Jan 24

In our 40s, 50s, 60s, and beyond, it is not always easy to stay upright. That is because after age 25, our balance begins to decline. Falls in the later years often result to wrist and hip fractures, which can have a devastating effect on our lifestyle or even threaten our life.

We juggle many activities, responsibilities, and people in our lives with grace. But sometimes we can be physically tossed off balance by a wet floor or uneven pavement. Falls can occur anytime, anyplace, and to anyone while doing everyday activities, such as climbing stairs or getting out of the bathtub.

As we age, our sight, hearing, muscle strength, coordination and reflexes change, weakening our balance. Also, some health conditions, such as diabetes, heart disease, and circulation problems, affect balance. Even some medications have been known to make people dizzy.

Unfortunately, all of these factors make falls more likely. But then, you do not have to be one of them. You can take simple steps to improve your balance and reduce your risk of falling.

And since balance tends to erode over time, regularly performing balance exercises is one of the best ways to protect against falls that lead to temporary or permanent disability. Balance exercises take only a few minutes and often fit easily into the warm-up portion of a workout. Many strength-training exercises also serve as balance exercises. Balance-enhancing movements may simply be woven into other forms of exercise, such as tai chi, yoga, and pilates.

Balance exercises can help us maintain our balance and confidence at any age. This can also improve our coordination. For older adults, balance exercises can promote independence.

Balance may be improved with exercises that strengthen the ankle, knee, and hip muscles, and with exercises that improve the function of the vestibular system, which regulates ones balance.

Nearly any activity that keeps us on our feet, such as walking, can help us maintain good balance. You can also include balance exercises in your daily routine. Try balancing on one foot while waiting in line, or stand up and sit down without using your hands. For a more targeted approach, try specific balance exercises. If you have severe balance problems or an orthopedic condition, get your doctor’s approval before doing balance exercises.

Once a physical therapist has reviewed a complete medical history and thoroughly examined you, he or she will develop a personalized plan. This may include a walking regimen with balance components such as changes in surfaces/terrains, distance, and elevations. The physical therapist may also teach specific strengthening and balance exercises that can be performed at home.

Exercise A:

* Stand directly behind a table or chair and place your feet slightly apart.

* Lift one leg six inches out to the side.

* Hold this position for 10 seconds.

* Repeat with the opposite leg.

Exercise B:

* Stand directly behind a table or chair and place your feet slightly apart.

* Slowly bend one knee toward your chest lifting your foot six inches off the floor.

* Hold this position for 10 seconds.

* Repeat with the opposite leg.

Exercise C:

* Stand directly behind a table or chair and place your feet slightly apart.

* Lift one leg straight back, keeping your knee straight.

* Hold this position for 10 seconds.

* Repeat with the opposite leg.

The above exercises should be performed two to three times a day.

Balance Exercise Safety Guidelines:

* Be aware of your posture. Try to maintain your weight over your ankles.

* Avoid fast movements including quick turns or changes in position.

* Use a chair as a place to not only perform seated exercise but also to hold on to while standing.

* Always get up slowly when rising from a chair.

* Don’t close your eyes when exercising or standing from your chair.

* If you are taking medications, ask your doctor if there are any side effects which may cause light-headedness or decreased balance.

*** Lost your balance and fell? Visit www.doability.co.uk. We might be able to help you.

Nov 21

In my previous article, I focused on how medical organizations from around the world try to reduce harm from falls in their own facilities on a macro level. Now I am going to delve on more practical advice on how to reduce the incidence of falls within our homes or workplace.

Risk assessment provides a useful framework when tackling accidents caused by trips, slips and falls. Here is a five-step approach for this:

1. Look out for anything that may cause an accident. It could be objects lying around the floor like toys or rubbish; a wet floor; or basically, the proverbial banana peel that can cause people to slip.

2. Identify and decide who is at risk. It could be young children, the handicapped, or the elderly.

3. Take preventive measures, like doing repairs or renovations, making sure the area is regularly cleaned and cleared of any obstruction.

4. Keep a record of what you have changed. Now this one is a bit of a stretch to expect at home, but for commercial establishments and public places, it is certainly necessary.

5. Continually monitor your living space or work area. This is more of a continuation of the first 4 steps. It wouldn’t be effective if you just stop at recording and don’t follow through, so there has to be constant monitoring.

Now here are more practical tips to prevent the incidence of falls:

- Keep pathways clear. Arrange your furniture in a way that it allows easy movement, and not serve as an obstruction. Clean pathways and remove any unnecessary clutter, like boxes, telephone cords, and loose wires from high-traffic areas. Make pathways that are wide enough for plenty of people to use, to avoid possible collision.

- Provide ample light. Make sure areas like hallways and stairways are well lit. Have rechargeable emergency lights and flashlights handy in case of power outages.

- Safeguard stairways. Keep stairways in good repair. Make sure all stairways have sturdy railings and that steps have a non-skid surface.

- Secure rugs and flooring. Secure loose rugs and carpets with tacks or a slip-resistant backing. Repair frayed carpet and loose floorboards. Avoid small throw rugs as much as possible.

- Keep your bathroom safe. Install grab bars in your shower or bath and near your toilet. Use non-skid mats in the shower or bath.

- Keep necessities handy. Store supplies, clothing, dishes, food, and other everyday items within easy reach.

You can improve your general well-being, and help reduce the risk of trips and falls by keeping yourself active and healthy. A good way to make your muscles stronger and to improve your balance is to have a regular exercise and a proper diet. You do not have to go to the gym to remain active. Simple tasks, like gardening, regular house work, and walking can boost energy levels and improve coordination and balance.

Exercise is very important for older people since they are more prone to falling.

*** For all your disability equipment needs, visit www.doability.co.uk.

Nov 13

I am no stranger to minor accidents at home and outside. Slips, trips, and falls happen to a lot of people of all ages, from all places, and in all walks of life. These would sometimes lead to injuries which would require hospitalization, or at least a visit to the nearest doctor.

What a lot of us do not realize is that these falls happen to patients in the hospitals and medical facilities, too. There is nothing worse than injuring a person who is already sick, and the cause of such injury is the person who is supposed to be taking care of the patient, like the doctor or nurse. It is like adding injury to an existing injury.

Patient safety has been constantly one of the most pressing challenges in the health care industry, and a significant part of patient injuries come from falls while confined in the hospitals and nursing homes. Reducing harm from falls is becoming one of the top priorities of hospitals and health care organizations around the world. Patients, regardless of age, fall. While certain risk factors are common in younger people, falls are most likely to occur in older patients and they are much more likely to experience serious injuries. A significant number of falls result in injury, or even death, costing millions per annum for immediate health care treatment alone, not to mention the additional costs of rehabilitation and social care. In addition to these financial costs, there are additional costs that are more difficult to quantify. It not only includes the obvious distress, pain, injury, but also loss of confidence and independence to the patient.

There are lots of researches and reports around the internet on patient safety, specifically on how to reduce harm from falls, but it seems that there is not one single guide for all. What is apparent is that non-profit organizations from countries like the UK, Sweden, Australia, Canada and the USA are at the forefront when it comes to these initiatives with The Institute for Healthcare Improvement IHI in Cambridge, Massachusetts providing the main thrust. In the UK, there is Patient Safety First Campaign sponsored by the National Patient Safety Agency, the NHS Institute for Innovation and Improvement and The Health Foundation. In Australia, there is the Australian Patient Safety Foundation. While in Canada, there is the Canadian Patient Safety Institute.

The approaches are varied, localized, and sometimes isolated depending on the case. But what is common is the need to recognize these harms, identify patients prone to falls, record, monitor, and measure these incidents to be able to come up with actionable plans. These are for more organizational solutions though. Ultimately, it all boils down to the care and dedication given by our doctors, nurses, and caregivers that would spell a big difference.

Accidents do happen but a lot of them can also be avoided with the right actions and presence of mind. For those that cannot be avoided totally, there are ways to reduce the harms and risks brought about by these accidents. While this is easier said than done, it is doable with a little effort and good luck.