This PowerPoint presentation was developed for the American Occupational Therapy Association (AOTA) by Elizabeth Peterson, PhD, OTR/L, FAOTA, Clinical Professor, University of Illinois at Chicago; and Bonita Lynn Beattie, PT, MPT, MHA, Vice President, Injury Prevention & Lead, Falls Free® Initiative, Center for Healthy Aging, National Council on Aging. Occupational therapy practitioners are encouraged to use this presentation in association with Falls Prevention Awareness Day and throughout the year to educate the public and promote the role of Occupational Therapy in Falls Prevention. This presentation should be used and shown for educational purposes only. For all other uses, contact .

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Please note: Two handouts accompany this presentation as follows:

1)  Tips for Living Life To Its Fullest: Fall Prevention for Older Adults

2)  Fall Prevention Resources.

STAYING ACTIVE AND FALLS FREE WITH OCCUPATIONAL THERAPY

15-minute script (to be delivered by an OTA or OT)

SLIDE 1-Title Slide

Welcome and thank you for coming to this talk on how you can reduce your fall risk with the help of occupational therapy.

SLIDE 2-Welcome

My name is ______; I am an occupational therapist (or occupational therapy assistant) and my work at ______(insert name of place of work) has helped me appreciate the importance of taking steps to prevent falls.

By a raise of hands, tell me…

Who here has fallen in the past year or knows of someone who has?

As you may be able to tell from the show of hands, falls are a major health concern.

Although falls are the leading cause of injury and accidental death in adults over the age of 65, they can be prevented. By taking control of your health and utilizing the resources available to you, you can reduce your risk of falls and continue to participate in the activities that you enjoy.

You are not alone in your efforts to manage your fall risk. Occupational therapy practitioners (that is, occupational therapists and occupational therapy assistants), other health care providers, and many people in your community are dedicated to supporting your health and well-being.

But you are the leader of your fall prevention team.

SLIDE 3-Presentation Goals

By the end of this presentation, which will take about 15 minutes, you will gain knowledge that will help you lead your health care team to reduce your risk of falls.

Specifically, by the end of this presentation, you will be able to:

•  Recognize that most falls result from interacting risk factors.

•  Describe how occupational therapy practitioners can help you reduce your risk of falls.

•  Identify strategies and resources that you can use to reduce your risk for falls.

I also have two (speaker, edit # as needed) handouts for you that you will receive at the end of the presentation. One lists several helpful fall prevention resources. The others provide fall prevention tips.

SLIDE 4-Why do Falls Happen?

In most cases, falls experienced by older adults are caused by several risk factors that occur at once.

SLIDE 5-Types of Fall Risk Factors

Fall risk factors are commonly placed into three categories: Physical, behavioral, and environmental, but keep in mind that risk factors frequently interact to cause a fall.

Physical risk factors relate to changes in your body that increase your risk for a fall. Impaired balance is an example of a physical risk factor.

Behavioral risk factors are the things we do OR don’t do that increase our fall risk. For example, not asking for help when doing something that might cause a fall is a behavioral risk factor.

Environmental risk factors are typically hazards in our home or community such as loose throw rugs or unclear pathways, or even pets in our way!

SLIDE 6 (Transition slide)-What is Occupational Therapy?

Now that you have a better understanding of why most falls happen, let’s talk about the role of occupational therapy to help with fall prevention efforts. But before we do, let’s begin with the question, “What is occupational therapy?”

Raise your hand if you have worked with an occupational therapy practitioner before, or know someone who has.

SLIDE 7-About Occupational Therapy

Occupational therapy helps people of every age do the things they want and need to do through the therapeutic use of everyday activities—or, as we refer to them—occupations. In other words, we focus on your daily activities to be sure you remain as independent as possible and function as well as you can, despite injury, illness, or disability.

SLIDE 8-About Occupations

The term “occupation” refers to a person’s meaningful activities. Your life is made up of many occupations.

My occupations include XXX. (Here offer approximately 3 examples of occupations that are important to you, e.g., activities related to taking care of your family, house, pets; contributing to your community and fulfilling your job responsibilities.)

Your occupations, the day-to-day things you love to do, are linked to important roles in your life, such as being a grandparent, friend, volunteer, employee, spouse, or caregiver.

Most of us are happiest when we engage in activities that reflect our values and identities.

Fear of falling or an injury caused from a fall can keep us from doing the things we like to do. That is where occupational therapy comes in to help us safely do what is meaningful to us.

SLIDE 9-Role of Occupational Therapy in Falls Prevention

When it comes to preventing falls, occupational therapy practitioners can help in many ways and in various settings, including hospitals, rehabilitation centers, homes, and in the community.

Occupational therapy practitioners work with people at risk for falls to help them better understand and manage their risk factors—whether these are physical, behavioral, or environmental.

SLIDE 10-Role of Occupational Therapy in Falls Prevention

Occupational therapy practitioners also work with people after they have had a fall when their injury disrupts their ability to be involved in what they really want to do. They work with people who have sustained injuries such as hip fractures, wrist fractures, or head injuries after a fall to answer the question: “How can I do the things I need to do on a daily basis to care for myself and my home, and to fulfill my responsibilities?

SLIDE 11-Role of Occupational Therapy in Falls Prevention

For those with physical and mental changes that make it harder to do things, occupational therapy can be directed at improving skills and abilities, like strength or balance or how we plan tasks, teaching people how to modify activities so they can do them safely, or changing the area or environment around them to reduce the risk of falls. Your home can be made safer by doing things like improving lighting, and removing tripping hazards like clutter and electrical cords.

SLIDE 12-Minimizing Your Risk Factors

It is important to remember that the risk of falling increases with the number of risk factors present.

