Embracing Life's Balancing Act

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Unknown
Welcome. Welcome, everyone. Just going to give it a few more minutes or so for people to come on. Welcome.

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Unknown
All right, well, everyone, let's get into it. Okay. So hello. Hello. Welcome to the webinar Embracing Life's Balancing Act. I'm Megan. Claire Chase and I and the breast cancer program director here at Share. And I'm also a cancer survivor. Now, this webinar will address the effective strategy as we can put in place to reduce our chance of falling and of injury in the event that we do fall.

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Unknown
We know many in the cancer and chronic illness spaces can experience falling because of an array of issues such as aging side effects from medications or side effects from chemotherapy like chemo induced peripheral neuropathy. So for more information about sippin humanity's peripheral neuropathy, please make sure to check out our past webinar on understanding and managing sippin. And Victoria, we'll put that in the chat for you all now before the presentation begins to tell you a little bit about Share.

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Unknown
Share is a national nonprofit that supports, educates and empowers anyone who has been diagnosed with breast or gynecologic cancers and provides outreach to the general public about signs and symptoms. Because no one should have to face breast, ovarian, uterine, cervical or metastatic breast cancer alone. For more information about upcoming webinars, support groups, podcasts and our help lines, please visit our website at Share Cancer Support DOT org.

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Unknown
Now all participants will be muted during the presentation. Once our fabulous speakers are finished presenting, we'll begin the Q&A discussion. So feel free to ask any questions through the Q&A section at the bottom of your screen. And remember that our speakers are unable to give specific medical advice, so please keep your questions general in nature. The chat is enabled so please, you know.

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Unknown
Comment. Interact with each other in the chat, but make sure you're selecting everyone and not host panelists and make sure you use that little dropdown arrow in the chat sections and choose everyone. We also have closed captioning available and you can enable this feature by clicking the live transcript button at the bottom of your screen and selecting the subtitle option.

00:03:00:05 - 00:03:30:13
Unknown
The webinar is being recorded and will be available on the share website soon. Now before we get started, we have some poll questions for you. All right. All right. So our first poll question is, please tell us about yourself. Are you a patient? Are you a caregiver? Are you a family member? Are you a friend? And argue a health care professional?

00:03:30:15 - 00:04:05:17
Unknown
And then our second question is, have you ever experienced a fall? I'm going to say, yes, I have. I have multiple falls. So we're going to give that a few moments for you all to check, which one applies to you. Right. Okay. Lots of patients here today, some family members, some friends and. Wow. Okay. I'm just, you know, kind of split there.

00:04:05:17 - 00:04:32:14
Unknown
Some have fallen and some have not fallen. So this is really great. We're going to learn more about falls today. And I'm excited to have our first presenter speak. So, Aiden, the screen is yours. Wonderful. Thank you. Megan. Claire. I'll go ahead and share my screen here in just a moment. So here's me. Great. This is wonderful. So a little bit about me.

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Unknown
I'm a false prevention consultant and I'm also a master trainer in an evidence based program called A Matter of Balance. I've been working in the prevention field for over ten years now, and I'm currently working on a couple of different grant projects in New York State. But I have consulted the federal, local and state levels for fall prevention.

00:04:53:23 - 00:05:16:07
Unknown
I'm also trained as a contest diving coach, which is a way of having end of life conversations to enhance quality of life even until the very end. So without further ado, let me bring up my science and we'll go ahead. All right.

00:05:16:09 - 00:05:42:15
Unknown
So everybody's seeing that. Okay, wonderful. So I'd like to ask that question again about how many of us have fallen in our lifetime. So maybe you're thinking of a certain time period. But I would imagine if we asked that question in the course of your entire life, how many of us have ever had a fall? Can any of you you know, even if you don't remember, sometimes you get the naysayers that say, Well, I've never in my whole life.

00:05:42:15 - 00:06:12:12
Unknown
But even thinking back when to when you were a child, I imagine when you were learning to walk. Megan Clare Yeah. So all of us at some point have probably had a fall. It's just a matter of as we've gotten older or as we're dealing with a different kind of condition, the falling affects us differently, right? So that's something that I just want to bring us all into the same page about and make sure that we recognize that this is a shared concern.

00:06:12:14 - 00:06:33:05
Unknown
This is something that happens in life. It's nothing that we need to be embarrassed about or, you know, there's all of these, you know, think of the Three Stooges are all the time in our media, right? That we see that falling is funny or embarrassing somehow. But truly, it's not. It's just something that is something that's going to affect us quite differently depending on where we are in life.

00:06:33:07 - 00:07:00:23
Unknown
That's the first thing I want to do, is just kind of peel back that stigma that there is around falling and it being this, this, this kind of scary imagery. Lisa Sure. As a kid, Yeah, exactly. Yeah. Thank you. Joni Thank you. Exactly. So that's one thing I wanted to establish. The next thing is that I wanted to share a story, and I invite you all to think of your stories as you are listening to mine.

00:07:01:01 - 00:07:31:20
Unknown
Because the chances are that this is not a necessarily unique story. It's something that you probably know somebody or you yourself maybe have experienced. So essentially, these photos are photos of my grandfather. His name was Howe Jones, and he was very much a horseman. He was into harness racing. If any of you live anywhere near Yonkers or the Meadowlands, Ohio, those are places where there's some pretty big horse tracks that have a lot of history.

00:07:31:22 - 00:07:51:03
Unknown
And so his role, you know, for generations, his family have been into horses. He has his father had a job taking care of the horses at a a rural cemetery in Kentucky. And when they told him they were bringing in a truck, an engine truck, it was they're going to get a vehicle. He said, well, I don't want the job anymore.

00:07:51:06 - 00:08:12:23
Unknown
He moved up to Ohio to find a job with horses. So a long history of that in his family. So as you can imagine, he was on a farm. He was a pretty active guy for the majority of his life. You can see him to the left here when he was younger. And it was something that as time went on, you know, his parents didn't really live out of their fifties.

00:08:13:00 - 00:08:30:23
Unknown
So people didn't necessarily expect of this generation. Right. They weren't expecting that they would ever see a day where they lived until they were eight years old. And so I think what that challenge brought as a society, as people were coming out of the Great Depression, there was a lot of other things that people were concerned about and falling.

