Fall Prevention—Which footwear is best?

I hope you chose the black shoes with custom elastic laces! Many times seniors have edema in their feet and with the different length laces, occupational therapy makes it an easy slip-on shoe using a long shoe horn. A shoe repair shop permanently sews the “tongue” in a proximal “top” corner! I have used the below 2-page shoe test handout successfully for 15 years.

Shoe Test PDF: bit.ly/ShoeTestPDF_1

In 2017 OHSU (Oregon Health Science University) did multiple types of screening with STEADI (Stopping Elderly Accidents, Deaths & Injuries). Of the 170 patients screened as high-risk using the “Stay Independent” questionnaire, 109 (64%) received additional fall risk assessments and interventions, whereas the remaining 36% had their fall prevention intervention deferred.

The research article addressed footwear as being an important fall prevention component!  Of the 109 seniors that were assessed using STEADI to be high risk, 75% had feet or footwear issues.

The OHSU research article recommended a footwear assessment that included a monofilament exam or review of last monofilament exam if the patient was diabetic. For nondiabetic patients, the PCP evaluated whether the patient generally wore appropriate footwear (e.g., no flip flops, no bare feet at home, no high heels) and made appropriate recommendations.

Here are the other factors they discovered. 109 Seniors (64%) received STEADI interventions (gait, vision, and feet assessment, orthostatic blood pressure measurement, vitamin D, and medication review). Providers intervened on 85% with gait impairment, 97% with orthostatic hypotension, 82% with vision impairment, 90% taking inadequate vitamin D, 75% with feet or footwear issues, and 22% on high-risk medications.

Here is a link to the whole article: http://bit.ly/2KKpSjt

STEADI coordinates well with the goals of value-based health care, better rehab outcomes, and decrease medical costs. Therefore, the quadruple aim is achieved. It has a multitude of evidenced based research. I’ve used STEADI successfully for 15 years. It is fun and easy to use!

 

EXCITING TIMES!  October 2019 U.S. Senate Committee on Aging report:  https://www.aging.senate.gov/imo/media/doc/SCA_Falls_Report_2019.pdf

  • How is your state doing, see page 10?
  • Upper State New York did a STEADI- based program and reduced hospitalizations due to falls by 40%! See pages 20-21
  • Examine how Epic EHR integrated STEADI. See how innovative programs in different states decreased senior falls with home environment safety changes, effective community balance programs, and medication recommendations

I provide Fall Prevention Classes to MDs, Medical Professionals, Insurance Companies and Senior Communities. Let’s decrease re-hospitalizations!  http://bit.ly/30ivwxB

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