Transcription:

Bill Klaproth (Host): Slips and falls are a big concern as you age, and the winter months are especially of concern. Something you want to watch out for. So, if you’re worried about falling, here’s how to prevent them. With us is Kaitlin Watson, an occupational therapist at Summit Therapy and Health services with Pullman Regional Hospital. Kaitlin thank you for your time. So, it is winter. What is the best way to walk on slippery ground?

Kaitlin Watson, OTR/L (Guest): Well, Bill, if you’ve ever heard the saying walk like a penguin outside in the snow, that’s a really good way to go. You go slow. You have your feet with your toes pointed outwards taking small steps. Keep your arms free. Try to avoid carrying anything in your arms when you're walking on slippery ground that way your arms can do their job of being a good counter balance for you. Turn slowly, and really avoid taking any quick movements whatsoever. So that’s the penguin walk and that can be really helpful.

Other tips, in Pullman especially we have a lot of hills. So, if you are an avid walker and enjoy walking outside year-round, try to avoid major steep hills or even driveways with big slants on them. You can always choose really supportive shoes with good traction. You can even consider adding some additional traction to your shoes, like using Yaktrax or something similar to help with that grip. Or even using trekking poles or a walking stick if you really like to walk. I would always encourage people to walk with a friend or at least a cell phone so you can call for help if you happen to fall.

If you do fall, take a minute to assess yourself. Make sure you're not injured. If you can get up and keep going, get inside. Keep assessing yourself for any injury after you’ve fallen. If you have a hard time getting up from the ground, a good technique is to get onto your hands and knees and crawl to a stable surface where you can slowly pull yourself up with your arms and sit down for a while before getting inside. Then, like I said, just keep assessing yourself to make sure no other symptoms that arise.

Host: Well those are really good tips and I'm dating myself now. I've heard of the song Walk Like an Egyptian, but I've never heard walk like a penguin. So, we will remember that. Walk like a penguin. Not walk like an Egyptian, walk like a penguin. Wear supportive shoes, use a walking stick or trekking poles, and walk with friends if you can. So those are really good tips. So, thank you for sharing those Kaitlin. So, with ice and snow on the ground, there is more risk of falling, but is this the only time to be concerned about falls?

Kaitlin: Well, of course in the winter time there is an increased chance of falls. But like I said, it’s really for all ages in the winter. We see folks with falls and fractures from our teenagers up to our 70 plus year olds. But on a year-round basis, it’s really smart to be aware of fall and fall risk if you're 65 and older. The reason is folks 65 and older have a 30% chance of falling every year. That’s nationwide based on population demographics. In fact, the American Geriatric Society and the Center for Disease Control and Medicare, they all recommend folks 65 years and older get screened for falls every year or every time you present to a healthcare practitioner. We obviously want to try to prevent falls and identify any risk factors early on so that we can adjust that likelihood to falls to make it less likely to fall based on a number of factors.

Host: Okay Kaitlin. That’s really good to know. So, what are the risk factors then related to falls?

Kaitlin: Well there’s five main risk factors and these are really well documented in the therapy literature. The main five things are any history of falls, specifically in the last six months. So, if someone has had even one fall in the last six months, that puts you at a higher risk for falling again in the future. Taking any psychoactive medications is a risk. Those type of medications involve are opioids and anti-depressives, anti-psychotics. Any sedatives or sleeping agents. The CDC has a list of medications that are most highly related to falls.

The third thing is is needing any assistance with your self-care tasks or activities. That usually is because of any physical pain or impairment that might limit your ability to take care of yourself. That is a risk factor for fall. Any self-reported fear of falling and a fear that kind of limits you from participating in activities that you enjoy or that are needed to get through your daily life. Then last, a gait or balance impairment is highly related to the risk of future falls.

Now so they’re the five main ones, but there’s other ones also that are just associated with increasing your risk. Low vision. For example, if someone wears bifocals, that’s an increased risk for falls when you're walking on stairs or uneven ground. So, I try to just mention that to my patients that do wear bifocals just to take your extra time and be real careful. Low muscle strength or flexibility is associated with falls. Also, urinary incontinence or urinary urgency, pain, depression, impaired cognition. Dizziness or frequent short of breath, tingling or numbness in your feet, and then, of course, alcohol and drug use is also associated with falls.

Host:  Well those are all good points to remember. So, what can someone do to prevent falls?

Kaitlin: I think the primary thing to do is talk to your doctor about any symptoms that you may have relating to those risk factors we just talked about. You can also ask your doctor about your medications that you're taking to see if any of those might increase your likelihood of falling. Mention vitamin D when you're talking to your doctor and see if that’s right for you. Ask for a multi-factorial fall evaluation from a physical therapist.

Without having to go to your doctor, there are also a number of things that someone can do on their own. For example, we always recommend you get your vision and hearing checked each year. I already mentioned this earlier but wearing good shoes all year around can really help prevent falls. Try to avoid flipflops or sandals or any shoes that your feet might wiggle out of. Staying active. Keeping up just enjoyable activities and an enjoyable active lifestyle is always a really good idea. Then looking at your home. Reduce any home trip hazards like throw rugs. Be careful of pets. Keep your passage ways clear of anything you could possibly catch a toe or a walker on. Use good lighting in your home. Keep smoke detectors up to date. Those kinds of things. The CDC has a great brochure with tips on home safety that you can download straight from their website. You can also request a home safety evaluation from an occupational therapist. Again, that would be through an outpatient service and a referral from your doctor for that.

Host: Alright. That is really good to know. So last question Kaitlin, what resources are available locally?

Kaitlin: At Pullman Regional Hospital, we keep an alignment with the CDC and Washington state recommendations for providing attention and services for reducing fall risk through a variety of means. We have a free fall risk screening on the third Tuesday of every month, and that’s here at Summit Therapy. Folks are welcome to come in and just start asking those questions and see where you're at. It doesn’t take too long and then we can kind of direct you from there about what would be the best direction to go. We have some excellent outpatient physical and occupational therapists that work on this multi-factorial evaluation and treatment. We can have a home visit to address home safety and strategies and equipment needs. We’ve got some vestibular therapists who really focus on the factors associated with dizziness and vertigo. We also have some pelvic help therapists, both men and women, that can maybe address some of those needs of the urinary urgency and incontinence. So, all of those kinds of factors that are related to falls if needed.

Then on a community wide basis that is available for anyone to come to, we’ve got some excellent classes. Our Tai Chi for arthritis class and our Qigong are both really lovely movement classes that are open to the public and held here at Summit Therapy. At Bishop Place there’s a SAIL class, and SAIL stands for stay active and independent living, that’s offered three times a week at Bishop Place. There’s also a SAIL class offered in [Puluth ph?]. I would recommend if anyone is wanting just to kind of stay active under the guidance of a physical therapist checking out those SAIL classes or the Tai Chi class that’s run by an OT. Both of those classes are proven in the literature to help reduce falls. Then if you have any questions at all, you can always contact Summit Therapy or come by on that third Tuesday of every month to get screened. Or you can even email me here at the hospital.

Host: Kaitlin great information. What is your email address if someone wants to email you directly?

Kaitlin: I am kaitlin.watson@pullmanregional.org.

Host: Excellent. Kaitlin thank you so much for the great information. To learn more, please visit pullmanregional.org. That’s pullmanregional.org. This is the health podcast from Pullman Regional. I’m Bill Klaproth. Thanks for listening.