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Unknown
When you were getting older, you necessarily weren't going to need to worry about well, as it as it came to be. As he started getting older, he, you know, gravity is weighing on us our whole lives and gravity starts bringing us down. And if you've seen people who are doing the slump, have you ever seen people that are walking this way?

00:08:49:17 - 00:09:05:20
Unknown
They're already kind of like halfway there. Well, that's how he started to walk. He started so he was going out. You know, he would you would drive his little golf cart. He would drive around, you know, look, check on his horses every day. But over time, it was getting more and more difficult. He was starting to have some issues.

00:09:05:20 - 00:09:31:10
Unknown
You could see him kind of shuffling around. And, you know, the family that was around him had good intentions and they wanted to figure out how to put in place some some strategies that would help him. But they didn't really know a lot about this topic. So they they tried to help as best they could. They bought him a walker at CVS and they saw he was kind of having this mobility issue.

00:09:31:12 - 00:10:00:01
Unknown
And now remember, remember I said that because these are points that I'm gonna go back to later and then they had tried to to just set up his house where in a way that, you know, he could stay at home. So unfortunately, one of the things that that happened is the the walker caught on the lip of a doorframe as he was going through it and the it it rolled right out from under him and he went down onto a stone floor.

00:10:00:03 - 00:10:16:19
Unknown
And, you know, one of his sons was home at the time and no, you know, dad, we got to get you up right away. Remember I said that, too, because that's going to be another point to come back to. And they had tried to move him to the car so that they could take him to the emergency room.

00:10:16:19 - 00:10:36:15
Unknown
So they could tell that there was probably a significant injury. So he gets down there to the county hospital and they take one look at him and they said, boy, you know, yeah, this is going to be more severe. We need to send you on to the big hospital in the next county. That is a trauma center where they're going to be able to help more and more effectively.

00:10:36:17 - 00:11:02:12
Unknown
I see you got a chart here telling us made you a stronger person. Wisdom is learned. Absolutely. Yeah. With with each each scenario. Right. We learn something. Exactly. Exactly that. And so anyway, so they sent her down to the trauma center. And once he gets there, they take a look at his medication list. This paperwork, they get in touch with his primary doctor and they go, Why in the world are you on all of these medications?

00:11:02:12 - 00:11:23:05
Unknown
He's on like eight different things and they're, you know, trying to get him ready for surgery because he's got a fever, a fracture of his his right leg. He had a shoulder injury as well. But the the leg was the thing that really was going to require surgery. So he goes through, you know, a couple of days of getting ready for that.

00:11:23:07 - 00:11:44:19
Unknown
They they do the surgery now. He had already had some sensitivity in his throat. He had been losing his voice for a couple of years when they put that that the tubes there to do the surgery, they ended up damaging his trachea and he couldn't swallow when he woke up from the surgery. And so the next step, they're after about four days and that they had given him an I.V. fluids.

00:11:44:19 - 00:12:08:18
Unknown
But he's not getting any nutrition. They they figure out what we can't because of whatever inflammation and damage is here, we're not able to get a feeding tube in here. So. All right. We're going to have to put in a peg to fill your stomach. So they they go through that surgery in that process. And after a few weeks, you know, a couple of weeks there, then he enters a rehab facility that's closer to his home.

00:12:08:20 - 00:12:31:19
Unknown
Yeah. Thank you, Bridget. Yeah. And so from there, he spends a couple of months in this rehab facility. They they've, at this point, adjusted his meds. He's had seizures. And this whole you know, he's in this institution in an unfamiliar environment, and he's he's really not fully with us at this point, is talking about he's going to get on a boat.

00:12:31:21 - 00:12:49:09
Unknown
That was the thing. You know, last time I talked to him, I got to find my wallet because I got to get you know, when the boat comes in, I got to was he was getting ready for a journey. And so they tried to do physical therapy with him. But because he was cognitively just not all there, they were really limited in what they were able to do for him.

00:12:49:09 - 00:13:14:09
Unknown
And so the decision was was getting ready to be made to send him home where he was going to end up being primarily in a bed with with not very much mobility at all. So in preparation for that, they start having those conversations, The family starts to get things in place for the home. And he he starts to have some internal bleeding at some point at this point.

00:13:14:09 - 00:13:38:21
Unknown
And they say, okay, well, it looks like we're going to send you back to the hospital. And he, you know, on the way there says to one of his sons, yeah, I don't know this. I don't know if I'm going to get here. And sure enough, he ended up getting sepsis and passing away. His fall was in October of 2015, and he passed away at the end of January of 2015.

00:13:38:23 - 00:14:04:12
Unknown
So why am I sharing this really sad, depressing story with you? Because there's a lot to be learned from it. And because I want to not just scare people, but I want to prepare people so that, you know, all of the things possible that you could do to prevent a fall. And then if you do have all the things to know so that you can be sure to have the best health outcomes possible.

00:14:04:14 - 00:14:26:14
Unknown
So one thing to know, the good news here we go for the light is the light at the end of the tunnel here, falls can be prevented. Statistically, we know this. The research is very clear on this. There is a lot of things we can do. The biggest challenge, Tiger, can you slow down and enunciate better? Okay. Thank you, Karen, for that feedback.

00:14:26:14 - 00:14:51:05
Unknown
I will try to do that. All right. So falls can be prevented. And there's some statistics out there that suggest that potentially up to 70% of falls could be prevented. So that's great news because that means that 70% of the time we could look back and say there's something we could have done here that would have changed the outcome.

00:14:51:06 - 00:15:07:14
Unknown
And that other 30% of the time, we can probably do something that will have made it easier for us to get through it. Right. Maybe we have to fall because falling is just going to be a part of life when we live on a planet that it has gravity, but there is something that we can do about it.

00:15:07:16 - 00:15:27:02
Unknown
We can be proactive and make sure that even if we do have those little bumps in the road along the way of life and have a fall, that we can minimize the impact. The number one thing that I want you to know is that exercise should be looked at as like a medication, Right? You're going to take your blood pressure pills for that.

00:15:27:02 - 00:15:49:05
Unknown
You're going to take whatever other medications you're taking for you as your doctor is instructing you. Movement is medicine for sure. Even when you don't feel good, it might actually help us feel a little better. And you should also know that see here my aunt has been prone to falling. She has been diagnosed with liver cancer just recently.

