{"id":15,"date":"2015-01-18T16:51:27","date_gmt":"2015-01-18T16:51:27","guid":{"rendered":"http:\/\/stories.kera.org\/broken-hip\/?p=15"},"modified":"2015-12-31T15:54:53","modified_gmt":"2015-12-31T15:54:53","slug":"preventing-the-fall","status":"publish","type":"post","link":"https:\/\/stories.kera.org\/the-broken-hip\/2015\/01\/18\/preventing-the-fall\/","title":{"rendered":"Preventing The Fall"},"content":{"rendered":"

In 2011, more than 60,000 Texans older than 50 were hospitalized for falls. And 95 percent of hip fractures are the result of falls. Those who do fall are afraid of falling again. High-tech gear is helping some people get over their fear of falling — and helping others prevent future falls. And a local hospital is using technology and teamwork to reduce falls among patients.<\/em><\/p>\n

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Nine years ago, Joyce Powell was in a hospital, on her way to the bathroom, when she fell and broke her hip.<\/strong><\/p>\n

She recovered. But there\u2019s something she hasn\u2019t gotten over: A fear of falling.<\/p>\n

\u201cIt stays with you,\u201d Powell says. \u201cYou\u2019re aware that you can\u2019t function like you once did.\u201d<\/p>\n

It might sound silly, but it turns out that people who are afraid of falling are actually more likely to fall.<\/p>\n

\"Nine

Nine years ago, Joyce Powell fell and broke her hip. Although she recovered, she’s still overcoming the fear of falling.<\/p><\/div>\n

That\u2019s why Powell attends a fall prevention class at the University of Texas at Arlington: not just to get stronger, but to face her demons.<\/p>\n

At one recent session, an instructor tells participants: \u201c<\/em>All right, so now what we\u2019re going to do is a toe touch with the right foot, if you feel comfortable.”<\/p>\n

Participants are in their 70s, 80s and 90s, and their workouts involve everything from balance balls to playing Wii games.<\/p>\n

\u201cThe greatest predictor of a future fall is a previous fall,\u201d says Chris Ray, the kinesiologist who\u2019s leading the efforts at UT-Arlington\u2019s Center for Healthy Living and Longevity<\/a>.<\/p>\n

Improving balance is key<\/h4>\n

The greatest risk for older people who\u2019ve fallen? They\u2019ll simply stop exercising, Ray said.<\/p>\n

But exercise is key: Studies show exercise can prevent falls in older people.<\/p>\n

\u201cWe start to restrict the activities we perform,\u201d he says. \u201cAs we age, if we were walking on an icy sidewalk, we decide we\u2019re not going to walk on icy sidewalks anymore. And that’s a very appropriate selection. But if we don\u2019t replace that, then we see a decline of strength, neurological, eventually cardiovascular, pulmonary, skeletal, all these systems start to decline. Eventually, that has a very compounding effect. \u201d<\/p>\n

One of the keys to preventing falls is improving balance. As we age, natural changes occur in hearing, vision and proprioperception — what you feel in your toes and hands. It makes it harder to stay upright and oriented. If seniors can learn to better use those senses, then they\u2019ll be less likely to fall.<\/p>\n

\"\u201cThe

\u201cThe greatest predictor of a future fall is a previous fall,” says Chris Ray, the kinesiologist leading the efforts at UT-Arlington\u2019s Center for Healthy Living and Longevity.<\/p><\/div>\n

To do that, Ray tests them using something that looks like an open photo booth you would expect to find at an amusement park. The machine assesses how well someone can use the senses to maintain balance. The walls shift, the screen changes and the floor tilts.<\/p>\n

\u201cIn daily life, when we see seniors that fall, it\u2019s usually during multitasking,\u201d Ray explains. \u201cSo what we\u2019ll do is we have the opportunity to recreate that. We pipe in loud noises, city sound or music, pipe in visual distractors on the screen, or a test on the screen as they\u2019re trying to maintain their postural control while the walls are moving in concert.\u201d<\/p>\n

This isn\u2019t just for amusement. The goal, Ray explains, is to identify the best intervention for each individual. For some, a regimen of tai chi might be enough. For others, it might be weightlifting or even practicing walking with their eyes closed.<\/p>\n

“I want to be free”<\/h4>\n

Powell says she\u2019s felt more confident getting around and traveling since she began classes at UT-Arlington. Still, she\u2019s cautious.<\/p>\n

