Fall risk/balance assessment

2024-08-14T10:11:55-07:00

Greetings, My colleagues and I are seeking information on best practices. We work with adults in the vocational rehabilitation department of a state agency, most of the work is center based or within

Fall risk/balance assessment

ALLEN Deana * OCB All Messages By This Member #2001 开云体育 Greetings, My colleagues and I are seeking information on best practices. We work with adults in the vocational rehabilitation department of a state agency, most of the work is center based or within the city.? The O&M staff is curious how O&Ms from similar backgrounds address balance concerns. Specifically, we would like to know how others assess and serve individuals who have a history of falls that cannot be accounted for by loss of vision alone. Our agency does not require medical records from our clients so we cannot glean any information from that source. Do you seek assessment from physical or occupational therapists? Which professional formal balance assessment is most appropriate for orientation and mobility? ? I know liability is a state-by-state issue, but what is your understanding of what can occur if an individual is injured after falling when they present with a fall history?? Any information or direction would be greatly appreciated by the O&M staff.? We want to serve our clients as safely and effectively as possible by addressing any balance concerns that might impact their training. ? Deana Allen COMS ?
Dona Sauerburger All Messages By This Member #2002 开云体育 Wow, Deanna, great question, I look forward to some wisdom from folks on the list. For myself, I always refer to PT, we (O&Ms) are not prepared to address those problems. ?I have once or twice suspended my training till I’m satisfied that the balance issue is being addressed, as I’m not comfortable being responsible for their safety if they have problems with falling, but that’s rare, and I will resume before the balance issue is completely resolved if I feel confident I can take precautions recommended by the PT. — Dona ————————— Dona Sauerburger, COMS Certified Orientation and Mobility Specialist for the blind www.sauerburger.org toggle quoted message Show quoted text On Aug 14, 2024, at 10:42 AM, ALLEN Deana * OCB <deana.allen@...> wrote: ? Greetings, My colleagues and I are seeking information on best practices. We work with adults in the vocational rehabilitation department of a state agency, most of the work is center based or within the city.? The O&M staff is curious how O&Ms from similar backgrounds address balance concerns. Specifically, we would like to know how others assess and serve individuals who have a history of falls that cannot be accounted for by loss of vision alone. Our agency does not require medical records from our clients so we cannot glean any information from that source. Do you seek assessment from physical or occupational therapists? Which professional formal balance assessment is most appropriate for orientation and mobility? ? I know liability is a state-by-state issue, but what is your understanding of what can occur if an individual is injured after falling when they present with a fall history?? Any information or direction would be greatly appreciated by the O&M staff.? We want to serve our clients as safely and effectively as possible by addressing any balance concerns that might impact their training. ? Deana Allen COMS ?
Chris Tabb All Messages By This Member #2003 开云体育 Hi Deana, Wherever there is opportunity to collaborate with PT’s, OT’s, the local VA, local agencies on aging, etc., I encourage you to reach out to see what is already available and what folks are willing to work on together. We just presented for our county aging services in one of their fall prevention programs; they request this annualy to address the role of vision loss in connection with falls.? Whatever you do with clients, it is important to clarify that you are not a PT, OT, MD, etc. (unless you also hold and maintain those additional credentials). We encourage people to be active and move, helping them address areas that make that possible is also part of what we do (just this guys opinion). I do regularly issue white, support canes from Ambutech. I set the length of the cane to the break in the wrist as learned from OT’s and PT’s, but always tell the client that I am not a PT, OT, doctor, etc. and encourage them to talk with their doctor or specialist to verify it is at the correct height. If more support is needed, I encourage them to consider a rollator style walker (but I do not issue those).? When I have worked in organiztions where there are PT’s and OT’s on staff and in the same facility, the collaboration is easier. Arranging co-appointments to observe one another working with the learner is also a helpful strategy.? Just as I encourage regular visits to the eye care specialist to monitor eye health, the audiologist to maintain hearing health, the same must be true if physicsl mobility challenges are present, whether orthopedic, neurological, neuropathy, etc. Helping them identify who can best meet their physical mobility needs is part of our responsibility, as well as connecting them with programs and activities that can develop their balance and reduce risk of falls.? Here is a link to one of the LiveBinder tabs with information and programs to consider…

Sent from iPhone

Chris Tabb

chris@...

512.660.2750

开云体育

This is indeed an issue of concern, and I champion your research. I will offer some of my experiences with this issue. I do not know that I can propose any profound solutions.

When I first became a COMS, my first employment was with Envision Vision Rehabilitation Clinic in Wichita, Kansas. Envision is a multi-faceted private, not for profit, service provider for people who are blind and low vision. In addition to my position as ?COMS, they had a staff OT, and an OT assistant who worked with her. Both of these individuals were very competent. Envision additionally had several PTs under contract. If clients had balance issues, and many did, I was expected to refer to OT or PT depending on the nature of the issue. I found the OT consultations to generally be useful. Most of the time, PTs simply approved whatever I was suggesting.

I left Envision in 2017 and worked as a School COMS under contract with six school districts. All districts of course also had OTs and PTs under contract. I could occasionally consult with them, and generally felt I got the support I needed. I left ,my school practice in 2021. I am now semi-retired and work in private practice. I office out of a very small not for profit based in the Topeka, Kansas area. I do not have OTs or PTs on staff or under contract. I can suggest to clients that they consult an OT or PT, but the decision is really their’s. I can not force them. I have never had to discontinue work with anyone because they refused to follow up on this suggestion, but I would do so if it were to occur and I felt the consultation was needed.

The biggest issue I have had in private practice is that, if the individual has been prescribed and fitted with a support cane by a PT, and has then become legally blind, I want them to use a white support cane for identification purposes. I order a support cane of similar design and weight to the non-white cane that they have been using, and I adjust it to the exact height the PT has set their non-white cane to. ?I have run into a couple of vendors who will not sell white support canes to me because they only will sell under a prescription from a PT.

I continue to pay for a full medical liability policy through HPSO. I have no experience, however, with complaints or suits occurring because a client has fallen.

Michael Byington, Certified Orientation and Mobility Specialist (COMS)

> President of Kansas Association for the Blind and Visually Impaired, Inc.

>> Membership Coordinator for Friends In Art of the American Council of the Blind

>> 712 S. Kansas Avenue

>> Suite 414D-F

>> Topeka, Kansas 66603

>> (785) 221-7111

>> ByingtonCOMS@...