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Great Steps℠ Fall Prevention Program
Patient Case Study


Gene is an 84 year old male who had three falls in the last two months. He has been to the hospital
for falls, to treat an abrasion and contusions. He followed up with his physician the next day due
to his concern with these changes. He has also expressed a desire to continue to remain in his own

His physician initiated Great Lakes Home Health to evaluate the patient in his home. The physical
therapist initiated the Great Steps℠ fall prevention program to identify the cause of the increased
falls. An advanced assessment was conducted which included BEST testing, reactive compensation
strategies, positional testing and Vestibulo-ocular reflex test (VOR). The use of these assessment
tools assisted to identify the root cause of the falls. Medication review showed contributions to the
falls from pain medication. His physician was contacted and med adjustment was implemented.
The history of TIAs and age affected his sensory orientation, which affects his balance. With the
causes identified, the physical therapist and physician put a plan in place to decrease the falls and
improve balance, strength, gait and vision.

Prior to interventions the patient was relying on furniture and walls for support. A cane and
walker were introduced for balance and safety. This helped with the patient’s fear of falling again.
Exercises were implemented to increase strength and endurance. Due to the patient’s gait being
wide, with shuffling and poor posture, exercises were implemented on to improve his problems.

With several weeks of therapy visits, home exercises, along with education, the patient
demonstrated progress with no reported falls two weeks after the interventions were implemented.
The patient also self-reported an increase in self-esteem as well as safety in and out of the home.

Great Lakes Caring Home Health was able to help this patient reduce his risk of falls, regain
his strength and balance, and allow him to safely care for himself.


Presented by Sarah Thurston, LMSW
Great Lakes Caring Director of Education
October 2017