The First Step: How Can You Prevent A Fall? Introduction

Research shows that there are more than twenty risk factors linked to falls. Most of these risks can be reduced through awareness and simple changes. This booklet will outline some risk factors and things you can do to prevent a fall. It suggests:

 What you can do

 Where to go

 Who to phone

Page 1 How to Take Your “First Step” to Prevent Falls

1. Complete the “Fall Risk Questions” on pages 3-4.

2. For each question answered “Yes” go to the section that applies.

3. Put a check mark beside every item that applies to you.

4. Complete “My Plan to Prevent Falls” on page 30.

Take control now to stay on your feet.

Page 2 Fall Risk Questions Do you ... Circle “Yes” or “No” If “Yes” go to page ...

1. Ever feel dizzy? Yes No 5 Dizziness

2. Take three or more medications? Yes No 6 Medication Use

3. Drink alcohol or use drugs often? Yes No 7 Alcohol or Drug Use

4. Have foot problems? Yes No 8-9 Foot Problems

5. Have weak muscles or stiff joints? Yes No 10-11 Muscles/Joints

6. Have to rush to the bathroom? Yes No 12-13 Continence

7. Have vision problems? Yes No 14-15 Vision

8. Have hearing problems? Yes No 16-17 Hearing

Page 3 Fall Risk Questions Do you ... Circle “Yes” or “No” If “Yes” go to page ...

9. Have sleeping problems? Yes No 18-19 Sleep

10. Have concentration problems? Yes No 20-21 Concentration

11. Have shortness of breath? Yes No 22 Shortness of Breath

12. Forget to check for safety hazards in Yes No and around the home? 23-26 Safety Hazards

13. Walk in places that are uneven, Yes No slippery or icy? 27 Outdoor Walking Hazards

14. Have balance problems? Yes No 28 Keeping Your Balance

15. Have frequent slips, trips, near falls, Yes No *Please read the complete booklet. or falls?

Page 4 Dizziness

What can cause Where to go or What you can do dizziness who to phone

 Standing up too quickly.  Sit on the side of the bed for a few  See your family doctor and ask for a minutes before you stand up. medication review.  Getting up quickly from lying down.  Move your ankles up and down for  Go to a vestibular physiotherapist for  Dehydration. 30 seconds before you stand up to treatment. See page 33 to learn how to  Low blood pressure. improve blood flow. find a physiotherapist.  Taking medication for high blood  Drink water often.  See page 33 for information on how to pressure (for 1–2 hours after taking call HealthLinkBC for free advice from  Change positions often and avoid blood pressure medications you may a nurse, pharmacist or dietitian. staying in bed for long periods of time. have a low blood pressure response).  Drop in programs for blood pressure  After standing, march on the spot  Medication side effects. checks are held at some Community before you take a step. Centres. See pages 31-32 for the list of  Inner ear problems.  Tell your doctor if your medication is Community Centres and Seniors Centres. making you drowsy or dizzy.  Poor eating habits.  Check your blood pressure at your  Low blood sugar.  Have your blood pressure checked local pharmacy. regularly.  Certain medical conditions (e.g. diabetes).  Ask your doctor if compression stockings are right for you.  Have your ears checked.  Do not go longer than five hours during the day without eating.  If you get low blood sugar, keep a sugar source with you at all times (e.g. glucose gel or glucose tablets

© Coastal Health © Vancouver Coastal Health or fruit juice).

Page 5 Medication Use

What can cause Where to go or What you can do medication concerns who to phone

 Taking over the counter (non- prescription)  Ask your pharmacist or doctor  Review your medications with your doctor medications, herbal remedies or alcohol before taking any over the counter at least every six months and whenever with prescription medications. medications or herbal remedies with any medication is added or stopped. prescription medications.  Not taking medications as directed.  Talk to your local pharmacist about your  Take medications as directed. medications.  Forgetting to take medications.  Use a weekly pill reminder/dosette/  See page 33 for information on how  Your doctor may not know the side bubble pack. Ask your pharmacist to call HealthLinkBC for advice from a effects you are having. about bubble packing or dosettes. nurse, pharmacist or dietitian.  Not knowing what medications you are  Avoid alcohol when you are taking taking, how many you should take, and prescription medications. why you need to take them.  Never borrow medication from others.  Using someone else’s medications.  Ask your pharmacist about side effects  Using outdated medication. and possible drug interactions before  Your doctor may not be aware of all the taking any medication. medications you are taking, especially if  Always use the same pharmacy. you visit more than one doctor.  Bring outdated medications back to the  Taking sedatives/sleeping pills or any pharmacy for disposal. medication with the side effect of making you drowsy/dizzy (prescription  Keep a list of your medications in your or over-the-counter). wallet or purse and on the fridge.  If you are taking sleeping pills, discuss the risks and benefits of the medication with your doctor. Sleeping pills increase your risk for falls, especially during the night.

