Risky Business: Falls Why They Happen and What to Do
This time of year we are all at more risk for falls due to snow and ice on sidewalks and parking lots. However, did you know that people with intellectual disabilities are always at a higher risk for falls, no matter what time of year it is? Not only is the risk of falling greater for people with intellectual disabilities compared to the general population, but also they are more likely to be injured by the fall. Why are the people we support at a greater risk?
Decreasing Physical Ability
When we are with someone everyday, it is hard to recognize that they may not be as strong or steady on their feet as they used to be. Look for changes in how they walk. For example, do they grab onto rails or walls more frequently to balance themselves? Do they need extra assistance when getting up from a seated position? All of these are indicators that a person may be a greater fall risk. If you see these signs, contact their medical provider about obtaining a physical therapy consult.
Epilepsy
About 25% of the people our HCQU supports have a diagnosis of epilepsy or seizures according to the Health Risk Screening Tool (HRST). Comparatively, about 2% of the general population will have those same diagnoses. Having a seizure increases the likelihood that someone will fall.
Impulsiveness
When someone is impulsive they may make sudden movements or have an unsteady walk which can lead to falls. Therefore, be aware that someone with behavioral or psychiatric concerns may be at an increased risk of falls.
Fall Risk Increasing Drugs/Medication (FRID)
People with intellectual disabilities are more likely to be prescribed a medication associated with an increased fall risk (2006-2012 study). These medications are antidepressants, anxiolytics, hypnotics and sedatives, and antipsychotics. Be sure to watch and communicate changes to the prescribing physician. Report any slight changes in walking, behavior, and if the person feels dizzy or lightheaded.
Incontinence
People who are rushing to the bathroom to prevent incontinence can be at a higher risk for a fall. A frequent toileting schedule can help prevent this problem.
History of Previous Falls
People with intellectual disabilities who have fallen before or have a history of falls are more likely to fall again for various reasons. The fall could be related to the above causes or an injury caused by a previous fall.
Non-use of an Assistive Device
Sometimes people are prescribed canes or walkers but they choose not to use, or use improperly. If an assistive device is ordered, try to encourage proper use of the equipment.
Special Considerations
If you are supporting a person that is on a blood thinner, like Coumadin, Eliquis, Xarelto, Aspirin, or Plavix, they will be more likely to bleed if they fall. The injury might be internal and you will not be able to see it. Talk with the prescribing medical professional and ask what steps need taken if the person falls. The medical professional may recommend that the person go to the Emergency Room for any fall.
What can I do if a person falls?
Remain calm, speak slowly, and reassure the person you are going to stay with them.
The level of treatment depends on the severity. A simple bump or scrape could require a band-aid and maybe an over-the-counter pain medication. However, if you suspect that the injury is more concerning, you may need to transport the person to the Emergency Room. For a severe fall, do not move the person and call 911. If the person is unconscious and not breathing, follow the guidelines by the American Red Cross: start CPR/AED and call 911.
If a person has fallen, remember, it is always better to receive treatment and not need it, than need it and not receive it.