00:15:49:06 - 00:16:07:16
Unknown
I'm concerned for her that this can happen again if she gets more treatment. Yeah, Bridget And we can come back to some discussion at the end about that. But that's very much going to put her at higher risk. But I think you'll find as we go through this that there are things that we can do about it. So a couple of points here.

00:16:07:18 - 00:16:29:03
Unknown
You know, we want to build essentially what we call in our modern balanced program. No faulty habits, right? We want to create these habits in our courts of our day. I want to teach people to put on their fall prevention goggles and be able to navigate around more safely. And so movement is one of the best ways that you can do that.

00:16:29:08 - 00:16:56:20
Unknown
Dependent no matter where you're at, Right? You can do things when you're seated. You can do movements when you're in a bed. You know, you can get your your rotating your ankles. You know, these are some really important joints. Any of your hinge joints are going to be super important. I would say that physical therapy referral is something that you would want to ask your doctor for, to figure out for your body what exactly is going to be the very best option for you in that regard.

00:16:56:22 - 00:17:23:01
Unknown
You other points. So as you're listening to my grandfather's story, here's some things that could have been different for him that could have made his trajectory quite, quite different. Number one is, as it was noticed, that his posture was changing and his his mobility was changing, he could have joined a program in today's world with luckily even more so than ever before, We have a lot of virtual options.

00:17:23:01 - 00:17:47:11
Unknown
So even if it feels difficult to get out of the house, you can join via Zoom, You can look at something on YouTube. There's a lot of options or inspiration on how to move and how to incorporate movement throughout your day. So that's number one. He could have done something differently there. All right. What we've got in the chart here, thank you for putting the link there for the YouTube.

00:17:47:11 - 00:18:16:15
Unknown
I'm going to show that here in just a moment. Yeah. Recuperation, physical therapy. And I think that's excellent. Yeah. So there we go. Another testament to physical therapy being super importance. So that's one thing that could have been different for him. Another thing that gets overlooked a lot, assistive devices. Number one, I'd like to just take away any type of stigma people have about, you are old or we all like I'm a cripple.

00:18:16:17 - 00:18:40:17
Unknown
I've used a walker. Well, you know what? That's your tool. What are your tools for freedom, right? Because that's going to help you stay safe and help you continue to do activities that you like to do. So a walker is absolutely essential if the doctor suggests that, you know what? Here's what what you should know. Do not just buy one at CVS and assume that that's the best one for you.

00:18:40:18 - 00:19:01:18
Unknown
What you need to do if you are going to have a mobility device, you need to have it fitted by a physical therapist. It needs to be, you know, don't don't take your, you know, your aunt or your sister or somebody have one lying around and they don't need it anymore. If you do that, take it to your physical therapist and ensure that it's measured to your specific body.

00:19:01:20 - 00:19:21:13
Unknown
Because what can happen is that it could become more of a hazard than a help if it's not the correct kind of walker, because there's a variety of them out there. So in my grandfather's case, they had him using one that was not the correct kind of walker for him, and it was slipping out from under him quite, quite frequently.

00:19:21:18 - 00:19:44:02
Unknown
And that ultimately was what led to his demise, was that that Walker was not fitted for him. And it was not the correct kind of walker for him. So that's a really important note. Another thing I'd love to if you've got to respond in the chat, what do you think I'm going to say next? So he has the fall, he's on the floor and people rushing to pick him up off the floor.

00:19:44:04 - 00:19:56:07
Unknown
Anybody have any thoughts on that? Why is that not the best thing to do?

00:19:56:09 - 00:20:31:01
Unknown
Yeah. So the reason that's not okay, somebody is responding. They could be hurt. Something could be broken. Exactly. Thank you, Marianne. Cheryl. So that's exactly it, right? Because what ended up happening for him, you can hurt yourself and injure him more. Yes. Thank you. That's exactly it. So what ended up happening for him? He had this complex fracture of his femur and the bone of his femur ended up moving almost all the way down to his knee, which is one of the reasons why the county hospital looked at him and said, wow, this is a significant trauma.

00:20:31:01 - 00:20:51:21
Unknown
We got to send you somewhere else. And it was just that much more time before they could really address what was going on for him. Don't pick them up. They can be more hurt. That's exactly right. So if you do end up having a fall, you need to take a moment and just kind of assess. And if people are there around you, don't let them pick you up off the floor just yet.

00:20:52:02 - 00:21:17:22
Unknown
Just take a moment and see how you're feeling. And then if there's if there is a significant injury, then it's really important for that injury to be stabilized by emergency services. You want to bring EMS, then you want to let them stabilize the injury before they pick you up and take you anywhere. Any questions on that?

00:21:18:00 - 00:21:39:01
Unknown
So the next thing that could have gone wrong for him, as you might imagine, when he gets to the hospital and he's on many medications and he's not even really sure what they're all for, his doctor. Got a doctor here and he had a doctor there and the specialist didn't communicate with the primary. So he was actually on more ills than he needed to be.

00:21:39:03 - 00:22:06:18
Unknown
This is another really important factor, because if you are on four or more medications, that is a risk factor for falling. And so it's important to know, you know, that your doctors are talking and in a day and age today, we're getting better at this because there are more and more electronic health record systems in place that are helping us to catch these type of things before they become disastrous.

00:22:06:19 - 00:22:47:01
Unknown
So in his case, some of the medication interactions were probably not helpful for him for his balance right. And so that's another thing that could have gone differently. So the other thing was, you know, after he was in this kind of compromised state, he wasn't really able to get up and move. And while obviously we want to be careful with ourselves because the recovery from a surgery is a significant thing, we do want to try to move when as we can and get right into doing that, because there are plenty of studies now that show that when we're able to do that, we do have better health outcomes.

00:22:47:03 - 00:23:16:06
Unknown
And so this is a place where we go back to that exercise as medicine, because if you're doing Taichi, for instance, is a really excellent way to sort of challenge your balance and then get back on balance. So you're you're practicing these cross hemisphere movements. So do you all, if you know anything about neuro brain science, when we do this kind of move, I know my hand is still here because my two sides of my brain are talking to each other.

00:23:16:08 - 00:23:47:10
Unknown
When you do this, you know you're getting your two sides of your brain to communicate. And then when your feet are going, your practice seeing that movement of catching yourself from a fall, essentially. So the next thing I want to say, you know, you're hearing all these things also, Michelle practices tie to your ear. You're there. So that's the key to finding something that you enjoy that's going to give you opportunity as when you set up those patterns in your brain, it's going to be easier to catch yourself from a fall.