\u201cWhen I walk, I look to see where I am, particularly if I\u2019m on uneven ground,\u201d she says. \u201cBut I look at my feet and I\u2019m constantly looking to see what I\u2019m stepping on, to see if there\u2019s something there that would create a problem.\u201d<\/p>\n

\"Joyce

Joyce Powell, with her husband, Thomas, says she\u2019s felt more confident getting around and traveling since she began exercise classes at UT-Arlington.<\/p><\/div>\n

Freedom from falls is never guaranteed. But dedication to an exercise program can help seniors keep their balance without giving up the activities they love.<\/p>\n

\u201cIt\u2019s one of the things I\u2019ve learned you just have to do in order to protect yourself to remain upright,\u201d Powell says. \u201cI guess I could use a walker to do it but I don\u2019t want to. I want to be free.\u201d<\/p>\n

“I told you to sit down. Don\u2019t get up!”<\/h4>\n

Learn how John Peter Smith Hospital in Fort Worth is trying to reduce falls among patients, thanks to technology and teamwork.<\/em><\/p>\n

632.<\/p>\n

\"At

At John Peter Smith Hospital in Fort Worth, gold stars indicate a patient’s risk of falling.<\/p><\/div>\n

That\u2019s how many patients fell inside of John Peter Smith Hospital in Fort Worth last year.<\/p>\n

\u201cNobody wants to hurt their patient,\u201d Elisabeth Rodgers says. \u201cThe patients come into the hospital, they trust us, and they trust us to take care of them. We don\u2019t want to send them home worse than they came in.\u201d<\/p>\n

Rodgers is a nurse leading a project to reduce falls at the hospital. Of those 632 falls, only one person broke a hip. Still, it cost JPS. The hospital alone had to pay more than $500,000 for things like diagnostic tests.<\/p>\n

Then there\u2019s the price families pay. Rodgers knows that firsthand. Her 83-year-old mom fell twice while in the hospital this year.<\/p>\n

\u201cBecause of that fall, she was in rehab for eight months,\u201d Rodgers says. \u201cI would have to drive her, my family would have to drive her to the grocery store. It influenced our whole extended family just to care for her. She was the exact picture of what we deal with [at JPS] every single day.\u201d<\/p>\n

Pharmacists help, too<\/h4>\n

Every shift change, JPS nurses gather around a whiteboard to review which patients are considered a fall risk and why.<\/p>\n

In the past, nurses were on their own when it came to preventing falls. Now, even the pharmacists are involved.<\/p>\n

\u201cPatients are coming in and they\u2019re on so many different medications that they weren\u2019t on prior to admission,\u201d said Christy Johnson, who manages JPS\u2019 clinical pharmacy. \u201cWe\u2019re evaluating those to find out if there\u2019s anything putting them at extra risk.\u201d<\/p>\n

Johnson says it used to be labor intensive for pharmacists to review medications and calculate fall risk. Now, with electronic medical records, it\u2019s easy to automatically come up with a fall risk score for each patient.<\/p>\n

\u201cNow, every order that they write generates a score in the background that [gets sent] to the pharmacy, so that we are aware — like this new med causes them to be at increased risk, so in real time we\u2019re able to see that,\u201d Johnson says.<\/p>\n

Another technology that\u2019s helping to prevent falls is a sort of high-tech bed alarm. The standard bed alarm goes off when a patient tries to get out of bed, but it often goes off too late for a nurse to sprint in and help. Fall monitors \u2013 JPS uses one called the \u201csitter\u201d \u2013 use sensors to detect slight movements, and the messages can be personalized.<\/p>\n

For example: \u201cOK, Mike; I told you to sit down. Don\u2019t get up!\u201d<\/p>\n

Communicating the risks to patients and their families can be tricky. Nurse Sylvia Baker says for many patients, getting out of the bed and going to the bathroom alone is a statement of independence.<\/p>\n

\u201cIt seems like it would be easy for them to realize they\u2019re going to be a falls risk but they\u2019re like: \u2018No; I can do this!\u2019\u201d Baker says. \u201cAnd they don\u2019t realize until they\u2019ve fallen.\u201d<\/p>\n\n

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    Elisabeth Rodgers is a nurse leading a project to reduce falls at JPS.<\/div><\/div><\/li>\n
  • \"\"
    Christy Johnson manages JPS' clinical pharmacy.<\/div><\/div><\/li>\n
  • \"\"
    Julie Griffith and Sylvia Baker are nurse team leaders in JPS' oncology unit. <\/div><\/div><\/li>\n <\/ul>\n <\/div>\n \n <\/div>\n