Balance and Falls Prevention: It's Not Just a PT Thing..

By Dr. Katherine Lewis, OTD, OTR/L

Falls are a main cause of devastating injuries that can have profound impact on one’s ability to function

independently in everyday life. The Center for Disease Control reports that each year, millions of older

people (aged 65+) fall, one out of five in which results in a serious injury such as broken bones or a head

injury. Falls can be a result of several factors; some of which include general weakness, medication

interactions that may cause dizziness or sleepiness, unaddressed vision problems, and home hazards.

While it is not always within our power to prevent a fall, there are measures we can take to reduce our

risk. Working with an Occupational Therapist is one effective way to do so.

Physical Therapists are excellent professionals in regards to how they address balance and falls

prevention. Physical Therapists are experts in assessing and targeting lower body strength, improving

posture, as well as recommending the use of assistive devices for safe mobility. But what about

Occupational Therapists?

Occupational Therapists not only address the underlying personal factors that may lead to deficits in

balance through prescribed exercises, but are masters in compensatory strategies and environmental

changes. The main focus of occupational therapy is to engage individuals of all backgrounds in

occupations, or in other words, meaningful activity. Occupations consist of everything we do, from

brushing our teeth in the morning to going to the grocery store. Occupational Therapists are experts at

looking at an individual holistically, considering both their strengths and areas of need, and understanding

how the person’s environment will either support or hinder their ability to engage in desired occupations

both as safely and as independently as possible.

Take a minute to consider how difficult something such as loading and unloading the dishwasher, getting

up from sitting on a toilet, putting away laundry, or taking your dog for a walk would be if your balance

was compromised. In Occupational Therapy, interventions are targeted and tailored to meet individual

needs to address what is keeping you from living a functional, independent life. Rather than letting an

individual believe they will never obtain the strength and coordination they need to engage in occupations

safely, Occupational Therapists meet their patients exactly where they are and find ways to allow them to

continue operating in a way that is meaningful for them.

Occupational Therapists are masters of the environment. They are trained to think critically about how to

modify and adapt environments to meet individual needs in order to create an optimal fit for functional,

independent living. Occupational Therapists analyze environmental limitations, meticulously pointing out

throw rugs that should be removed, areas where lighting can be made more optimal, and curate

individualized schedules for planned toileting to reduce urgent mobility. When fall prevention is looked at

through this lens, there is no longer any blame placed on the individual for having deficits in balance,

strength, coordination. Occupational Therapists see practical solutions to facilitating a more optimal

environment that works to support you and your functioning as you currently are.

While it is always recommended to strive for growth and take the best possible care of ourselves, when

your health is compromised, it can feel overwhelming to have professionals in various professions

informing you of all the things you should start doing; the medications you need to be taking, the

exercises you need to be doing, the diet you should stick to, and the lifestyle you need to uphold. These

may be new and scary changes to make all at once for some individuals. There are often times where a

more ideal solution would be to address the other things in life we can control, and find ways to continue

functioning within the confinements we are experiencing in the moment.

If an individual finds that they feel more unstable when they have to quickly get from the bed to the

bathroom in the middle of the night, it is an Occupational Therapist who may recommend setting up a

bedside commode in the bedroom for a closer stop. If an individual finds that they often feel fatigued after

taking a long, hot shower, it is an Occupational Therapist who recommends showering while seated on a

shower chair to conserve energy to reduce fall risk. If an individual finds themself feeling unstable every

time they reach into an overhead cabinet for a skillet to cook their meal, it is an Occupational Therapist

who recommends keeping commonly used items in lower, more accessible spaces. You would be amazed

to discover the simple, yet practical ways Occupational Therapists are known for problem-solving to

make life more accessible for all despite any injury, illness, or disability.

Occupational Therapists are trained professionals in identifying and implementing strategies to challenge

and improve balance in order to reduce fall risk and maintain functional participation in everyday tasks.

This is achieved not only through changing individual factors to improve strength, coordination, and the

use of assistive devices, but also by finding ways to modify the environment appropriately.

There is an overwhelming misconception that only Physical Therapists work on balance and falls

prevention. On the contrary, a person's full potential and independence with safety is only met with a

combination of both Physical and Occupational Therapy.

So keep calm and OT on!