00:23:47:12 - 00:24:22:19
Unknown
So I'm going to show this video in contrast for you to my grandfather's situation, that was pretty much the worst case scenario. I want to show you the best case scenario. This is a this is called this story. And it's it's kind of what what could go right if everything went right for you, a different kind of an outcome.

00:24:22:21 - 00:25:12:07
Unknown
You can't hear it. I can share for you. Yeah. Aiden, We'll let Victoria share it so we can make sure we hear the sound. You can't hear the sound. We can't hear it. okay. now we can. Well, my story begins in 2009. In the fall of 2009, all of a sudden, my back went. I had had two previous climbing activities and I couldn't move.

00:25:12:09 - 00:25:39:06
Unknown
And tried different things and it didn't work. And finally I had surgery in February. I ended up with a cane and I was constantly falling that in January 2015, January 20th, I took my little dog's £10 dog outside to go potty playing, find slippers on, and she started to fall and I ran to get her. And of course I didn't get very far.

00:25:39:06 - 00:26:13:12
Unknown
I get down on the ice and I broke my femur on my right leg. I went to rehab. I had three months of private physical therapy, and I was still on a walker. I still couldn't walk. It was so frustrating and it just wasn't fun. I didn't go out of the house. I was like, I became very down in the dumps and I, I Walker became my friend, and I hated it.

00:26:13:14 - 00:26:41:11
Unknown
My daughter found an ad in the paper about a better balance course, and she said, I think you should try it. And I not very nicely said, come on, Kate tried everything else. What do you think stupid course on balance is going to do? And she said, Well, just try it, Mom. So I went toting my little walker, and lo and behold, it did really good.

00:26:41:12 - 00:27:02:21
Unknown
About four weeks into the program, it's an eight week program. I was using a cane and I thought, Whoa, this is pretty good. That ended. I went down to the Jersey seashore. I walked ten miles on the boardwalk because it was old car weekend and I didn't want to miss any of the cars. And I thought that was pretty good.

00:27:02:21 - 00:27:41:10
Unknown
I hadn't done anything like that in years. There's something about this program that teaches you to think as you're doing and not just take it for granted. That's what I think we need as we age. I think we need to keep in tune with our bodies. And we seem to we we don't. One of the success stories we've had from this program is our is standing to gained that confidence to be able to know what to do and she was no longer is fearful of falling she's gone on to be a coach for the program and as well as participating in the next program that we have which is Taiji Kwan and what it does,

00:27:41:10 - 00:28:03:18
Unknown
it helps people kind of get off balance and to get back on balance so that you're learning what you need to do, that if you should start to lose your balance, you can regain it and you're less likely to fall. That's really powerful. First day I said, This isn't me. I'm not a yoga person. I don't do tai chi, I am not an earthmoving and now I am.

00:28:03:18 - 00:28:30:18
Unknown
And there's nothing. I took the Taiji with an about two and a half months. I didn't even use the cane. And that was the middle of winter. And it starts very slowly and starts with just like swaying your ankles, learning to feel your muscles, and you do feel them and they don't hurt. It doesn't give you pain. Just recently I was certified.

00:28:30:20 - 00:28:53:01
Unknown
Last April, I was certified in the Better Balance and now I just was certified in Taiji about a week and a half ago because I want to teach. I think people should I want them to be able to be as mobile as I am, to be able to realize they can get up and move. I wasn't able to.

00:28:53:06 - 00:29:14:08
Unknown
And now I am. I can walk. I go shopping, I can do all the things I like to do. I'm free. I can do what I want to do. I don't have to sit in that foolish house and feel sorry for myself. I really, really didn't think it would work. And then I took these courses and now I am here again.

00:29:14:10 - 00:29:56:12
Unknown
And I'm me again. And thank you again for helping with the technical aspects of those video. So great. So I think you can see the contrast there, right? You can see the difference between all of these seniors come to the emergency room, both. Sorry, was that a question? No. Bit scared. You're okay. Keep going. Eight and like. All right.

00:29:56:14 - 00:30:40:01
Unknown
All righty. Go find my slides. Yeah. Okay. So any thoughts or any reaction scenes to that video? Do you see, you know, basically the contrast there, how different it was for Sandy when she was able to find the right resources and figure out the right things to do. So big difference, right? Something that I think is really important to point out to and what she is discussing about the matter balance program is is very much, I think, a universal experience that when we figure out what works for us.

00:30:40:03 - 00:31:04:14
Unknown
Right. And when she was open minded to say, well, you know, I'm not a nurse, my friend, but, you know, she found something that was making her feel better. So this is really the key thing to that I think is important to know about fall prevention, that this is really you know, many of you probably heard of mindfulness, right when we were kind of looking at that, that body and brain, mind, spirit, the whole connection when everything comes together in harmony.

00:31:04:14 - 00:31:27:18
Unknown
Right. And it has to be different for each one of us. So while there are a lot of best practice things out there for fall prevention that we know according to the research, the best solutions for this issue are going to be personal and practical, right? It's not going to be realistic if, you know Zumba is not your thing, but you're like, I got to get to the Zoom class so I don't have a fall injury.

00:31:27:18 - 00:31:48:12
Unknown
Well, that's not necessarily going to be realistic. It has to be something that you're going to enjoy doing. Right. And it also doesn't mean you have to be running marathons there. Again, it's not anything you have to be super ambitious about. There are really small, simple movements. You can do a lot of them from a seated position where, you know, you can create more flexibility and mobility.

00:31:48:14 - 00:32:11:06
Unknown
And the reason why this is so important is if you do have a fall and you've already set up all of these things in the best way possible, there's pretty clear evidence that you're going to have less injury and you're going to have an easier recovery time from the injuries and any surgeries that are necessary if your body is already in this kind of flexibility state, if you're already practicing some of these moves.

00:32:11:06 - 00:32:32:23
Unknown
Right. Okay. So can a program like that be used for someone with dementia? Jodi That's a really good question. So be a matter of balance. Program in particular does require some decision making that can be difficult. And it's conversation based sort of like a support group. Sometimes people with dementia are not really going to get that much out of it, but certainly some of the movements would be helpful.

00:32:32:23 - 00:32:57:07
Unknown
And there are a variety of other exercise classes. There's even seated TAICHI classes that they've done with dementia patients that are very effective and very helpful. Are there many physical therapists that work specifically with cancer patients? I would take to that to the share crew. I think they probably have the best resources for that. And Cheryl, my physical therapist, comes to my house and shows me things I can do with machines at the gym.

00:32:57:08 - 00:33:16:20
Unknown
Awesome. And they give me the incentive to continue even when I don't want to do anything. Exactly. And having that kind of partnership and support system is also really key. And we definitely see that when people are able to create that kind of support network, they are also going to have better health outcomes and fewer false. All right.

00:33:16:20 - 00:33:40:21
Unknown
So this is just a little bit if we have time, just a couple of minutes here about what was going to work for you. You know, what is your specific scenario? What do you know works for you? Well, because one of the things that's beautiful about program, like a matter of balance or any time you're in a community environment or even an online support group and you have an online community, is when you share those best practice ideas with each other and it can be peer led.

00:33:40:23 - 00:34:02:19
Unknown
That's where that magic happens, right? Where you might learn something or you might share something that really affects pain and really helps the person next to you to to make a real difference in their day. So some people have already been doing that. So Bridget included the name of the organization again for Dancing. So that particular program is called A Matter of Balance.

00:34:02:21 - 00:34:26:17
Unknown
That program is available in most states. It's also now available virtually. And so it's certainly something that you could join a lot of times being offered through an area agency on aging. It may also be offered through some health care systems. And so if you would like to be connected, that program specifically, then by all means, yes, thank you for putting that link.

00:34:26:17 - 00:34:46:02
Unknown
So there's the link for the larger program. You can learn more about it, but if you want to find a local community that's that's doing it, I'm happy to help put you in touch with the correct person for your location. So Aiden, we can get to your closing soon, so we make sure we have enough time for our second employer.

00:34:46:04 - 00:35:07:23
Unknown
You're there? Yes. Yep, That's it. So thank you very much. Please be touch, if you'd like, with any additional questions or thoughts or, you know, we can definitely make more community resources available to you all for this issue. But I hope this has been helpful for you and for us alone. Thank you so much, Aiden. All right, everyone.

00:35:08:01 - 00:35:39:12
Unknown
I like to hand the screen over to our next speaker. Janvier. Janvier, the screen is yours. Thank you. So. Hello, everyone. Good afternoon. My name is Janvier Hoyes Forester. I am a doctoral student at the New York Institute of Technology, currently pursuing a degree in occupational therapy. I'm actually in my last semester, so I'm doing my capstone now under the guidance of Megan Clear and a very pertinent topic of my capstone is fall prevention and fall preparedness.

00:35:39:12 - 00:35:56:05
Unknown
Right? So making sure that we do all the steps to reduce the risk of falling or also prepared and confident in our ability to do it safely because falls are inevitable and we have to, you know, come to terms with that and say, okay, well, if I do fall, am I going to be safe? Do I know how to do it?

00:35:56:05 - 00:36:38:02
Unknown
Do I have a plan or so I'm going to get into my presentation. Okay. So today we're just going to talk about how to fall safely right after you get a diagnosis when you're in treatment and when you're in survivorship, because falls will happen throughout. Right. So I want to preface this by saying it is a safe space, even if you haven't experienced a fall related to cancer, if you're a caregiver, you know, with someone who may have experienced a fall, this is a safe space for everyone to learn about, for safety.

00:36:38:03 - 00:36:58:18
Unknown
Right. And for prevention. So falling can make you feel clumsy, especially if it happens frequently. It can make you feel fearful, frustrated. And those are all valid feelings and those are natural feelings. So I just wanted to reiterate that it's okay and you may fall throughout this journey, but this presentation is just to help you feel safe while you continue to heal.

00:36:58:19 - 00:37:26:08
Unknown
Right? So I want to speak about side effects and sensitivities. And I know that you didn't kind of touched on this topic a little bit, right? Well, more than a little bit when she spoke about how their medications that will have us feel at certain times the way. So if we experience dizziness, if we develop CPN from certain adjunctive therapies like chemotherapy or radiation, those will affect our body and our bodies.

00:37:26:08 - 00:37:51:21
Unknown
Reactions will either cause us to be at a higher risk of falling or will cause it to be more dangerous if we do fall right. So for example, if we're on blood thinners or we're taking chemotherapy, wouldn't actually thins our blood out, we may be more likely to bleed for prolonged periods of time. So if we fall and we get a cut and we're bleeding, we need to make sure that, you know, we have the right systems in place to get help as soon as possible, or we may be more prone to bruising.

00:37:51:21 - 00:38:10:13
Unknown
Right. Because our blood is thinner and we may have internal bleeding associated TPN. So damage to the peripheral nerves that can alter sensation. I know that Sharon has a webinar on the website about 6 p.m. It was from a few weeks ago where they went into depth. So if you want to learn more about it, definitely check that out.

00:38:10:15 - 00:38:26:03
Unknown
But the lack of sensation that we may experience in our hands and our feet can make us insecure about walking right? Because we don't know if we're taking the correct step or if we're feeling balanced. So those are things to consider when we think about fall prevention and fall preparedness. Right? Being aware of the side effects of medication.

00:38:26:04 - 00:38:52:06
Unknown
And so how are we going to protect ourselves? First and foremost, I want us to think about our head as prime real estate, right? So this is the most important part of our body, and this is the part that we need to protect the most simply because of what we mentioned before, the medications. Right? So if our head makes direct impact with the ground, we may get cuts on our head, we may have internal bleeding, and we want to reduce that risk at all costs.

00:38:52:06 - 00:39:19:23
Unknown
We don't want any injuries to the head that can result in more complications. Right. And when we think about protecting our head, we have to make it something that we're trying to do all the time. Whenever we're falling or experiencing a fall, simply because we may be in a certain stage of our cancer journey where we may not have hair, we're experiencing hair loss, or we're in preparation for treatment and we're removing our hair, but we're in survivorship in our hair, starting to go back.

00:39:20:04 - 00:39:36:03
Unknown
But it may not be as full as it was before, right? So hair is a natural barrier, especially when you come into impact or contact with the ground. It may not be as hard simply because your hair is there. So when it's not there, we have to accommodate for that. And how are we going to accommodate for that?

00:39:36:04 - 00:39:53:05
Unknown
We're going to protect our head, right? We're going to put our hands and our arms and we're going to shield our head and our face so that we can limit head trauma or the risk of head trauma. So I can't see you, but I'm hoping we're going to do this together. Right. So there's just a few steps on how to protect our head effectively.

00:39:53:07 - 00:40:15:19
Unknown
So our first step is we're going to lower our head by checking our chin into our chest just like this. I'm hoping you do it with with me to be like our first practice session. Two, We're going to place both of our hands around our head with our elbows directly in front of us. Right? So it's like we're cradling her head and those are the steps like before we follow, like at the beginning of our fall.

00:40:16:01 - 00:40:42:17
Unknown
And as we're descending and going down to the ground, we're going to try our best to turn to the side. Okay, So we're holding and returning to the side. And the reason that we're doing that is because we want the cushion of our arms, right. To take the force of the impact before a head does. Right. So this reduces the risk of head trauma and broken bones now say you're not falling forward or you can't turn to the side quick enough.

00:40:42:19 - 00:41:06:19
Unknown
If you fall backwards, it is okay. You just readjust your hand placement so that it's a little further back right in. You're holding your head and you just don't want it to make direct impact on the ground. And of course, if you cannot, you know, protect your head in a timely manner, if the fall is too quick, just make sure that you contact your medical provider immediately and let them know, hey, look, I've had a injury.

00:41:06:19 - 00:41:25:12
Unknown
Like I fell, I hit my head. Just want to make sure that everything's okay. And I'm kind of briefly going to go over this slide. This is basically saying that we want to go to the side, right? So try for the side. These are all like little catch phrases I made up to help remember it, to make it more easy.

00:41:25:14 - 00:41:47:16
Unknown
So when we fall, we want to try to go for our side because there's more cushion there, right? So on our arms, on our I know that naturally we may try to put our hands out when we fall. I know that I do that sometimes. And that can be very dangerous right? Especially because we're more prone to injuries at like our wrist or dislocation of the shoulder.

00:41:47:20 - 00:42:06:18
Unknown
It can lead to broken bones when we try to catch ourselves. So it's best that we try to land on areas with a little bit more cushion, a And I know that when we're falling, it can be a shock in fear, right? Because it's like, my gosh, I'm falling. Like, what do I do? You know, I want to make sure that I'm okay.

00:42:06:18 - 00:42:29:14
Unknown
I'm want to protect myself. But sometimes natural instinct kicks in and we may deviate from how we're supposed to protect ourselves in the safest manner. And what that deviation can be like tensing our bodies because we're fearful of impact. So we need to make sure that we're breathing. And I know that sounds difficult, but breathing will actually help you go through the motions and it'll help your body absorb the impact better.

00:42:29:16 - 00:42:52:05
Unknown
So if you're tense and you hit the ground, you're more likely to be injured. So I like to say be loose as a goose. Right? Think of this little goose that's in the corner. Want to be loosey goosey, right? Breathe through it. Go with the motion. And as you're going through the motion, I want you to roll. Now, I'm not saying roll about 20, 30 times like you're rolling down a hill.

00:42:52:07 - 00:43:17:01
Unknown
Maybe like once, right? And that way it just helps prolong the fall. And it better helps your body absorb the impact by spreading it out. Right? So if I just land on one side, the impact is on that side. But if I land on one side and kind of roll with it, I'm spreading out that force and it reduces the likelihood of injuries to one side of my body and only do it if you have a clear pass.

00:43:17:03 - 00:43:34:06
Unknown
So those are last steps, right? Like I want you to protect your hand. I want you to try to aim for your side. I want you to breathe as you go. Like I want you to be loose as a goose and I want you to roll. And realistically, when you are falling or about to fall, that's a lot of steps to go through.

00:43:34:08 - 00:43:55:10
Unknown
Especially in a period of three or 5 seconds. So I'm aware of this. And what I like to tell people that I come into contact with patients, caregivers as we have to be real, right? So one, we're going to protect the head always. And if we cannot get through the other three steps that were in between there, we're going to meet with meat.

00:43:55:12 - 00:44:17:05
Unknown
Now, as funny as it may sound, it is a really good catch phrase because it sticks. So you want to meet the ground or whatever surface you're falling on. What the most cushioned areas or meaty areas of your body. So if that's your butt, if that's the side of your arms, if that's the thighs, it allows the body to be able to absorb the impact better, right?

00:44:17:05 - 00:44:35:14
Unknown
Because there's more tissue that has to get through before it hits bone. And if it has a direct impact with bone, you're more likely to break it. And this is, you know, just if all else fails, you can't remember the other steps. You don't have time to go to the other steps. That's okay. And I want to reiterate that practice makes perfect, right?

00:44:35:14 - 00:44:56:22
Unknown
So the more you practice, the more second nature it'll become. I don't expect you to be following safely in the next week or so. Right. It's a continuous thing. So you fall in and out and Aiden lightly brushed on this as well. So checking for injuries is very vital. And like she said, if you feel injuries, if you see injuries.

00:44:56:22 - 00:45:18:11
Unknown
Right, because sometimes you may not be able to feel if we do have the IPN or other side effects that affect our sensitivity or skin integrity, we need to check visually check, right. If we feel those don't get up and call the emergency services. If you don't feel anything right, if you feel like, okay, I'm kind of fine, I can get up a little first.

00:45:18:11 - 00:45:39:14
Unknown
I would suggest like setting up, right? And then we move from there and there are ways to get up safely, like different techniques. I tried it briefly later, but not really go too deep into it because it kind of is tailored to the person and their condition and some impairments that you may have. So you're checking for injuries if you feel like you can get up, get up.

00:45:39:14 - 00:46:00:20
Unknown
If you have injuries, stay down right. And wait for emergency services to get to you. Either way, notifying someone is very important. And if you do get up from a fall, Right. And so you go sit in a chair, I would notify someone immediately whether that's a caregiver or someone within your support system just because it lets them know, Hey, okay, she fell.

00:46:01:00 - 00:46:22:15
Unknown
Let me check on her later just to see if she's okay. And it's also a chance for caregivers to document this, right? So to say, okay, she fell at this time. These were the circumstances around the fall and this is how she felt after the fall. And the documentation can show you whether it's happening more frequently, if it's spread out and you can show it to your provider and say, do you think that we need different services?

