Fall Prevention and Management

  • By Judith Sullivan
  • 31 Mar, 2017
  • 20 Jan, 2016
    Author/blogger Reggie Simpson

How to Reduce Your Risk of Falling

I was recently in the United States for the holidays and ‘stumbled’ across an article entitled ‘Fear of Falling’, which highlighted that the medical costs of falling run more than 30 billion dollars a year. Famous fallers include former US president George H W Bush, aged 91, and Democratic presidential candidate Hillary Clinton, 68.

Closer to home, a number of our Betafeet Podiatry patients have reported a fall or falls and we have advised them about an excellent falls prevention and management service provided by the NHS in Hertfordshire (see website link at the end of this blog).

Regardless of age, we are all prone to falling or tripping unexpectedly, often causing severe foot, knee and back injuries and often other consequences such as sprained ankles, torn ligaments and abnormal movement of joints.  Statistics says that one in three older adults fall each year with resulting consequences such as broken bones, trouble getting around and a host of other health problems.  

The impact of falls

According to ageUK, about a third of all people aged over 65 fall each year, with higher rates among those over 75. Falls represent over half of hospital admissions for accidental injury, particularly hip fracture.  Half of those with hip fracture never regain their former level of function and one in five die within three months.  Of those older people who enter falls prevention programmes, most do so only after they have fallen, by which time they may have suffered serious consequences.

You can make small provisions to prevent falls and hence reduce the risk of associated injuries. Try the tips below:

  • Perform regular exercises to improve strength in your legs and back as well as to promote balance in your posture. Appropriate exercises can do wonders for your stance and whole body alignment, so make sure that you take some guidance before starting any exercise. Special balance training classes have been shown to be highly effective in reducing falls in older adults. You can also try yoga and Pilates!

  • Ensure that the medications you take are not making you dizzy, sleepy or drowsy. Ask your doctor or thoroughly read the medicine information sheet for any side effects that may affect your balance. Anti-allergies medications as well as those prescribed to asthmatics are frequently associated with drowsiness. Try to choose non-drowsy options to prevent falls.
  • Get your eyesight checked by an optometrist, at least, in every one to two years, more often if you are older. Poor eyesight leads to misjudgement of how close or far objects are and are one of the major causes of falls. Update your prescription glasses and contact lenses according to changes in your vision.
  • There are also key steps and changes that you can make at home to make it a safer place. Bathrooms are often slippery, so make sure you immediately dry them off with a sponge. Also, install grab bars inside and outside your bathtub or shower to make it easy to get out without getting misbalanced. Use non-slippery substances to clean tiles and flooring in your home and always keep unnecessary clutter out of the way that can lead to people tripping and falling.
  • When outside ensure that your footwear is the correct size and is not causing you any discomfort that may interfere with your balance. If you are experiencing any issues with your gait or foot stance, then consult a foot specialist as soon as possible to correct these issues.

Preventing falls is important to our health; the tips above are simple ways that you can prevent dangerous falls.

Local services in Hertfordshire

There is local support for Hertfordshire residents of any age to help manage oneself for falls. Please visit the following link for reference:

http://www.hertsdirect.org/services/healthsoc/healthherts/fallsprevention/

AgeUK also has some excellent advice on the subject for patients and practitioners alike:

http://www.ageuk.org.uk/professional-resources-home/services-and-practice/health-and-wellbeing/falls-prevention-resources/


By Judith Sullivan 18 Jul, 2017
Andre was an associate podiatrist at Betafeet for five months.  His contributions to the practice were considerable.  Sadly we lost him to a higher professional and personal calling.

After a stellar educational background and career, Andre joined babylon Healthcare Services, UK based, with a view to helping them set up and deliver the first digital healthcare pilot services to the NHS.   Digital healthcare is a cluster of new and emerging applications and technologies that exploit digital, mobile and cloud platforms for treating and supporting patients. Digital Healthcare is being applied to a  wide range of social and health problems, ranging from monitoring patients in intensive care, general wards, in convalescence or at home – to helping doctors make better and more accurate diagnoses, improving drugs prescription and referral decisions for clinical treatment.