Page 6 Alcohol or Drug Use

What can cause Where to go or What you can do over-use of alcohol or drugs who to phone

 Using alcohol or drugs to help you  Learn about how your body responds  Access Central – Detox Referral Line sleep (alcohol and drugs disrupt normal differently to alcohol and drugs with Provides phone numbers to alcohol/ sleeping patterns). age. Aging decreases your tolerance drug addiction services in your area. to alcohol and drugs. 1-866-658-1221  Using alcohol or drugs to relieve aches and pains (alcohol or drugs can cause  Find healthy ways to deal with your  Seniors Distress Line – offers greater aches and pains). feelings. information and resources for support groups, withdrawal management,   Loneliness. Share your feelings with someone you counseling on alcohol and medication trust such as a family member, friend  Sadness or depression. use as well as problems related to or seniors peer counselor. misuse for people 55 or older.  Grief and loss.  If you are feeling sad or nervous, do not 604-687-7927 (24 hours)  Boredom. feel like eating, or start losing interest  Alcohol and Drug Information and in your activities, talk with a community Referral Service  Stressful situations. nurse, a counselor or your doctor. 604-660-9382  Addiction.  Join a community group or start a 1-800-663-1441  Social expectations. new activity.  Stepping Stones – North Shore Adult  Tell your doctor about your aches and and Seniors Addiction Day Program pains and discuss ways to manage 604-904-6180 the problem.  Richmond Addiction Services (RAS)  Talk with someone who is trained to 604-270-9220 counsel on alcohol or drug misuse.

Page 7 Foot Problems

What can cause Where to go or What you can do foot problems who to phone

 Poorly fitting shoes, slippers, or boots.  Wear proper-fitting, supportive shoes  For hard-to-fit or specialty fitting with nonskid soles and low, broad footwear:  Shoes with high narrow heels, slippery heels that are enclosed at both your  Contact a pedorthist if you have any soles, “sticky” soles, or poor support. toes and heels. Avoid slip- on style pressure or red areas on your feet  Pain in your feet from untreated foot shoes or slippers. from wearing your current shoes. A pedorthist can help with shoe problems like calluses, bunions, corns,  Make sure your shoes are in good untrimmed toenails, or ingrown toenails. condition. modifications or custom footwear if needed to prevent wounds.  Talk with a podiatrist (foot doctor) pedorthic.ca about calluses, bunions, corns, or  Call your local Home and Community ingrown toenails. Corn plasters are Health Services office.See page 31. not recommended for people with diabetes, heart or blood vessel disease.  Find a BC Podiatrist at bcpodiatrists.ca or call  DO NOT wear socks on linoleum, BC Podiatric Medical Association hardwood or tiled flooring. 604-985-3338 (FEET)  Buy your shoes in the late afternoon for  Canadian Diabetes Association a good fit. diabetes.ca • CDA Customer Contact Center 1-800-226-8464 (English) 604-732-8187 or 1-888-666-8586 (Chinese)  Find a foot care nurse at lmfna.ca

continued on next page... Page 8 Foot Problems

What can cause Where to go or What you can do foot problems who to phone

 Swollen feet.  When you are lying down, use a pillow Diabetes Education: under your knees and lower legs to  • Aboriginal Diabetes Awareness Loss of feeling in your feet as a result keep your feet higher than your hips. of some diseases (e.g. diabetes). Prevention and Teaching  Try to move your ankles by pointing 604-254-9949 your toes up and down for 30 seconds • VGH – Diamond Health Centre every hour to improve blood flow. 604-875-4111 ext. 55910 (referral required) • UBC – Koerner Pavilion  If there are dents in your skin from (nutritional counseling) your socks, the socks are too tight 604-822-7255 or you have swelling in your legs. Choose a looser pair of socks and talk • St Paul’s Hospital 604-806-8357 © Vancouver Coastal Health to a health care provider about how to decrease swelling. (English, Mandarin, Cantonese) • Vancouver – SUCCESS  Ask a health care provider to help you 604-684-1628 find a good daily foot care routine. (English, Mandarin, Cantonese)  Check your feet daily if you have diabetes. • West Vancouver Community Health Look for redness from pressure. Centre 604-984-5752 (referral required)  If you often have swelling in your • Richmond Hospital feet and ankles ask your doctor if 604-244-5163 (referral required) compression stockings are right for you • Richmond Public Health © Vancouver Coastal Health © Vancouver Coastal Health (nutritional counseling) 604-233-3150 ext. 4655 • Powell River – PRGH 604-485-3211 • Bella Coola – BCGH 604-799-5311 (referral required) • Sea to Sky – Squamish Health Unit 604-892-2293 (referral required)

Page 9 Muscles/Joints

What can cause weak Where to go or What you can do muscles & stiff joints who to phone

 Unresolved injury, pain or discomfort  See a physiotherapist, kinesiologist,  Go to a physiotherapist for treatment. or personal trainer for specialized See page 33 to learn how to find a  Conditions affecting the muscles, exercises. physiotherapist. nervous system and joints such as arthritis, osteoporosis, Parkinson's  Talk with your health care professional  Mary Pack Arthritis Program disease and stroke. about your discomfort or soreness. You need a doctor's referral to be assessed by a clinician. You do not need  Chronic pain.  Write down details about your pain: a referral to attend online classes. time of day and what increases or 604-875-4040 mpap.vch.ca decreases the pain.  Arthritis Answers Line  Change your position often. 1-800-321-1433  Arthritis Society arthritis.ca  Osteoporosis Canada 1-800-463-6842 osteoporosis.ca  BC Parkinson’s Disease Association 604-662-3240 or 1-800-668-3330 parkinson.bc.ca  Stroke Recovery Association of BC 604-688-3603 or 1-888-313-3377 strokerecoverybc.ca  Pain BC Resources and supports for people living with chronic pain. painbc.ca liveplanbe.ca 1-844-880-7246 (Monday-Friday 9:00 am to 4:00 pm) 2-1-1 continued on next page... Page 10 Muscles/Joints

