Fear of Falling

1. Fear of Falling Don’t let a fear of falling keep you from doing the things you enjoy doing.

2. Sharing Experiences Would anyone like to share their experiences with falls? What are you hoping to get out of this meeting?

3. In this session we’ll… • talk about how fear of falling can affect your wellness, lifestyle and independence, • learn some strategies for approaching valued activities in a safe way (the Canadian Model of Occupational Performance), • observe and possibly try some techniques for getting up from the floor, and • discuss some basic safety strategies to ensure that help is available if a fall does occur.

4. Impact of Falls on Life Roles What difference would a fall make in your life? We invite you to fill in the “Impact of Falls on Life Roles” form.

5. What are some activities around your home or community that you are afraid might result in another fall or injury?We invite you to fill in the “Feared Activities” Form

6. Environment Physical Institutional Occupation Physical Self Care Leisure Person Psycho-Social Cognitive Productivity Social Cultural The Canadian Model of Occupational Performance Townsend, E (ed), Enabling Occupation: An Occupational Therapy Perspective, Canadian Association of Occupational Therapists, Ottawa, ON, 2002

7. Person Your characteristics, abilities, skills experience, interests • Physical includes strength, balance, flexibility, the medications that you take, your nutrition, blood pressure, vision, hearing • Cognitive includes thinking, planning, concentration and attention • Emotional – depression

8. Environment Physical - where you live, e.g. the design of your home; also the outside environment such as the access to your building, the city’s snow removal plans etc. Social - the help you may have in your home, the support you have from Meals-on-Wheels or a family member. Cultural – the values and expectations that you have because of the people or experiences in your life, e.g. the standards you have developed in your housework, your beliefs about a man’s role vs a women’s role Institutional – laws, rules and regulations

9. Occupations • Everything we do during the day and how we do it • Daily routine that makes up your day • Occupations change over time, with the seasons

10. Now let’s apply these principles to the activities you’ve identified

11. Getting in and out of the bathtub Person • Improve strength, flexibility and standing balance through participation in a regular exercise program. Environment • Consider installing grab bars on the side and back walls of the bathtub. • Use non-slip mats inside and outside the bathtub • Be sure the lighting is bright enough to see where you are stepping. • Using the towel rack, soap dish or shower curtain to steady yourself is risky and may cause more serious injuries if they give way. Install proper equipment. • Consider using a bathtub seat and a hand held shower rather than sitting right in the bottom of the bathtub. It will make getting up easier. Occupation • Take your time. Rushing after being in a hot tub or hot shower can make you dizzy or weak. • Dry yourself while still in the bathtub. If your legs and feet are dry, there will be less chance of slipping. • Stay away from bath oils that will make your hands and feet oily or slippery.

12. Apply the “Person, Environment, Occupation” model to your examples.

13. Getting up from a Fall Do not try to get up from a fall too quickly. If you feel dizzy or weak, wait until you feel more stable. Move slowly. Do not rush. Do not attempt to get up if you are in severe pain or feel that you are injured. Wait and call for help.

14. How to get up from a fall to the floor: • Curl your legs toward your body and place your hands to the side • Push yourself up to a kneeling position (on your hands and knees) • Place one foot flat on the floor near the other knee • Place hands on the upper knee • Using the combination of arms/hands and leg strength to lift yourself to a standing position. • Rest a moment prior to proceeding with further movement to feel more balanced and stable.

15. How to get up using a chair or couch • Inch your way along the floor to reach the chair or couch. • Kneel on one knee and place the other foot flat on the floor beside the knee that is bent. • Lean on the seat of the chair and straighten the bent knee. • Straighten your back and stand up. • Find an area to sit down and rest. Call for assistance if it is needed.

16. Some Safety Factors to Consider: • Have multiple phones in your house so that you are not far away from a phone at any point. • Get a portable phone and carry it with you. Take it into the bathroom when you are taking a bath if you live alone. • Consider getting a personal safety alarm which you wear around your neck or on a belt or as a watch. If you fall, you can get help. • Arrange with family or friends to have someone call every day to check in. • Don’t lock the bathroom door when you take a bath or shower. If you need help, people will need to get in.

17. You are invited to return for future sessions where we can talk about how you are doing trying out activities. We will be talking about assistive devices that might be of use to you, and community resources that might be helpful.