00:46:22:15 - 00:46:49:00
Unknown
Do you think that we need occupational therapy or physical therapy to address this? Right? Or is it something underlying? Is it the medications reacting with one another? And it's one of the most important things that I personally love to have as a program programing emergency phone numbers into phone. I feel like emergency preparedness is very vital and I feel like it should be practiced before the emergency happens.

00:46:49:00 - 00:47:12:06
Unknown
Right. So whether you have a smartphone and you can just say like, hey, Siri or hey, whoever, you know, can you contact my emergency contact? Having that phone number in there prior to the emergency happening will reduce the amount of time that someone needs to get to you. And if you have a phone that doesn't have like the voice activation, there are ways that you can program it in with pressing like pound in the number or star in the number.

00:47:12:12 - 00:47:48:01
Unknown
Right? It just reduces the steps that it takes for someone to get to you as a check on you. And a part of that plan is also making spare keys, right? So having a spare key, nothing a lot like tape is very key to the mailbox or anything, you know, ridiculous like that. But maybe having a spare key hider so they have like little rocks and garden gnomes that you can leave outside the house that are very discreet or apartment buildings you can have like lockbox is so that someone can get to you in a timely manner without panicking or having to, like, bust on it or, you know, anything dramatic in that sense.

00:47:48:03 - 00:48:07:08
Unknown
So I did include ways to get up from a fall. I'm not going to go over it just because I want to ask to have time to answer questions. But there are different techniques to get different areas, do it different ways, and sometimes it's very tailored to the person to make sure that they're comfortable and that they feel confident in that way of getting up.

00:48:07:10 - 00:48:25:10
Unknown
But when this is posted on the show website, you can definitely go through it. It is just a general way to get up safely. And I know for me I'm a very visual learner, so this was a lot of information to take and I know that I went through it very quickly, so I provided some links, I provided a YouTube link and they should be in the chat soon.

00:48:25:12 - 00:48:49:19
Unknown
I provided a YouTube link on how to get up safely and how to fall safely, and I provided an AARP visual instruction guide. So it's just pictures and words that will take you through. But just so you can visually see someone doing it right. And if you want more information on it, you can always type into Google step by step of how to safely just make sure it's from verified organizations or trained professionals.

00:48:49:23 - 00:49:11:03
Unknown
And there's a lot of programs like the one eight and mentioned. There's also like Fearless Falling. That's another program that you can attend if you want to. You So what am I takeaways from this presentation? If you don't remember anything else, I hope that you at least remember these five. So first, protect your head. That is prime real estate, right?

00:49:11:05 - 00:49:38:13
Unknown
We want to make sure that we reduce the risk of head trauma or head injuries, because that's a whole nother ball game. Right. Meet with me. So if we don't remember the steps in between or after protect the Head, we want to make sure that we're meeting with the most cushioned parts of our bodies. So we're reducing our risk of broken bones right through expect bruising, especially when we're on adjunctive therapies like chemotherapy or radiation or medications that mix in our blood.

00:49:38:13 - 00:50:05:02
Unknown
Right, Because bruising will be natural with the fall. The severity of the bruising can deferred right. And if you're ever concerned about the amount of bruising, you can always contact your health care provider or have the emergency contact plan in place. Practice the emergency contact plan to see if it is effective, as if it is efficient. Right. And if it's not, tweak it and make it adjusted so that it fits and works for you.

00:50:05:04 - 00:50:33:23
Unknown
And lastly, practice makes perfect. So the more you practice, the more natural you will become at these techniques. Right? You know, you can pick and choose Kinder. Not really. I would prefer that you did it, but you definitely need to protect your head and meet with me. Those are the things that I suggest more often than not. And your therapist, If you do have a therapist, you can work with physical therapist or occupational therapist, and they both address fall prevention.

00:50:34:01 - 00:51:03:00
Unknown
Right? And it's very client centered. So we'll make it work for you and what you want. And that's my presentation. Thank you so much. Sean's a year, so we are going to get to some Q&A. Elaine, I see your question in there. I'm she she definitely wants to see the slides. And like we said, just we can get to a couple of more questions, but we will have those slides available in the recording in a few weeks.

00:51:03:00 - 00:51:47:15
Unknown
And we did do a program about sippin on that talks about falls and things done specifically in relation to Key manages peripheral neuropathy. So Victoria, if you could put that in the chat again, a link to that webinar. And so Aiden and Javier, what can caregivers do to help prevent falls? Because I know Xavier, you mentioned having that emergency contact, but what, what are some tips that we can give our caregivers for us to help reduce our fall risk or to get help from a fall?

00:51:47:17 - 00:52:08:15
Unknown
Either one of you can take that first score. So I think the biggest thing is that do not the inclination always is, going to get you up right away, but do not practice. The pause, I think is a big, big important one and another one that we see quite often is when someone is proactively trying to address their fall risk by doing exercises.

00:52:08:17 - 00:52:33:04
Unknown
Sometimes the caregivers are all just sit right down and let me do that for you. But really you need to allow that person to get in some type of movement in a safe way, of course. But if they're participating in a program or working with physical therapists, allow them that space to practice those movements so that they can set up that patterning in the brain that will help them catch themselves from a fall and encourage them to find the space in their day to do those things as well.

00:52:33:06 - 00:52:55:22
Unknown
Yes, I agree with you then, especially on the last part, not necessarily babying someone or like walking them through the motions, giving them that chance to do things because we learn from experience. Right. So if we're doing actions that we have to do in our everyday life, like getting dressed or putting on our shoes, we have to make sure that we can do them and stay balanced.

00:52:55:22 - 00:53:21:21
Unknown
Right. But we won't learn that unless we practice it. So giving them the space to do that on their own would really be beneficial. So I know mobile devices were mentioned and as someone who has been a fall risk, I actually have to say that if I go in for a procedure hospital and have to put a little wristband on me and I am someone who was, you know, not on the older scale.

00:53:21:21 - 00:53:49:02
Unknown
And for those of us that have had cancer, no matter our age, it ages us. Right. And so we've got a couple of questions. And I'm kind of combining these. Are there any good tips on like walking sticks or a cane and also any type of shoes that are recommended or describe like the type of soles that would best work for people who are fall risks?

00:53:49:04 - 00:54:11:14
Unknown
Yeah, I can tell you how slippers and flip flops are absolute nos. And so things that are very good support that work with the curve and shape of your foot, consider seeing a podiatrist, a specialist in feet who can recommend something specific. I think those would be really helpful things don't. Do you have anything to add on? Yes.