What can cause weak Where to go or What you can do muscles & stiff joints who to phone

 Lack of physical activity (e.g. sitting or  Join an exercise program at a  Call Physical Activity Services at laying down for much of the day). Community Centre (in water or on land). HealthLinkBC for physical activity information.   Tight muscles. Plan a regular activity such as daily walks. See page 33 for more details. It helps to have an exercise partner.  Engaging in physical exercise that your  Osteofit body is not used to.  If you have limited endurance, walk An exercise program for people who small amounts often throughout the day. have osteoporosis. To find a location for a class visit: osteofit.org  Try to slowly increase the amount  SteadyFeet you walk. You can increase the An exercise program for people who distance or how often you walk. have balance and mobility concerns To find a location for a class visit:  Join an Osteofit or SteadyFeet steadyfeet.vch.ca exercise class.  The UBC Changing Aging Program:  Join a walking program in your exercise programs for older people: local mall. 604-822-0207 kin.educ.ubc.ca/outreach/body-works/ bodyworks-fitness-classes/  Check what programs are at your local Community Centre. See page 32.  Self-Management BC The Health Coach Program is a one-on-one telephone support program in which coaches support people living with chronic conditions by helping them to become better self-managers. Visit selfmanagementbc.ca for more programs. email: [email protected] 604-940-1273 or 1-866-902-3767

Page 11 Continence

What can cause changes in Where to go or What you can do bladder & bowel control who to phone

 Changes in your eating and drinking  Avoid beverages that have caffeine.  See page 33 for information on how habits. Caffeine irritates the bladder, making you to call HealthLinkBC for advice from a urinate more often and more urgently. nurse, pharmacist or dietitian.  Side effects of medications.  If you are constipated: eat a high fiber  Bladder Care Centre - UBC Hospital  Stress. diet (vegetables, fruit, whole grains), drink A referral from your urologist or plenty of fluid, and exercise regularly. gynecologist is required.  Infection.  If you have diarrhea: drink plenty of 604-822-6143  Prostate problems. fluids and eat a bland diet (e.g. rice,  Continence Clinic potatoes, and yogurt).  Menopause. BC Women’s Hospital & Health Centre  Drink enough fluids so that your urine Self-referral or referral by your doctor.  Constipation can lead to bladder is light yellow in colour. 604-875-3137 or 604-875-3060 problems.  Avoid infection by drinking enough  Incontinence products for women and  Changes in bladder habits - going too fluids. men are available at medical supply frequently, not fully emptying the bladder. stores, grocery stores and pharmacies.  Use incontinence pads or briefs.  Overactive pelvic floor muscles. Choose the product that meets your needs (eg for heavy night-time  Diabetes. leakage). These are very effective and prevent the need to rush to the toilet.  Hemorrhoids Change immediately if wet or soiled.  Neurological conditions.  Ensure proper footwear and lighting when going to bathroom.  Retrain your bladder to be able to hold longer.  Use behavioural techniques to settle the urge. continued on next page... Page 12 Continence

What can cause changes in Where to go or What you can do bladder & bowel control who to phone

 Weakness of pelvic floor muscles that  Speak to your physiotherapist,  Talk to a community nurse or your family control the flow of urine. doctor or nurse to learn exercises to doctor. See page 31 for a list of Home strengthen the pelvic floor muscles. and Community Health Services.  Use your pelvic floor muscles to  Make an appointment with a prevent leakage. Uro-gynecology Physiotherapist. BC Women’s Health Centre  Retrain bladder habits. Continence clinic  See your doctor if you have any changes Self referrals accepted. in bladder and/or bowel control. 604-875-3137 Tell your doctor about any:  Go to a pelvic floor physiotherapist for • blood in your urine, treatment. • foul smelling urine, See page 33 to learn how to find a • difficulty or pain urinating, physiotherapist. • having to urinate more often  Canadian Continence Foundation than usual, 1-800-265-9575 • difficulty getting to the bathroom The Source, the first complete Canadian on time, continence resource book, is available • constipation or diarrhea for download.  Go to the bathroom before going to bed. canadiancontinence.ca/EN/the-source- guide.php

Page 13

Vision

What can cause Where to go or What you can do vision difficulties who to phone

 A change in eyesight prescription.  Check your eyesight at the optometrist  Vision Loss Rehabilitation Canada – or ophthalmologist once a year. Rehabilitation services – Low Vision,  Dirty or scratched eye glasses. Independent Living Skills, Orientation  Clean glasses regularly. Use a and Mobility and Assistive Technology  Increasing age causes your eyes to non- glare cleaner and soft cloth. 1-844-887-8572 become more sensitive to glaring light.  Wear sunglasses when in the sun. bc.visionlossrehab.ca  [email protected] Getting used to bifocals.  Wear special glasses/filters that cut  Low lighting causing eye strain. down on the glare.  CNIB Foundation 604-431-2121 or 1-800-563-2642  Use blue light filters to assist with  Diseases of the eye such as cataracts, cnib.ca digital eye strain. macular degeneration, glaucoma or infections.  Pause and give your eyes time to  Canadian Diabetes Association – adapt to changes in light. Provides information and support for  Diseases that affect eyesight such people with diabetes. as diabetes.  Use good lighting in halls, stairways, 1-800-BANTING (226-8464) and bathrooms. diabetes.ca

