Falls….Fear of Falling….Overcoming Falls in the Elderly

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Learn Physical Therapy Techniques for getting elderly off the floor, reasons for elderly falls, and easy home-based balance exercises for the elderly.

There are several reasons for elderly falls.  However, the Balance Strategies of the ankle and hip and Elderly fear of falling are two contributing factors that are commonly overlooked!  Before we delve into elderly fear of falling and balance strategies, I would like to show you a safe wheelchair floor transfer technique!

 

 

Sometimes Falls Just Happen…How to Get Elderly Off the Floor

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Ok, so if a loved one falls, is obviously not hurt, and needs to get off the floor–what are your options?  If you have a wheelchair AND the armrests can be removed, then you can use a wheelchair transfer technique to lift your loved one off the floor (as seen in the video below).  I have also used sturdy chairs like a dining room chair to demonstrate and train the floor transfer technique featured in the video below.  REMEMBER:  Do NOT move,lift, or transfer anyone from the floor if you suspect or observe an injury as the result of a fall.  In the same manner, ask for HELP–even if the person helping you just guides/spots you during the transfer.

 

Elderly fear of falling, Basiphobia (the fear of falling), is REAL, can be a LIFE CHANGING event, and can steal a person’s QUALITY of LIFE away in the blink of an eye.  Senior citizens are more vulnerable to developing a fear of falling–generally following a substantial fall that required hospitalization, surgery, or medical treatment of a significant injury.  Typically, the fear of falling does not develop from a single fall.  The fear of falling generally develops over time through a cycle of events.

BREAKING THE CYCLE

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The cycle can be broken at any stage!  Focused management of swelling, bruising, pain, and stiffness can minimize inactivity that leads to total body weakness.  Strengthening the leg muscles and the 3-balance strategies can promote increased walking with decreased anxiety. Increased walking and activity will decrease the risk of secondary problems such as blood clots, pressure sores, pneumonia, and joint contractures.

 

Strengthening the leg muscles is not very difficult.  One the fastest, easiest and most effective lower leg exercise–besides walking–is the sit to stand!  Similar to doing a squat, the sit to stand exercise is easily modified, very versatile, and has the added benefit of strengthening the pelvic floor muscles responsible for bladder control.  Here are some tips for progressing and doing different variations of the sit-to-stand exercise:

 

Variations	Easiest	Hardest
Height of Sitting Surface	Higher/Elevated	Lower
Firmness of Sitting Surface	Very Firm/Does not move	Very Soft/Rocks and moves
Use of hands to push shoulders over the feet	Use both hands	No hands are used/the legs do all the work
Position of the feet	Shoulder-width apart or Stronger leg slightly behind	The weaker leg/foot is slightly behind
Scooting out to the EDGE	Scoot all the way to the front	Stand up without scooting forward
Number of Repetitions	Less than 5	More than 8

Combining different variations from the table above such as standing from a low/soft surface (couch) with one armrest (using one hand) and completing 3 repetitions with different foot positions (Both feet shoulder width apart, the Right foot slightly behind the Left foot, and then the Left foot slightly behind the Right foot) is another way to use the sit to stand exercise to both challenge and strengthen the lower legs.

 

Balance Strategies of the Ankle and Hip

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Have you ever heard of Balance Strategies-the techniques our bodies use to correct loss of balance and prevent falls?  There are 3 strategies for correcting different levels of loss of balance.  Here is a video explaining the 3 strategies because if you understand how balance is lost, you can relate to the exercises and understand the rationale behind specific exercises used to decrease falls associated with weakness and delayed reaction times.

If you go watch people work out in a gym or fitness facility, you typically observe people strengthening the large muscles of the legs, the abdominals for those washboard abs, and the arms.  Rarely you will see people target 1 out of 3 most important areas responsible for balance–the ankles.

 

When I work with patient’s in the home setting, I always address the ankles and the Ankle Balance Strategy.  Below are some general balance-based exercises I have my patients complete.

 

Balance Exercise Tips

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Warm up

Sit to Stand 8 to 10 repetitions
Standing Up do 8 to 10 heel raises
Standing Up do 8 to 10 toe raises
Side Step either along the edge of a couch or a bed

Walking

Walk Forward
Walk Backward
Walk in a Grapevine pattern: cross one foot over the other foot in the front of you, then cross the other foot over behind you!

Sitting Balance (You Need a Balance Ball!)

Bounce Up and Down
Shift Your Weight Side to Side
Shift Your Weight Forward and Backward
Alternate Kicking Your Legs in Front of You
Alternate Marching or Raising Your Knees Up

Ultimately, I hope your loved one does not fall and get hurt, but hopefully, you learned more about how Physical Therapists address strengthening, balance, and transfers to manage the risk of falling.

I want to thank you for visiting my site and I hope you leave with having learned something to make caregiving easier/safer and a desire to return for future updates.  Please leave a comment, question, or idea so I can continue to help you with any other daily caregiving issues.

Once again thank you for stopping by and I look forward to seeing you again soon!

 

 

Best Regards,

 

 

Shawna PT, MPT

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