‘Falls are the number one reason older people are taken into A&E’: Preventing a fall when your client needs to stand

According to Public Health England falls are the most common cause of death from injury in the over 65’s and cost the NHS over £2bn and over 4 million bed days per year. Consequently, falls are the number one factor for a person losing independence and going into long term care and the risk of falling is dramatically increased by the effect of ageing – frailty, medication and multiple illnesses.

As a result, falls can be complex, complex because they’re linked to a range of risk which often co-exist in older people. Whilst it can be complex, a fall is not inevitable, it’s not a natural part of ageing and the risk of your client falling when they need to stand can be reduced.

The transition from sitting to standing often incurs the risk of falling. Reducing the risk of a fall begins with analysing the capabilities of the client performing the sit-to-stand; following an initial assessment Handicare are able to provide support and equipment which will work for both the client, and the carer.

Assessment considerations can include:

  • Monitoring the range of movement that an individual has through their ankle joints – if they’re unable to lift the ball of their foot off the floor whilst their heel stays in contact with the floor, they will struggle with difficulty to stand.
  • Consider the strength of the individual by asking them to lift their foot off the ground to check the strength of their thighs – if they cannot lift their lower leg against gravity, they may be unable to stand.

“The correct use of your clients core skills to perform a sit-to-stand can maximise the potential for the individual to complete the task, where you are working with or without stand assistive devices such as the ReTurn7500i. Assessing a client’s core skills is an important consideration during any assessment. ”   Mark Ripley – Direct Healthcare Group National Patient Handling Adivser.

Forming an analysis will encompass many other assessment considerations such as client and caregiver capabilities, the environment that the sit-to-stand will be occurring within and whether the patient is able to walk after standing as this may change our approach. Recommendations will be formulated based on some of the following:

  • What is the pattern of movement that the individual likes to use?
  • How much do we want to activate the individual?
  • What is the rehabilitation potential of the patient?
  • How much risk are we trying to reduce?
  • Does the individual have a natural pattern of movement, do they bend forwards more than normal or do they lean back too much?

Following an initial assessment, some scenario’s identified may be:*

My client has a natural pattern of movement

To enable someone to keep moving we can use simpler products to assist an individual to stand. Quite often we will use something that improves the reach of the caregiver – reducing their strain, providing a safer grip and creating space for the individual to move. The ReTurn7500i stimulates the user’s natural pattern of movement during a sit-to-stand transfer and is the ideal solution within this scenario.

My client is bending forwards

When an individual flex’s too far forwards during a sit-to-stand transfer, we must encourage them to focus on moving upwards. A bar or handle where the individual can stabilise and compensate through an upper limb is often the best solution, helping to direct the movement upwards and reduce the risk of falling. The rising ladder on the ReTurn7500i allows the client to do this whilst supporting a natural pattern of movement and closeness.

My client is leaning back

This movement creates a risk of falling back into the chair, placing more strain on the carer and increasing the risk of injury. A stand-aid hoist such as the MiniLift160 Classic with ThoraxSling is often used in these situations.

My client cannot stand for long

There are some patients who can perform a sit-to-stand quite well, but do not have the ability to stand for a prolonged period of time. We can apply different approaches in this type of situation such as a solution that provides support to keep the individual standing safely. This can include supportive slings for sit-to-stand hoists, or ReTurn accessories such as ReTurnBelt and HeelStrap. Another approach would be to provide a product which offers a drop down seat such as the QuickMove with BackSupport– the small and convenient sit-to-stand and transfer aid that safeguards and strengthens the users abilities. Nevertheless, both approaches have multiple benefits in different situations.

My client is in an environment with reduced space

Sometimes in environments with limited space, we might resort to using products with a smaller footprint and a good turning circle. With reduced space and weaker patients, we often recommend transferring to a hygiene product such as a wheeled commode.

There are many different clinical situations with their own unique complexities and many possible solutions. With decreased access to support services and a general funding reduction in council-funded social care it’s extremely important that we take precautions to enable an easy transfer and prevent a fall when your client needs to stand. Handicare Moving and Handling & Bathing Solutions reduce the complexity of such situations by promoting the best pattern of movement and reducing strain on caregivers with equipment that is most appropriate within the right environment. Handicare acknowledge that for equipment to be used to its full potential, those using it must have a full understanding of everything it can do. The Ethos Education Programme underpins this belief by providing practical tips and solutions supported by theory-based learning. Ethos is free of charge for healthcare professionals and provides access to 6 CPD accredited workshops.

For free assessment advice or for more information regarding the Ethos Education Programme please email [email protected]