It might be difficult to get rid of all of our risk factors, but a little bit can go a long way because even small changes can make a big difference!

Consider this “tower analogy.” <PAUSE>

Imagine you are building a tower of bricks, with one brick stacked up on the next. Each brick represents one risk factor. As the tower gets taller it becomes more unstable. Likewise, when your risk factors stack up, your risk of falling increases.

The goal is to shrink the tower. We might always have some bricks or risk factors, especially since some risk factors, like having already fallen or getting older, cannot be changed, but we can shrink the tower and thereby reduce our risk for falls.

SLIDE 13 (Transition Slide)-Minimizing Your Risk Factors With Occupational Therapy

Now let’s talk about how you can reduce your risk factors.

Remember, the hallmark of all occupational therapy interventions is that they incorporate your valued occupations into the occupational therapy process. So, an occupational therapy practitioner will look at what you want to do and how you want to do it, considering all your risk factors.

To discuss specifics, let’s frame our conversation around the different types of risk factors—physical, environmental, and behavioral. I’ll highlight just a few key fall risk factors, and occupational therapy’s role in addressing them.

When it comes to physical risk factors, medication interactions, impaired vision, and poor balance, are very powerful influences on fall risk.

SLIDE 14-Physical Risk Factors: Medications

It is not unusual for a person to use many different types of over-the-counter and prescription medications. However, these medications can interact and create health problems that increase fall risk. Speaking with your doctor or pharmacist about your medications and how they make you feel is an essential step to reduce your fall risk. Together, you can come up with a medication plan that addresses your needs. It is also important to stay hydrated since medications can reduce your hydration level, and that can lead to dizziness, confusion, or falls.

Once you and your doctor determine a medication plan that works for you, occupational therapy practitioners can also help you incorporate it into your everyday routine through lists, schedules, and reminders so you don’t forget.

SLIDE–15 Physical Risk Factors: Vision

Have any of you noticed changes in your vision as you’ve gotten older? This can be a major fall risk.

Vision issues can cause difficulty with balance. Vision problems can also make it hard to judge how far something is away from you, and to move around obstacles in your path. It is important to have your vision checked by an eye doctor on a regular basis to monitor any vision declines. Exercise and sleep are also important to eye health.

Occupational therapy practitioners can also help by teaching people living with macular degeneration, glaucoma, diabetic retinopathy, or other vision issues how to complete daily tasks by helping them learn new skills, such as visual tracking, or the ability to move one’s eyes from left to right to see any potential barriers in the environment. Vision skills, such as tracking, can help people learn to use their remaining vision more efficiently and effectively. Occupational therapy practitioners can recommend special devices and products to compensate for low vision. Tailored equipment such as magnifiers or talking computers, clocks, and timers that don’t require you to rely on vision, can really improve safety and functioning. A home safety assessment by an occupational therapist might be particularly helpful for a person with low vision to identify potential problems and solutions in the home. For example, an occupational therapist might make sure that there is adequate lighting within reach throughout a person’s house and make recommendations for lighting, such as nightlights and sensor lights as needed.

SLIDE 16–Physical Risk Factors: Balance

Not as steady on your feet as you used to be? Good news—a person can improve balance at any age!

For people needing to improve balance, occupational therapy practitioners use a number of strategies. Some suggest balance improvement programs such as Tai Chi, Moving for Better Balance. Others show clients how to safely improve their balance skills during day-to-day activities. <PAUSE>

The key is to safely maintain an active lifestyle. Occupational therapy practitioners can help people learn more about what their bodies can and cannot do, and teach people how to modify activities so they can still do these activities, as safely as possible.

SLIDE 17-Behavioral Risk Factors

Every person has to make decisions about how to engage in activities to be as safe as possible. Sometimes we need to plan ahead and modify how we do things to take advantage of our strengths and compensate for things we are no longer able to do as well as we used to. For example, when you go to sit down you might stop to think about the best place for you to sit and choose a higher chair instead of that comfortable sofa, to make it easier to stand back up.

SLIDE 18-Behavioral Risk Factors

Take a look at this picture. What could this woman be doing differently to put her at less of a risk for a fall? (Refer to key that follows

·  She is reaching overhead while standing on a stool.
·  The stool is not stable. Instead she could use a step stool with a support bar.
·  She could have organized her kitchen better so the items she needs are within easy reach.
·  She should remove clutter or obstacles on the floor that could be a fall hazard such as the vacuum.
·  She could have planned ahead and asked someone to help.

SLIDE 19-Environmental Risk Factors

Our homes may contain many fall risks that we may not be aware of. Take a look at this room in the picture. What might be a fall risk? (Refer to key that follows)

SLIDE 20-Environmental Risk Factors

What is the “occupational therapy difference” when it comes to home safety? To make your home safer, identifying fall risk factors is just a first step.

An occupational therapy home safety assessment involves carefully evaluating a person’s abilities and determining whether the home environment fits the person and supports independence. Room-by-room checks for safety hazards, combined with a thorough assessment of a person’s functioning in the home, provide a complete picture of home safety.

Occupational therapy practitioners consider many things when determining whether something is or is not a safety hazard—including how the person moves around the home and the habits that increase or reduce the fall risk.

In short, evidence available to date suggests that a one-size-fits-all approach to home safety will not reduce fall risks. That’s the difference occupational therapy makes: an occupational therapy practitioner puts you in the center of any changes recommended.

SLIDE 21-Falls Prevention Reflection

Reflecting on what we have talked about, what might you do or what have you done in the past to protect yourself from falls? Does anyone have tips to share that we haven’t covered?

SLIDE 22-Summary of Strategies to Reduce Falls Risk

Keeping in mind all that we learned today, here is a review of strategies to protect yourself from the possibility of a fall: