FINDING BALANCE ALGORITHM
Older adults can use a home safety checklist to examine their home for environmental risks. In situations where older adults or their families are unable to perform a home safety check list or where an older adult is being discharged from hospital following an admission for a fall-related fracture and/or with decreased mobility, a referral to the Extra Mural Program or seeking the assistance from another type of home care service may help to address environmental risk factors.
A referral to an occupational therapist (OT) may be appropriate for older adults identified as having foot and footwear issues, numerous environmental hazards, challenges with transfers, or if cognition or perception appears to be impacting their ability to safely get around in their environment.
Demands of the environment and the person's capacity to deal with them must be considered together when doing an assessment. An example would be an uneven sidewalk (environment) and the person's footwear and balance (capacity). These two factors together will impact the activity level of the individual including their ability to do self-care (ADL and IADL) and leisure activities.
Outdoor environmental hazards must also be assessed to determine how and where an individual will mobilize safely outdoors or mobilize at all. Activity restriction, social isolation and depression can all contribute to a downward spiral of the individual’s quality of life.
If the individual has severe visual impairment, identification and modification of environmental hazards by an occupational therapist can decrease the risk of further falls.