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Prevention of Falls

fallFollowing a stroke, some individuals have an increase in muscle weakness, loss of balance, partial loss of vision, or a change in their ability to walk. Individuals who experience any of these limitations after stroke have a higher risk of falling. Prevention of falls is especially important because a fall can result in major cuts or broken bones. Breaks of the hip or wrist are the most common, and are the cause of significant complications.

Most falls take place in the home.

As a caregiver of an individual with stroke there are many things you can do to reduce the risk of a fall for the individual with stroke.

FLOORS - Remove cords or throw rugs. Decrease clutter. Avoid rearranging furniture, unless it is done to promote safety.

FURNITURE - Discourage the individual with stroke from sitting in low chairs. Encourage the use of chairs with arms; these make it easier to get up. A lift chair may be helpful.

BATHROOMS - Install grab bars near the shower, tub and toilet. Use a raised toilet seat or tub transfer bench if necessary. Place non-skid surface in tub or shower. Use hand-held showerhead. Avoid bathroom rugs.

LIGHTING - Use good lighting in halls, stairway and doorways. Place a night light in the bedroom and bathroom. Turn on lights when the individual with stroke gets up during the night.Make sure switches are easily accessible.

KITCHEN - Remove throw rugs. Clean up spills right after they happen. Remember to step back before opening refrigerator or oven doors. Use a sturdy step stool with a hand rail when reaching items up high and store frequently used items at waist level.

STAIRS - Remove throw rugs and runners. Repair broken or worn steps. Install handrails. Make certain railings and carpets are secure. Never place items on steps. Make sure to practice steps with a therapist before trying them on your own especially if using an assistive device such as a walker.

FOOTWEAR - Encourage the individual with stroke to wear flat, sturdy, well fitted, rubber-soled shoes. Discourage the use of floppy or loose fitting slippers. Discourage walking in stocking feet.

CLOTHING - Make sure clothing does not drag on the floor. Make sure clothing does not restrict normal range of motions to all limbs

EXERCISE - A regular exercise program for the individual with stroke will increase strength. An exercise program may also help decrease loss of balance and improve strength and the ability to walk. Ask your health care provider about an exercise program that is safe.

ALCOHOLIC BEVERAGES - These should be avoided or kept to a minimum. Alcohol use increases the risk of a fall.

MEDICATIONS - Some medications have side effects that could cause the individual with stroke to feel dizzy or lightheaded - most frequently blood pressure medications. Encourage the individual with stroke to get up slowly from a sitting or lying position. If the individual with stroke continues to feel dizzy or lightheaded from these or other medications, contact your health care provider.

WALKER OR CANE - If the individual with stroke needs one of these devices, a physical therapist or health care provider should assess the correct fit and instruct in correct use. Slow down and take all the time you need when walking.

Additional Information:

Preventing Falls - Topic Overview: Web MD


References:

American Heart Association (2008). preventing falls important for stroke patients. Retrieved October 11, 2009, from http://americanheart.mediaroom.com

American Stroke Associat (2009) Keeping your balance, Retrieved October 2009, from www.strokeassociation.org

Dean, C., Rissel, C., Sherrington, C., Sharkey, M., Cumming, R., Lord, S., Barker, R., Kirkham, C., O’Rourke, S. (2011). Exercise intervention to prevent falls after stroke: Exercise intervention to prevent falls and enhance mobility in community dwellers after stroke: A randomised controlled trial. Sydney: NSW Ministry of Health. Retrieved from http://www.eldergym.com/elderly-balance.html

Lewis, E. (2011). Preventing falls after a stroke.  Retrieved from http://www.myomo.com/blog/bid/95172/Preventing-Falls-after-a-Stroke

National Osteoporosis Foundation. (2001). Fall prevention. Retrieved from http://www.nof.org

Temple University. (2001). The fall prevention project. Retrieved from
http://www.temple.edu/older_adult/

Developed in 2001 by Gerri Rupp, MSN, RN, CNP at The University of Toledo for the Caring~Web© Revised 2012


Last Updated: 6/17/14