 Use night lights.  BC Association of Optometrists  Position lighting to shine on the task 604-737-9907 and not in your face 1-888-393-2226 (BC only) bc.doctorsofoptometry.ca  Maintain good control of diabetes.  St. Paul’s Hospital Diabetes Health Centre  If you are wearing bifocals or 604-806-8357 progressive lenses do not look through the lower (reading) part of the glasses when walking or going up or down stairs. Tip your head down to use the upper (distance) part of the glasses. continued on next page... Page 14

Vision

What can cause Where to go or What you can do vision difficulties who to phone

 Remove "near" reading glasses when  North Shore Diabetes Education Centre walking. Referral is required from your doctor. 604-984-5752 ext. 2  Use tape or paint to add a contrasting colour on the top edge of all steps  Richmond Hospital - so you can see the stairs better. For Diabetic Education Centre example, use a light colour paint on Referral is required from your doctor. dark wood. 604-244-5163  Use bright coloured tape to mark objects in your home that you need to reach for (e.g. light switch, handrails, grab bars).  Use contrast. For example, make the object a different colour than the background (e.g. avoid pouring black coffee into a black coffee mug).  Protect your head with your hand when bending or reaching.  Push dining chairs in at the table after use.  Close doors, cupboards, drawers, and the dishwasher when not in use.  Request an orientation and mobility assessment with Vision Loss Rehabilitation Canada if tripping and bumping continue to be of concern.

Page 15 Hearing

What can cause Where to go or What you can do hearing difficulties who to phone

 Wax build up in your ears.  Get your hearing assessed by a  Wavefront Centre for Communication registered audiologist. Accessibility – Registered audiologists  Head Injury (e.g. fall). provide hearing tests and consultations.  Make sure your ears are clear of wax. Other services and programs available.  Excessive noise exposure. DO NOT use a cotton swab. (including Lend an Ear program – refurbished hearing aids for low-income  Aging.  See a family doctor to examine your individuals). ears and possibly flush out wax from  Chronic middle ear issues (e.g. infections, 604-736-7391 or 1-888-736-7391 your ears. problems with ear bones). TTY: 604-736-2527  Clean your hearing aids often and wavefrontcentre.ca  Hereditary and genetic-related hearing change the batteries regularly. loss.  Connect Hearing for hearing assessment  Turn on the Closed Captioning feature counseling.  Dirty hearing aids or old batteries in on your television. 1-888-501-2661 hearing aids. connecthearing.ca  Take a speech reading class.  Association of the  Learn how to communicate with Deaf TTY hearing loss strategies. 778-760-8861 deafbc.ca

 St. Paul’s Audiology Clinic Requires a doctor’s referral 604-806-8660

 Seniors Centre at Minoru Centre for Active Living 604-238-8450

continued on next page... Page 16 Hearing

What can cause Where to go or What you can do hearing difficulties who to phone

 If you are unable to leave your home for a hearing test, you can call Hear At Home mobile hearing clinic. 778-340-1101

 Canadian Hard of Hearing Association B.C. Chapter Voice/TTY 1-866-888-2442

 Living Successfully with Hearing Loss classes at Vancouver Community College Private hearing aid clinics for hearing assessments and hearing aids. vcc.ca/courses/dhhe-0618/ 604-871-7000 ext. 7342

Page 17 Sleep

What can cause Where to go or What you can do difficulties with sleeping who to phone

 Lack of sunlight.  The normal sleeping pattern for older  Sleep Disorder Clinic - UBC Hospital. adults is six hours of sleep per night, Doctor's referral needed.  Having coffee, tea, cola, alcohol or waking twice during the night, with 604-822-7606 chocolate in the evening. ~20 minutes to go back to sleep.  See page 33 for information on how  Napping in the late afternoon and  If you can’t sleep after 20 to 40 to call HealthLinkBC for advice from a early evening. minutes, get up and do something like nurse, pharmacist or dietitian. read a book or listen to music.  Stress.  BC Mental Health Support Line  Avoid caffeinated foods and drinks (Available 24 hours a day)  Feeling nervous or anxious. after 4:00 pm. Try warm milk instead. 310-6789 1-800-SUICIDE (1-800-784-2433)  Worrying.  Avoid napping in the late afternoon or heretohelp.ca  Sadness or depression. early evening.  Mental Health Services  Keep your bedroom cool and quiet. North Shore: 604-904-3540  Medication. Vancouver: 604-709-6785  Ensure your mattress is firm and Richmond: 604-675-3975 comfortable.  Bounce Back – coaching program  Learn relaxation techniques. offered by Canadian Mental Health Association  Avoid watching television or looking 1-866-639-0522 at electronics late at night as the lights [email protected] and the stimulation may cause sleep bouncebackbc.ca difficulties. Try reading instead.

 Talk with someone you trust about any feelings of anxiety or sadness.

continued on next page... Page 18 Sleep

What can cause Where to go or What you can do difficulties with sleeping who to phone

 Age-related intolerance to sleeping pills  Try to go outside and walk for  For fitness and recreation programs 20 minutes a day. If you are not able - see the list of Community Centres on  Aches and pains to go outside, walk in your home for page 32. 20 minutes.  Lack of physical activity  CHIMO Crisis Service - Provides free  Limit alcohol as it reduces the amount services to Richmond, Tsawwassen, and  Alcohol of restful sleep you get. Ladner residents who are in crisis. 604-279-7077  Talk to a health care professional, your community nurse, pharmacist or  Crisis Line family doctor. 604-872-3311 1-800-SUICIDE (784-2433)

 BC Bereavement Help Line - Acts as a resource and supports the bereaved and caregivers through referral and interdisciplinary communication. Offers counseling assistance to callers experiencing distress. 604-738-9950 or 1-877-779-2223

Page 19 Concentration

What can cause Where to go or What you can do difficulties with concentration who to phone

 Continually feeling rushed or stressed.  Slow down and pace yourself.  Peer Support for Seniors North Shore Neighbourhood House  Being afraid of falling.  Plan ahead. 604-987-8138  Keep daily activities in a consistent  Poor appetite or not eating properly. pattern and routine that is not hurried.  Mental Health North Vancouver 604-904-3540  Feeling nervous or anxious.  Rest when you are tired.  Fatigue.  Always give yourself extra time to get  Seniors Peer Counseling, Richmond to places or get things done. 604-279-7020  Insomnia.  Eat regularly to prevent physical  See page 33 for information on how  Some medical conditions (e.g. stroke, weakness and mental sluggishness. to call HealthLinkBC for advice from a high or low thyroid, dementia, lupus).  Write down activities that need to be nurse, pharmacist or dietitian  Chronic pain. done during the day.  West End Seniors Network  Some medications.  Keep a journal to remind yourself 604-669-7339 of activities.  411 Seniors Centre Society  Put a list on your refrigerator or near 604-684-8171 your phone and always keep it in the same place.  See page 31 to find your local Seniors Centre  Use a calendar with large spaces to note appointments, reminders, etc.  Talk with someone you can trust if you are feeling anxious or sad.  Talk to your doctor to find out if there is a treatable cause for your lack of concentration.

continued on next page... Page 20 Concentration

What can cause Where to go or What you can do difficulties with concentration who to phone

 Feeling sad, lonely or depressed.  Talk with your community nurse  BC Bereavement Help Line - or doctor about any recent loss of Acts as a resource and supports the  Worrying about poor memory or appetite, loss of interest in activities, bereaved and caregivers through referral memory gaps. difficulty sleeping or sleeping too and interdisciplinary communication.  Grief and loss. much, discomfort, or difficulty in Offers counseling assistance to callers remembering things. experiencing distress.  Medications (e.g. sleeping pills or pills 604-738-9950 or 1-877-779-2223 for anxiety).  Mental exercise aerobics, such as playing games, word search puzzles,  BC Mental Health Support Line  “Not exercising your brain” If you don’t crossword puzzles, etc. (Available 24 hours a day) use it you lose it! 310-6789  Stay active both physically and 1-800-SUICIDE (1-800-784-2433) mentally - Use it or lose it! heretohelp.ca  CHIMO Crisis Service - Provides free services to Richmond, Tsawwassen, and Ladner residents who are in crisis. 604-279-7077  Crisis Line 604-872-3311 1-800-SUICIDE (784-2433)

 Bounce Back – coaching program offered by Canadian Mental Health Association British Columbia 1-866-639-0522 [email protected] bouncebackbc.ca

Page 21 Shortness of Breath

What Can Cause Where to go or What you can do shortness of breath who to phone

 Smoking.  Cut down or stop smoking with help  Quit Now by Phone from your family, friends, doctor, and Tobacco cessation help line  Lack of physical activity/over-exertion. QuitNow/NRT (nicotine replacement 1-877-455-2233 therapy 3 months free at any quitnow.ca  Obesity/chronic pain/chronic cough. pharmacy with your driver’s license)  B.C. Lung Association  Pollution/weather. education programs. 604-731-LUNG (5864) or 1-800-665-LUNG (5864)  Try to stay away from places where  Paint/paint thinners.  Asthma Society of Canada air is polluted (e.g. smoking areas). 1-866-787-4050  Cleaning fluid, sprays, aerosols/room asthma.ca deodorizers.  Get your yearly flu shot and one time pneumonia vaccine to prevent severe  Cardiac Rehabilitation and Risk Factor  Excessive dust/dirt. respiratory infections. Management (Healthy Heart Program) VGH: 604-875-5389  Hairsprays, aftershave, perfumes.  Gradually increase your physical St. Paul’s Hospital: activity. 604-806-8591 or 604-806-9270  Respiratory infections. Richmond: 604-278-9711 ext. 4027  Start a walking program or join a  Breath Pulmonary Rehabilitation  Chronic diseases such as COPD/ fitness program. Pulmonary Fibrosis/asthma/heart Program - Lion’s Gate Hospital problems.  Eat healthy meals. 604-988-3131 ext. 4940  Heart and Stroke Foundation  Allergies/household moulds/pollens/  Talk with your doctor or lung specialist 604-736-4404 foods and preservatives/animal dander/ about shortness of breath, why you heartandstroke.ca stress/emotional. have it, when it happens, and how it  Healthy Living Program limits your activities. Breathe Well, Live Well Doctor’s referral is required. 604-267-4430  See page 33 for information on how to call HealthLinkBC for advice from a nurse, pharmacist or dietitian.

Page 22 Safety Hazards

What can be Where to go or What you can do hazardous indoors who to phone

 Rushing/not paying attention to  Take your time, especially when  If you are unsure of what changes your environment e.g. rushing to answer carrying objects. to make in your home to decrease the phone. your risk for falls, contact Home and  Remove loose carpet/rugs or use Community Health Services for a  Loose carpets, scatter rugs. double sided tape to secure carpet/ rugs to the floor. home safety assessment.  Clutter (phone/electrical cords, shoes, See page 31.  Fix uneven floors or mark the uneven pet dishes, papers, etc.).  patch with a bright colour. Home repair in Yellow Pages -  Slippery or wet floors or walkways. To tack on carpets, reroute electrical  Keep all walkways clear of clutter. cords, etc.  Floor wax or cleaning solution that may  Do not wax your floors.  Senior Citizen’s Repair Services - leave the floor slippery.  Wipe up spills promptly and leave For seniors who need help with minor  Phone and electrical cords in your something to remind you that the floor repairs. walking path. is wet. 604-529-1100 604-438-6990  Floppy ill-fitting shoes or slippers.  Coil and wrap phone or electrical  Clothing that is too long cords or wire with tape to keep them (e.g. nightgowns, dressing gowns, off your walking path. Tape them baggy pants that drag). down if necessary.  Use a cordless phone.  Always wear footwear (e.g. slippers or shoes). Avoid walking in socks or stockings.  Make sure your clothing fits well. Hem any pants, dresses, nightgowns or bathrobes that are too long.

continued on next page... Page 23 Safety Hazards

What can be Where to go or What you can do hazardous indoors who to phone

 Poor lighting.  Keep a night light in the bathroom,  BC Housing near the bed, and in your hallway. 604-433-2218  Poor furniture arrangement (e.g. not enough space to use your  Use non glare bulbs that are 100  If you are unsure of what changes walking aid). watts or greater. to make in your home to decrease your risk for falls, contact Home and  Swivel chairs or rocking chairs or chairs  Keep a lamp within easy reach of Community Health Services for a home with wheels. your bed so that you can turn on the light before you get up. safety assessment. See page 31.  If you use a walker, have someone arrange your furniture so that the walker can move freely through your home without catching the walker legs or wheels on any furniture or walls.  Replace any swivel/rocking chairs or chairs with wheels with a chair with solid legs and armrests.  Make sure all surfaces that you stand up from (e.g. bed, toilet, chair or sofa) are high enough that you can stand up easily (knee height or slightly higher).  If any surfaces are too low and you struggle to stand up easily, you can use furniture risers or platforms or a raised toilet seat.

continued on next page... Page 24 Safety Hazards

What can be Where to go or What you can do hazardous indoors who to phone

 Reaching for high objects.  Do not stand on a ladder, chair or stool.  If you are a high falls risk on the stairs and you have the money to install  Stairs and bathrooms without secure  Store heavier items on lower shelves. a stairlift, contact an occupational handholds.  Store items on easy to reach shelves, therapist at your local Home and  Bending over to reach low objects. counter level, or below shoulder height. Community Health Services office to discuss this option. See page 31.  Using step stools.  If you must reach items that are up high, ask a friend or family member to  Fall Alert System  Pets you may trip over. reach it for you. Telus Living Well Companion  Buy a long handled reacher at a 1-800-267-2001 medical supply store.  Lifeline or  Install handrails for all stairs inside 604-872-5433 1-800-387-8120 and outside the house, preferably on  OneCallAlert both sides of the stairway. 1-800-994-2095  Watch out for sleeping pets.  Get a personal alert system that will alert family and/or emergency medical services in case you fall.  If you choose not to get a personal alert system, carry a portable phone or cell phone with you at all times so that you can call for help if you fall.

continued on next page... Page 25 Safety Hazards

What can be Where to go or What you can do hazardous indoors who to phone

 Slipping in your tub or shower.  Install grab bars in the bathroom in  Medical suppliers can install grab bars the tub/shower and next to the toilet. in your bathroom. They also have other  Using a towel rack to hold onto for  safety equipment for your home. support in the bathroom. Towel racks are Sit down during baths/showers. not designed to hold an adult's weight. You can use a shower seat or stool or  VAC, Veterans’ Affairs Canada a tub transfer bench. (previously known as DVA). Veterans  Ask a family member or friend to may qualify for equipment funding. install a handheld shower head. These 1-866-522-2122 are available at any hardware store. veterans.gc.ca

 Use skid-proof or non-slip mats  Red Cross Medical Equipment in bathrooms, especially in your Loan Services bathtub. Vancouver: 604-301-2566 Richmond: 604-270-4224 North Vancouver: 604-988-7115  Vancouver Masonic Service Bureau - Equipment loan 604-732-5414  If you need help to select the safest and most appropriate bathing equipment, contact your Home and Community Health Services Centre and request a home safety assessment. See page 31.