Rwanda then beckoned.

Since joining babylon Rwanda in April 2016, Andre has been instrumental in successfully setting up and launching Africa's fastest growing digital healthcare service.  According to Lindsey McConaghy, babylon's PR manager, 'Rwanda has a population of around 12 million but doctor numbers are in the hundreds. There’s an imbalance between supply and demand'.  

Digital Healthcare is not without its sceptics nor controversies - at what point do you let an app do the diagnosis?  Will GPs embrace technology in this way?

Here is Andre's report about his experiences in Rwanda:  

Rwanda is a small ambitious country known as the land of 1000 hills with a population around 12 million and a rapidly growing economy. It has rolling hills for as far as you can see, a rain forest, gorillas and volcanoes, making for quite the site to any visitor. However, it is also known for the 1994 genocide in which over 1 million people were killed in 100 days across the country.

This tragic event has led to some very big health issues, which the country still faces, but thanks to a range of donor funding and strong political leadership, the country is on its way to quickly becoming a middle-income country.

As countries shift from low incomes to middle income economies, health issues become complex, where the country can face a mix of communicable disease (ie. malaria, HIV, TB) and the introduction of non-communicable disease (ie. diabetes, high BP, cholesterol) with changes in lifestyles.

Now you are probably wondering what this has to do with podiatry?

Well, as clinicians we play a role in the overall wellbeing of every patient that walks through our door for treatment and we become advocates for a number public health issues. While our specialist area is focused on the foot and ankle, an understanding of the bodily systems is imperative for understanding the impacts on the lower limb. This allows us to transition from clinical practice to other work streams such as health policy, public health programmes, service management and research.

As a podiatrist with a public health background, the increase of diabetes and chronic conditions in developing nations has become of personal interest. In many of these countries, diabetes is poorly understood and without proper prevention and care, can lead to a large economic burdens on the healthcare system. In 2012, the UK alone spent a whopping £639 million on foot ulcers and £662 on lower limb amputations, so the prevention and monitoring of these conditions is of paramount importance in the developing world.

The quality of life for individuals with diabetes is also drastically affected if not controlled, impacting mobility, footwear and overall lifestyle. Additionally, chronic ulceration and limb amputation, creates an increases risk (approximately 80%) of mortality within the first 5 years post amputation.

How did all this lead me to Africa, I hear you say?

In April of 2016, I (sadly) departed from the Betafeet clinic to implement an mhealth project in Rwanda in partnership with the Ministry of Health. This project, allows patients across the country to speak with a doctor and receive a prescription via SMS through their mobile phone, reducing the travel time, wait time and expense of receiving care from one of the local physical hospitals. The system is also working on monitoring both communicable and non-communicable disease using artificial intelligence, engaging patients to take ownership of their health.

This could be a major milestone for a country with stretched resources. To put things into perspective, over 80% of the population lives in remote areas of the country and works in the ‘in-formal’ sector as subsistence farmers with an average income of 2-3 dollars per day, which is not very much. To receive care, a patient may travel over an hour to reach their nearest hospital where a doctor is present and then wait anywhere from a few hours to a few days to receive the care they need. However almost 80% of the population already has a mobile phone.

Appropriate access to clinical care is a large part of the prevention and management of many conditions and undertaking this project has been a great experience. As a clinician, I have had the opportunity to utilise my knowledge to develop operational pathways and input into the technology development to shape the way patients receive their care. 

'Footnote'

It is with this experience I now look to move on to my next adventure focusing on Aboriginals and the utilisation of technology in the prevention of major non communicable disease such as diabetes.

Final comment from Reggie Simpson and Betafeet Podiatry

 We wish Andre the very best in his future and thank him for this interesting blog account.  We look forward to his next blog focused on his work with the Aboriginal population.  

By Judith Sullivan 12 Jun, 2017
By Reggie Simpson
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