend to take a less than sturdy step to try to keep our balance. The result: we fall.

Don’t prevent the falls. Build up the residents to prevent their own falls.

So Aegis has come up with what they call “Fall 1 2 3 4,” which is a program that actually prepares seniors for those “out of reach” moments. Sort of like training for an Olympic event.

Aegis has agreed to share the details of the program so that communities can put it into action. Here’s how it works:

  1. Look Up/Reach Up activities (can be done standing or sitting):

    1. Put hands over head

    2. Look up at the ceiling

    3. Stretch the neck from side to side

    4. Lean back towards the back of a chair

    5. Shrugging shoulders

  2. Reach High/Reach Low activities (can be done standing or sitting):

    1. Reach hands higher than shoulders, then lower than waist or knees

    2. Look and reach towards opposite hip

    3. Look and reach behind, then right and left and opposite

    4. Reach far enough, while sitting, that at least 1 buttock lifts off the chair

    5. Reach forward towards the floor

  3. Standing and stepping outside comfort zone activities:

    1. Step from the right to left leg, then left to right leg

    2. Step back and forth with one foot in front of the other

    3. Take a wide stance with feet apart

  4. Strengthening during activity:

    1. Lean one arm on the table, and reach with the other

    2. Push up off the chair with the arms

    3. Pull forward with the arms

    4. Increase standing duration

    5. Do knee bends to enable a low reach

    6. Stand on one foot with balance support

After putting these techniques into play, Aegis noticed a fairly dramatic reduction in the percentage of falls, along with overall better posture, both sitting and standing. And the families of residents noticed it too.

So are we caring too much? Or giving up too much?

“Staff has a tendency to do everything for the residents,” says Angela Edney, Occupational Therapist and National Clinical Director. “They do it to help, but they may be short-circuiting a resident’s potential ability to help themselves,” she adds.

Are caregivers caring too much? Or are they getting lazy? After all it’s a heck of a lot easier to grab that robe off the hook for the resident than to let them do it themselves. No one wants to think that our often overworked caregivers are becoming complacent. Or that the worry of a fall (and possible lawsuit) is hampering their efforts to help residents “do for themselves.”

Kudos to Aegis for presenting us with a no-nonsense approach to help strengthen residents that everyone can do. No fancy equipment needed.

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