My name is Mary Potter I started health advocacy
probably 20 years ago and then after retirement I decided to use my own health issues and
that of members of the family as a springboard into trying to help make
changes in the system. I was going out a door at dusk from the well-lit room
onto a pavement I was due to have cataract surgery and I missed a step
that was probably an inch high and on my back like a cockroach. So that ended up
with a broken arm - I've had terrific treatment and follow-up into a falls
prevention program actually, thorough check up on my bone density but the
arm didn't heal so I've been left with a legacy of an unhealed, unjoined broken
arm that still aches after three years just due to missing a one inch step.
My name is Megan Swan I'm an occupational therapist but I'm also a
health promotion worker and I've been involved in the program Stepping On
which is a community-based falls prevention program now for about 20 years.
Well we all fall as we as when we're young we fall and in the middle of
our life we fall but it's just as we get older and we fall things happen we break
our legs and and we lose our confidence so as we're getting older the things
that happen to our bodies make us more predisposed to falling.
So as people get older everything slows down - people's posture and balance deteriorates the
feedback they get from their legs and feet is not as good as it used to be
their vision is not as good as it used to be people balance is not as good.
That's the bad news, the good news is there's lots we can do to prevent falls
and Australia and New Zealand a leading cutting edge in that research so it's very exciting.
If a patient has significant comorbidities, significant
complexities I would usually refer people to a falls clinic.
There's a falls clinic at Mona Vale hospital which is run by the geriatric
service which is a multi disciplinary team involving a geriatrician, physios, OT's.
I use community based exercise strength and balance type exercise
programs the step beyond program I refer to.
when I had my fall in Melbourne they
referred me back again to the emergency department at our local hospital and
then they sent me to the fracture clinic and the fracture clinic followed that up
with referring me at the local hospital to a falls prevention program.
Since then I attend a local rehab hospital and do the exercises there and I do it a lot at home.
The way I often identify people to talk to as I actually
watch them get up and walk to the office from the waiting room and that's
quite frightening sometimes. I think it's predominantly an issue of the aging.
I mean everybody falls over. Certainly people who are on medications that slow
down their reactions people affected by drugs and alcohol we see not uncommonly.
Well falls are never a one-off thing there's always lots of things that
happen to create a fall. I'll just go through some of the areas that you can
do. I can start off with balance a lot of people tell me that they get wobbly as
they get older they lose their balance and that is something that happens
because we're not testing our balance we kind of start noticing it as we get older
and balance is very important to keeping ourselves upright but the good news is
the lots you can do about balance you can increase your balance. Strength our
legs lose up quite a bit of strength as we get older and we all know that our
legs aren't the same as they were in there our 20s
and it's quite a bit you can do with your strength. Our eyes aren't the
greatest there's things that happen to our eyes macular degeneration, glaucoma,
cataracts there's lots of things that can happen so we need to keep abreast of
our eyes because without our eyes we fall over we just have to stand on one
leg and close our eyes and we fall over so we've got to get our eyes checked.
Medication as we get older we usually get on more medication than when we were
younger and medication just doesn't mean over-the-counter it can be vitamins it can
be patches it can be herbal medicines and there is great correlation
between being on four or more medications and falling or also being on
sleeping tablets and falling and we talk about that in
Stepping On. Shoes that's another area a lot of people, they don't call them
slippers for nothing you slip on your slippers and we need you need to be able
to get that great heel toe walking that gets you upright and scanning
ahead and you can't do that with slippers or with shoes that haven't got the four
safe features of a good shoe which is fit, sole, heel and support are the four
features of a good shoe. It's really important to have shoes that hug your
feet so that you can do the heel toe but you also need a good a good grip on the sole
sole just like you have good tyres on your car. We also talk about you've got
to feel confident about the way you're walking and going up and down steps and stairs so
public transport is really important a lot of people get socially isolated and
they don't go out on public transport so we talk about the best way of getting on
and off buses and trains and escalators. You have to get somehow get some calcium
in your diet and you need more calcium - four servings a day which is quite a lot
and you need vitamin D we do need 10 minutes a day in summer and at least 20 minutes a day in winter
Public transport can be difficult catching a train
there's frequently a large gap between the platform and the and the carriage
not only a large gap but there's quite a large step so you have to gap plus the
step and that can be quite difficult.
My husband and I are natural clutterers
and so it's a matter of not leaving things on the floor and also not having
rugs because it's very easy to stumble over. Now I use a stick and I have
changed the end, the rubber tip on the end of my stick it's lovely it's spring
loaded so that eases my arm but it doesn't slip on wet pavement or a wet
floor whereas I have found ordinary walking sticks the that tip can slip so
I do need to look out constantly for the pavements that I'm walking on and in the
dark I walk very cautiously and try to have a torch something that will give me
some illumination or if there's no opportunity to turn on a light.
I've done follow-up exercises on an ongoing basis to try to strengthen my legs so that if
I get wobbly I've got the ability to counteract the wobbles and instead of
falling or going against a wall I'm able to correct any stumble.
For me it's vigilance the whole time and again I'm motivated I don't want another fall I've
had a lot of I've had hip surgery I certainly don't want to fall and break
my hip because that is another painful procedure and loss of independence and
I think most of us fight as hard as we can to maintain our independence.
I generally advise people to not give up doing what they're doing
so if you don't use it you lose it, so people should continue their
walking and do all of the things they normally do.