Question
Why should occupational therapists be involved in the treatment of falls?
Answer
Less than half the people tell their doctor when they fall. Conditions that contribute to falling include:
- Lower body weakness
- Vitamin D deficiency
- Medications
- Vision problems
- Foot pain
- Poor footwear
- Home hazards
The big question is, why should an occupational therapy professional be involved in fall prevention? I did not share the fall statistics to scare you or sensationalize the issue, but these numbers should be part of your client and clinician education so that they can see the impact. Again, if this presentation helps one person, it is worth it.
Less than half the people tell their doctor that they have had a fall. We are fortunate as therapists that we get to spend so much time with our clients and can establish rapport and trust. So if a patient does not tell you right away that they have had falls, this information may be shared over time. We need to massage those conversations so that revealing fall information does not appear to be a checkmark on their record. Many people fear what it means if they tell their healthcare professional that they have had a fall.
Some of the conditions that contribute to falls are lower body weakness, a vitamin D deficiency, certain medications, including those over-the-counter, problems with vision, foot pain, poor footwear, and home hazards. We are skilled at activity analysis and equipment recommendations. Thus, the home hazard piece certainly falls in OT's wheelhouse.
- According to the AOTA, “Occupational therapy practitioners possess the critical skills needed to address fall prevention with older adults.”
- Skillset includes:
- Reviewing the context
- Evaluating client limitations and strengths
- Interventions targeting improved abilities
- Modifying homes
- Changing patterns and behaviors
Beyond the fact that we are already in the picture and assessing these things, the American Occupational Therapy Association (AOTA) and other credible sources say that occupational therapy practitioners possess the critical skills needed to address fall prevention with older adults. Print that out and hang it up in your rehab gym or home care office or use it in your marketing to physicians.
Based on research, the AOTA says that falls are multifactorial. Falls are influenced by conditions within the individual, the environment, and the interaction between the two. The most successful fall prevention initiatives use multifaceted approaches. OT practitioners are skilled at evaluating and addressing influences from the person, their activity, roles and routines, and the environment to maximize independence. We link the client's goals and priorities with modifications and adaptations that support their ability to participate in meaningful activities. This is the hallmark of occupational therapy.
Many times facilities have a falls team, but often occupational therapy is not represented. It would be beneficial if OT and PT were both automatically referred in fall cases, and sometimes we have to educate our interdisciplinary teams on that. Often, people fall because they are doing things that are meaningful or everyday tasks, and we can work on that. I have a personal example of that. My mom was at my house when I was out of town. My dog had an accident on our rug in the front room. She went outside to clean it and fell. On the same weekend, she fell over a baby swing on the way to the bathroom because it is not usually there. She had two falls on the weekend doing things that were regular tasks. We had to go back to clear pathways. It is important to review the context of the fall.
We already look at limitations and strengths, but now we need to look keenly at what caused the fall. My mom can continue to take things outside to clean or carry heavy items, but we need to ensure that she is doing that safely. We already modify homes and are good at changing patterns and behaviors.
