Don’t Let a Fall Get You Down

1. Don’t Let a Fall Get You Down You can get back to the roles and activities that are important to you.

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… • reflect on the way a fall has affected the various roles in our lives, • learn an approach for analyzing situations (the Canadian Model of Occupational Performance) where they have fallen or fear falling to identify strategies for safely resuming the activity and reducing the risk of future falls.

4. Roles Roles - sets of behaviours, rights and obligations that come with a relationship or social situation. Examples of roles include spouse, neighbour, pet owner, club member, church member and volunteer.

5. You are invited to fill out the “Life Roles Survey” to identify the roles you play in your life.

6. Are there any activities that you can’t do since your fall, or don’t do or are worried about doing because you might fall again? What are they?

7. Environment Physical Institutional Occupation Physical Self Care Leisure Person Psycho-Social Cognitive Productivity Social Cultural The Canadian Model of Occupational Performance

8. 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 includes a positive attitude, depression

9. 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

10. 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

11. Example: setting the table Person– • Physical -strength & balance to carry the dishes to the table, • Cognitive - memory for bringing all the pieces, • Emotional - social awareness of others eating with you & their needs

12. Environment Physical environment-distance from the cupboard to the table, height of the cupboard to reach the dishes, set up of the kitchen, Social - how many people are there? Cultural - is it a special occasion? What are your expectations? Institutional - are there rules about how to set the table (e.g. restaurant)

13. Occupation How do you set the table? • Do you bring all the dishes at once? • Do you carry them or use a trolley? • Do you fill the dishes in the kitchen and carry them to the table, or carry all the dishes and the serving dishes to the table and fill the dishes there? • Are you paying attention or rushed and distracted?

14. Let’s look at the list of activities that you have identified that you can’t do since your fall, or don’t do or are worried about doing because you might fall again?

15. Grocery Shopping Person • Improve strength, flexibility and standing balance through participation in a regular exercise program. • Wear comfortable, supportive footwear with non-skid soles. • Discuss any medications with your doctor or pharmacist to determine if they might be affecting your balance. If so, ask whether there are other alternatives. • Make sure that you have eaten appropriately. If you are diabetic, be sure that your blood sugar levels are well controlled. Environment • Use the grocery cart to take the groceries right to your car, or use a grocery store where there is carry-out assistance. Some stores will call a grocery clerk to help you bring your bags to your car if you ask them. • Have a cart or wagon stored near your parking place at home. Move the groceries into the cart or wagon and then pull them to the door. • Keep a wheeled suitcase in your trunk. Put the groceries into that to move them from the car to the door. Occupation • Ask a family member or friend to pick up groceries for you. • Ask a family member or friend to go with you to grocery shop. You can make it a social activity and have someone to help you carry the groceries into the house. • Schedule your day so that you grocery shop when you have the most energy. • Phone the food order to the grocery store and have groceries delivered. • Take fewer bags at a time and make more trips from the car to the kitchen.

16. Going to the hockey rink to watch your grandchild play Person • Wear warm boots with good treads. If there is ice, wear clip-on ice treads. • Wear warm clothes, including a hat and gloves. You will stiffen up if you get too cold, and be more likely to fall. Discuss any medications with your doctor or pharmacist to determine if they might be affecting your balance. If so, ask whether there are other alternatives. • Make sure that you have eaten appropriately. If you are diabetic, be sure that your blood sugar levels are well controlled. Environment • Bring a cushion or “hot seat” (cushion that can be warmed in the microwave and will maintain heat for long period of time.) Occupation • Look for the handrails on bleachers or stairs and use them. • Ask for someone to help you when going up and down bleacher stairs. • Be particularly watchful on steps with open backs. You are more apt to catch your toe and trip. • Try to keep your hands free when going up and down the stairs. Bring a backpack or bag if you are carrying extra items. If you are carrying coffee, ask someone else to carry it for you so that you can use your hands on the handrails.

17. Dog Ownership Person • Walking the dog every day is a good way to stay fit. • Discuss any medications with your doctor or pharmacist to determine if they might be affecting your balance. If so, ask whether there are other alternatives. • Make sure that you have eaten appropriately. If you are diabetic, be sure that your blood sugar levels are well controlled. • Wear comfortable, supportive footwear with non-skid soles. Environment • Choose your routes according to the conditions. If snow or rain has left the ground slippery, stick to sidewalks that have been ploughed. Occupation • Have a back-up person who can walk the dog on days when it is too dangerous for you to go out. • Make sure your dog is well trained to walk by your side and stop on your command. One reason people fall is walking a dog that suddenly pulls forward or wraps the leash around their legs. Invest in a dog training program. • There are commercially available “pooper scoopers” that may not require you to bend down to pick up your dog’s waste. Ask your vet or pet store about what is available in your area. • Dry your dog’s paws when you come in from a walk in wet or snowy weather. Wet paws can mean wet and slippery floors, and danger for you.