Page 26 Outdoor Walking Hazards

What can be Where to go or What you can do hazardous outdoors who to phone

 Rushing/not paying attention to your  Walk slowly and pay attention to  Report any hazards (roads or sidewalks) environment. your environment. to City Engineering Departments.  Vancouver: 604-873-7000  Lack of railings on stairs. Install handrails on outdoor stairs, preferably on both sides. Richmond: 604-244-1262 North Vancouver District: 604-990-2450  Carrying too much, causing a loss of  Avoid carrying heavy items (use a North Vancouver City: 604-983-7333 balance or blocked vision. delivery service). West Vancouver: 604-925-7020  Walking on uneven ground.  Use a waist belt pack or backpack instead of carrying a purse.  Phone your local grocery store to ask for home delivery.  Wet leaves or fallen branches on  Use a portable/folding grocery cart. the street or sidewalk.  For information regarding meal and  Use walking aids as recommended grocery delivery programs or volunteer  Snow, ice or water puddles on the for you by a health professional. shopping services contact your local walkway or stairs.  Avoid walking on wet leaves, snow Home and Community Health Services or ice.  Raised or cracked sidewalks. office.See page 31.  Check regularly and replace your  Getting on and off buses. rubber cane tip when it is worn down.

 Poor outdoor lighting.  Install outdoor lighting that uses a timer or motion sensor.  Improper footwear for the type  Use footwear with a low, stable heel of weather. and good tread.  Moss or lichen on walkways.  Hire someone to pressure wash your walkways if moss or lichen are present.  Avoid going outside if it is snowy or icy. If you must go outside, have a family member or friend salt the walkways and assist you walking outside.

Page 27 Keeping Your Balance

What can affect Where to go or What you can do your balance who to phone

 Getting up too fast.  Take your time.  Connect with a Home and Community Health Services Physiotherapist.  Lack of physical activity.  Exercise to improve your balance. See page 31. See pages 10-11.  Poor vision.   Use corrective lenses for poor vision. Go to a physiotherapist for treatment  Alcohol. See page 14. and/or selection of walking aids. See page 33 to learn how to find a  Medication.  Avoid alcohol. See page 7. physiotherapist.  Poor footwear.  Use footwear that fits well. See pages  Go to a local medical supplier to 8-9.  Not using the right walking aid(s). purchase hip protectors.  Use recommended walking aid(s) and  Lack of sleep.  Join a Steadyfeet class to improve gradually increase your walking. balance and mobility.  Not eating enough or regularly.  Eat well balanced meals to give Medical clearance is required, so talk to  Medical conditions that affect your yourself energy throughout the day. your family doctor first. muscles or nerves.  Talk with support groups such as the Steadyfeet classes are offered at many Diabetes Association. See page 8. local Community Centres.  Medical conditions that affect your inner ear.  Talk with your doctor about your See page 32 for a list of Community medications and medical conditions. Centres or look online for locations  Medical conditions such as diabetes and steadyfeet.vch.ca multiple sclerosis that can affect your  Watch where you are going if you five senses (hearing, sight, touch, smell have less sensation in your feet.  See page 33 for information on how and taste). to call HealthLinkBC for advice from a  Consider hip protectors to pad your nurse, pharmacist, exercise physiologist hips and lower the risk of a hip or dietitian. fracture if you fall. This is especially important if you have osteoporosis and/or balance problems.

Page 28 Talking to Your Health Professional About Your Concerns Falling, slipping and tripping are not normal. You need to find out why this is happening and how to protect yourself. You know yourself best, so you need to be able to clearly tell your doctor about your problem(s). Trust and comfort are important for a good patient - doctor relationship. You can do your part by following the suggestions listed below when speaking with any health professional.  List your concerns on paper in order of “what is most important to you” before going to the doctor’s office.  Be clear about what you are asking the doctor to help you with.  When making your appointment, be sure to tell the person who is booking your appointment if you think you will need a longer time to speak with the doctor.  If you are unclear or unsure about the medical treatment plan, (e.g. tests, medications, therapists) ask that it be written down or repeated. It is not unusual to forget or not hear everything the doctor tells you because you may be feeling stressed at the time. You may choose to bring a friend or translator.  Do not be afraid to speak up for yourself. Tell your doctor if “the plan” or “treatment” is not working.  Keep a diary of medications and concerns, and take this with you.  Ask for resources (e.g. brochures, videos).  Do not start or stop taking a medication before talking to a health professional. See page 33 for information on how to call HealthLinkBC for advice from a nurse or pharmacist.  Have someone accompany you to the doctor’s appointment if you do not hear well, or have difficulty understanding information, or feel unsteady on your feet.

