Loss of balance and falls in one’s senior years are not as inevitable as many elderly citizens might think.

However, Kerrville ranks number one in the state for injuries due to falls.

More patients enter the Peterson Hospital Emergency Room due to unnecessary falls than any other regional hospital, according to ER records.

Registered Nurse Darin Smith from the Peterson ER says they treated about 1,200 cases of falls and injuries just between Oct. 1 last year and March 31 this year.

The Peterson Rehabilitation staff has created a new hospital program that will be sponsored by Peterson Health and offered bi-monthly for the public.

The class offers tips and exercises and education to prevent falls.

The classes are free, but the rehab staff asks those who want to attend to RSVP so the class leaders will have sufficient seating for everyone expected to attend.

Three of these four classes are upcoming, and will be held in the Ambulatory Care Center classroom, 4:30-5:30 p.m. on Tuesday, July 20; Tuesday, Sept. 21; and Tuesday, Nov. 16.

In this therapist-led class, attendees are learning how to reduce their fall risk at home by exploring the following topics:

• Medicines and other items that may affect balance;

• Improving your balance and strength;

• How to set up your home to keep you from falling;

• Using assistive devices;

• Receive a “File of Life” card for emergencies.

To host a class in your community, or to RSVP, call 258-7442, ext. 9, or email jcole@petersonhealth.com.

They are taking reservations for the July class now.

The instructors had a “test drive” for the class on May 20 over lunchtime for residents of Ingram Oaks. While they planned for about 20 people, the class drew increasing numbers of interested residents, and they kept adding chairs trying to fit everyone in.

So Physical Therapist Sam Amisano and RN Smith from the Peterson ER urge anyone wanting to attend one of the upcoming sessions to sign up as soon as possible.

Amisano said caregivers also can attend these classes, with the people they help care for, to get the same information.

They said they are also available to offer these classes outside the hospital to other community sites and groups in future.

“We’ve had one at a community site, and one at the ACC so far. And the people who came asked lots of good questions,” Amisano said.

She said Occupational Therapist Kat Kubista helped lead the first session and the community session at Ingram Oaks.

“The classes have been half lecture and half Q&A and demonstrations of the available aids and equipment people could consider.

“We talk about things that cause people to fall. That includes medications; the balance and strength each person has; and how good each person’s vision is,” Amisano said. “We tell them how to set up their home to avoid falls.”

Some of the fix-able problems in a home can include that it is dimly lit; or may have exposed cords on the floor.

‘File of Life’ card

She said they also give each attendee a “File of Life” card. It can be folded and inserted into the red sleeve with a magnet on the back, preferably to be stuck to one’s refrigerator. That’s where the Kerrville Fire Department personnel look for them.

Amisano said they worked with the KFD on this helpful aid, a card 5X9 inches with places to fill in essential information about an individual under the headings of identification; emergency contacts; medical data; medical conditions; allergies and medical insurance.

One side starts with medical data and the date it’s reviewed or entered including doctor and preferred hospital.

Under the medical data heading, it suggests filling the card out with pencil “for ease in making changes;” a few lines for special conditions/remarks.

There are about 10 lines for each medication, dosage and frequency, pharmacy name and phone.

It also lists birth-date; blood type; religion; “health care proxy on file at _____;” and “living will on file at ______.”

The other side is for listing recent surgery and date, a question on whether the person as an EMS-No CPR directive or a DNR form,  and where it’s filed.

There’s a list of medical conditions and boxes to check as they apply to the person who is named.

There is a similar but shorter list of possible allergies with boxes to check.

And there are five lines for medical insurance information.

Amisano said they urge people to fill out these cards and post them as recommended, as the KFD personnel look for this information when they respond to calls at citizens’ homes.

Class information

Amisano said in each of the classes, they present a Power Point of information.

And they set up the classroom to include a table of examples of tools and equipment that can make a person’s home safer.

“We talk to them about problems and fixes for door mats and area rugs, and the dangers in the lack of ‘grab bars’ in the bathroom.”

She said they show the attendees a box of things people can use to make their homes safer. Those items include double-sided tape that would stick rugs down or keep them from moving, and the covers found in stores to cover wires across the floor from computers and other items, that could be a hazard for tripping.

“The grab bars in bathrooms should be screwed into studs in the wall. And they need to be placed at a comfortable level where the particular patient naturally reaches out. And we tell them, too, there’s a difference between the height needed for a walk-in shower or a tub, and if a shower has the door on the left or the right,” Amisano said.

Then they ask and take questions from those attending. They ask each person to give their location and scenario.

“There are lots of variables. And some people have more than one thing in their medical conditions and at their homes that can be factors.”

Smith said falls can happen to anyone.

“Nurses take care of the medical end; and therapists help with rehabilitation if people break anything in a fall.”

Smith recommends people get regular eye exams with a doctor; that each person learns to manage their current medical problems, but adapt their homes. And, he added, lighting can be improved to help.

He said people also should be sure their regular doctors are talking to each other.

“The patient should go to their doctor armed with a list of questions to ask,” Smith said, “and then ask the doctor(s) first about side effects of medications and ask their pharmacies the same questions.

“People also can ask their pharmacies to put labels with larger print on the medicine bottles,” he said, “and ask for lids that are not childproof; or put their medications in pillboxes.”

Smith said the class covers a scope of all possible topics, and they try to keep the class interactive, with questions and feedback. People signing up for the class should bring a notebook or piece of paper and bring their questions. Some people take pictures of the recommended aid items with their cell phones.

They go home with a large bag donated by HEB that includes the File of Life card and holder, and exercise and nutrition ideas.

Amisano said in therapy they unfortunately see the consequences of falls on a daily basis. They want everyone to stay safe.

“Complex medical issues and complications can happen, and we recommend activity and exercise. Maintaining activity is really huge, whatever it looks like for each person,” she said. “It’s never normal to fall, ever. So far attendees have varying levels of mobility. And after the July class and the others, people can make a doctor’s appointment to follow up on the lessons they learned, and ask more questions.”

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