Hello everyone and Happy New Year!
It’s easy to understand that if a person has fallen before and gotten hurt (this may even be the reason they are in the hospital), that they are often afraid of falling again. Because of this fear, they avoid walking and quickly become weaker, which actually increases their risk of falling again. Sometimes people with arthritis shy away from exercise because they think it will be too painful, when exercise can help relieve arthritis pain. Keep in mind that people with dementia and other cognitive impairment need exercise just like everyone else. Exercise can also help reduce some of the challenging behaviors that can occur with dementia too.
Below are some strategies that you and your colleagues can try to help reduce patients’ fears about physical activity:
- Be sure that patients have consistent opportunities to walk safely with a nurse or nursing assistant.
- Practice sit-to-stand exercises with a handrail in the hallway and a gait belt if needed to help residents feel secure as they strengthen their lower body and improve balance.
- Ask patients about their fears and let them express how they feel; be sure to listen to what they are telling you.
- Educate—never stop educating!—your patients about the benefits of walking and regular exercise. Help break the vicious cycle of falling, not walking because of fear of falling again, then getting weak and falling again. What you teach them may stick with them when they leave the hospital. It helps for family members to hear this too, especially when the person has dementia.
- Start small. No need to begin with a walk around the unit! Start by walking a few doors down the hall or to the nurses’ station. Do 3 or 5 sit-to-stands and end with success. Gradually increase the number and frequency.
- Offer support and words of encouragement when a patient begins walking more, transferring from bed or wheelchair to a chair, and doing sit-to-stand exercises.
Finally, think about your own fears. Is your fear of a patient falling keeping you from encouraging and assisting them to walk or transfer even though they are physically able to do so? Are you worried that family members will be upset if they think you are asking their loved one to “do too much”? Consider discussing this topic at your next staff meeting and setting some physical activity goals for your unit.