Lowering Falls & Raising Independence for a Homecare Client

Community Therapy was contacted with a request to provide Physiotherapy for an 85-year-old man who has recently experienced multiple falls. The man lives at home with his wife, and the referral came from his Home Care provider.

Initial Assessment

All Community Therapy services are mobile, so the initial assessment took place at the client’s home.

The assessment revealed that this client had previously suffered a stroke which was contributing significantly to his falls.

An analysis of his current functional impairments revealed:

  • A decline in strength
  • Problems with balance
  • A decline in mobility
  • Left-sided neglect (including a visual and proprioceptive deficit on the left side)
  • Limited capacity for walking

The client was only able to walk very short distances. When walking, he required physical assistance from his wife as well as the use of a walker.

He was falling regularly, sometimes as often as twice a week. Thankfully he had not sustained a significant injury yet.

Goals and Planning

Our Physiotherapist implemented a program with very specific, meaningful goals. This included:

  • To reduce the number of falls the client was experiencing
  • To improve overall strength, balance, and mobility

Following our assessment, a management plan was developed. This included:

  • Twice-weekly Physiotherapy sessions
  • Specific exercises and strategies to combat the declines that had been identified (including balance, strength and mobility)

Outcomes 

Since commencing with this client we have seen significant improvements:

  • He is now able to walk independently, all around his home, with his four-wheel walker
  • His falls are now at a significantly lower frequency than what he was previously experiencing and we are working to eliminate them altogether

The biggest improvement, however,  has been in his confidence. He now feels capable and comfortable continuing to live at his home with his wife, which is highly meaningful.

His Physiotherapy sessions have reduced to once a week now, rather than the twice-weekly sessions he required when we first started.

Into the Future

While we have had significant success, there is further work to do. Our ongoing work with this client includes:

  • Strategies to enable him to access his walker more safely
  • New strategies and equipment to further decrease his fall rate
  • Assessments by our Occupational Therapist to review the safety of his bed (following a fall off the edge of the bed)

We have had excellent feedback from the client: he loves his Physiotherapy sessions and has a fantastic relationship with his Physiotherapist. He has also met several other members of the Community Therapy team as well.

For us at Community Therapy that kind of connection with our clients is really important. We value our ability to deliver person-centred healthcare. We really like to get to know our clients and for them to get to know us. We know that this builds trust, which ultimately improves our ability to work together to achieve good outcomes.