Page 29 My Plan to Prevent Falls

My greatest risk(s): I will do: I have done: Reviewed at: 3 month 6 month 9 month 1 year

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Page 30 Community, Recreation and Health Centres

Home and Community Health Services Falls Prevention Clinics Vancouver: Richmond Fall Prevention Program To request a service or referral call: 8100 Granville Ave...... 604-233-3150 Home and Community Health Services: Vancouver Falls Prevention Clinic: VGH Research Pavilion Central Intake ...... 604-263-7377 fallclinic.com ...... 604 875-4111 ext. 69611 CHA 1 Three Bridges CHC...... 604-331-8900 Elder Care Ambulatory Clinic CHA 2 Lee Family CHC...... 604-675-3980 St Paul’s Hospital...... 604-806-8029 CHA 3 Evergreen CHC...... 604-872-2511 providencehealthcare.org/elder-care-ambulatory-clinic CHA 4 Pacific Spirit CHC...... 604-261-6366 CHA 5 Raven Song CHC...... 604-709-6400 Seniors Centres CHA 6 South CHC...... 604-321-6151 Vancouver: Elder Care Clinics: 411 Seniors Centre...... 604-684-8171 St. Paul’s Hospital...... 604-806-8029 West End Seniors Network...... 604-669-5051 Mount St. Joseph Hospital...... 604-877-8371 or 604-877-8181 South Granville Seniors Centre...... 604-732-0812 Vancouver General Hospital...... 604-875-4111 ext. 61032 Oakridge Seniors Centre...... 604-263-1833 Richmond: Coastal (North Shore, Sea to Sky, Sunshine Coast and Powell River): Home and Community Health Services:...... 604-875-4510 Geriatric Assessment Program (GAP)...... 604-675-3649 North Shore Seniors’ One Stop Information Line ...... 604-983-3303 North Shore: North Vancouver: Home and Community Health Services:...... 604-986-7111 Silver Harbour ...... 604-980-2474 OASIS Molly Nye House ...... 604-987-5820 West Vancouver: OASIS (Osteoarthritis Service Integration System) Seniors Activity Centre ...... 604-925-7280 oasis.vch.ca Squamish: The 55 Activity Centre ...... 604-848-6898 Brennan Park Recreation Centre ...... 604-898-3604 Richmond: Minoru Place Seniors Centre...... 604-238-8450

Page 31 Community Centres Vancouver: North Shore (North Vancouver): Britannia...... 604-718-5800 Delbrook...... 604-983-6301 Carnegie Centre...... 604-665-2220 John Braithwaite...... 604-983-6471 Champlain Heights...... 604-718-6575 Mollie Nye House...... 604-987-5820 Coal Harbour...... 604-718-8222 Parkgate...... 604-983-6350 Creekside...... 604-257-3050 Harry Jerome...... 604-987-7529 Douglas Park...... 604-257-8130 Karen Magnussen...... 604-987-7529 Dunbar...... 604-222-6060 Lynn Valley...... 604-987-7529 Evelyne Saller...... 604-665-3075 Memorial...... 604-987-7529 False Creek Centre...... 604-257-8195 Mickey McDougall...... 604-987-7529 Gathering Place...... 604-665-2391 Ron Andrews...... 604-987-7529 Hastings...... 604-718-6222 Seylynn...... 604-987-7529 Hillcrest...... 604-257-8680 Kensington...... 604-718-6200 North Shore (West Vancouver): Kerrisdale...... 604-257-8100 Gleneagles...... 604-925-7270 Killarney...... 604-718-8200 West Vancouver...... 604-925-7270 Kitsilano...... 604-257-6976 Marpole-Oakridge...... 604-257-8180 Richmond: Mount Pleasant...... 604-257-3080 Cambie...... 604-2388399 Ray-Cam Co-Op...... 604-257-6949 Lang Centre...... 604-233-8910 Renfrew Park...... 604-257-8388 Hamilton...... 604-238-8055 Roundhouse...... 604-713-1800 Sea Island...... 604-238-8000 Strathcona...... 604-713-1838 South Arm...... 604-238-8060 Sunset...... 604-718-6505 Steveston...... 604-238-8080 Thunderbird...... 604-713-1818 Thompson...... 604-238-8422 Trout Lake...... 604-257-6955 West Richmond...... 604-238-8400 West End...... 604-257-8333 Please Note: For all other regions in B.C. call your local health centre or West Point Grey...... 604-257-8140 check Blue Pages or Yellow Pages for your local YMCA/YWCA.

Page 32  HealthLinkBC  Physiotherapy Association of British Columbia 8-1-1 (or 7-1-1 for the deaf and hard of hearing) To help you find a physiotherapist. healthlinkbc.ca bcphysio.org Free of charge in BC Click: Find a Physio/Clinic. No referral is required. Some clinics (called mobile clinics) will Translation services are available in over 130 languages. come to your home. A nurse answers questions about non-emergency health concerns 24 hours a day. A dietitian answers questions about healthy eating, food or nutrition. 9:00 am–5:00 pm Monday to Friday. A pharmacist gives information about medications, their use, and side effects 5:00 pm–9:00 am seven days a week. Physical Activity Services at HealthLink BC provides general physical activity information and professional guidance to residents of British Columbia. Qualified exercise professionals are available by phone or email. 9:00 am–5:00 pm Monday to Friday.

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For more copies, go online at vch.eduhealth.ca or email [email protected] and quote Catalogue No. BE.250.F519 © Vancouver Coastal Health, March 2021

The information in this document is intended solely for the person to whom it was given by the health care team. vch.ca