00:54:11:14 - 00:54:30:21
Unknown
So shoes with grips at the bottom can sometimes be a plus, but it can also sometimes be like a draw because it can be too heavy for the foot. So really wearing the shoe and seeing like, is this comfortable? Can I welcome this? Can I pick my foot up? And then there's also the option to add grips to the bottom of shoes.

00:54:30:21 - 00:54:51:09
Unknown
They saw them on my different websites and they varied in like thickness and you can add them to your shoe, whichever is more like if you have a pair of shoes that you really like, you can always, you know, help add to it so that it's less likely that you'll fall in them. In terms of the Canes and Walkers, Aidan mentioned it perfectly before.

00:54:51:09 - 00:55:09:15
Unknown
Like you have to go to a physical therapist to have them fitted for you. That's the safest way and the safest route to go do that. Occupational therapist Don't necessarily work with the canes and walkers, but physical therapists specialize in that in terms of mobility, right? So if you want it to work for you, you should go to a specialist so that it'll fit for you.

00:55:09:17 - 00:55:43:04
Unknown
Fantastic. And so I think it'd be great to hear what the difference is between physical therapy and occupational therapy and how either they are kind of similar and helping with cancer patients just to give our audience a better understanding of the differences between the two, of course. So the easiest way that I can explain it without making it super complicated is physical Therapists will help you get from point A to point B, right?

00:55:43:04 - 00:56:08:18
Unknown
So they work on mobility, they work on balance, they work on strength. Right? So how can I get you from here to here? And occupational therapy is more about how can I help you do the things that you need to do and you want to do while you're on the journey from A to B, right? So occupational therapy is more about the functional skills needed to do occupations that you do in your everyday life and occupations.

00:56:08:18 - 00:56:37:06
Unknown
Does it mean jobs? It means anything and everything you do. So brushing your teeth as an occupation, doing your hair, putting on your makeup driving your car. So we are the specialists who help you engage in those activities as safely as possible and as independently as possible. But we also do I want to say a little bit of physical therapy, but it is honestly like physical therapy where we work on strength, we work on balance and mobility, but we're doing so by helping you engage in those activities.

00:56:37:11 - 00:56:56:11
Unknown
So whereas it may be just like exercises with one, it's I'm actually going to bring you into the facility and we're going to practice putting on our socks, right? Because that's something that you have to do in everyday life. And if you need compensatory strategies, if I have to teach you how to do it in a safer way, that's what I'm here for.

00:56:56:15 - 00:57:19:07
Unknown
If I have to give you assistive or adaptive devices to help you. But that's not gone. That's what I'm here for. So yeah, that's kind of the difference. We just help you remain independent and engage in the occupations that you like to and want to or need to engage in. Whereas physical therapy focuses more on like your mobility and your ability to do those things right.

00:57:19:09 - 00:57:41:17
Unknown
that's interesting. Aidan, do you have anything to add? I just. I responded in the chat to Carol's question about walking sticks. We love walking sticks, especially some of those active agers really get out there. Younger folks like to use them. They're awesome. But I would still recommend asking a physical therapist just to check out the fit and all of the all the things to make sure that it's exactly right for you.

00:57:41:19 - 00:58:08:23
Unknown
We have a question here. It says, Please repeat three parts of P.T.. Okay. So they work with mobility, right? So your ability to move, they can work with balance. They can work with strengthening. Yes. Thank you. Thank you. So let's see. You mentioned I have to laugh with the meat. The meat. I'm like, I got some meat on me.

00:58:09:00 - 00:58:31:06
Unknown
All I do, I do. And as someone who actually has fallen, I had a grade three sprain like it was a hair away from my hairline fracture because I, I could not feel my feet. And I've learned now and some of the questions we received with registration, you know, it talks about like the side effects and both of you mentioned, you know, a side effects.

00:58:31:06 - 00:58:56:09
Unknown
And sometimes you may not even realize that you are dizzy or that even your balance is off until you fall. And so I'm wondering if you have, like any tips for recognizing the signs, even like before you fall or, you know, Yeah, I think, you know, a good point of vulnerability is anytime your medications change, know that you're going to be vulnerable.

00:58:56:09 - 00:59:24:00
Unknown
That's a potential kind of red zone. So any time there's a medication, teams, any adjustments like that that can cause Disney sadness or drowsiness, that's going to be a point of vulnerability. So really be careful in those that time period I think is an important one. And certainly if you know that you have vertigo, these kinds of things have that in place, have that walker available so that, you know, like there's something there, you know, there's a good semi-truck.

00:59:24:00 - 00:59:43:15
Unknown
Drivers have like these safety protocols and one of their safety protocols when they're up and down out of the trucks and hauling stuff around is three points of contact at all times. So at all times, if you're reaching for something, make sure you got two feet in one hand on something at all times. let's get one jumpy.

00:59:43:15 - 01:00:00:15
Unknown
RG Anything to add? No, no, I think Aiden's that it perfectly honestly, they teach us in school that, you know, when you are transitioning from certain that you have to give it a few weeks. So really see the side effects right. Because you may not see it right away. And then when you do notice those side effects, you can speak to your provider about them.

01:00:00:15 - 01:00:25:21
Unknown
If they, you know, bother you. But if it's like life saving medication, there's things that we can work around. Right. But can I add one thing? Sorry. So I did see in the chat that Kathy said that mobility really isn't every thing, isn't it? Maintaining it is crucial to quality of life. And I do want to point out quality of life is what we for as coaches, especially because, yes, we want you to walk.

01:00:25:21 - 01:00:41:14
Unknown
We want you to be able to get from place to place, but we want you to be as independent in everything that you do, right. So that you don't have to rely on anyone else as to best of your ability. So that's what we strive for as occupational therapist, is to improve quality of life and maintain quality of life.

01:00:41:16 - 01:01:09:21
Unknown
So we're just going to go over just a little bit on everyone because I just want to get a few more questions in there. I think what both of you just said is really great for also our caregivers because I want to just give a shout out to caregivers because though I'm a cancer survivor, my mother also has cancer and I have also been aware of any treatment changes and things like that and making sure she's got what's called a Motivo looks like a catalog.

01:01:09:22 - 01:01:30:15
Unknown
She gets compliments, but it's like a roll later. But it's very fancy. But like recognizing, you know, I'm like, Hey, it's too long of a distance. I really think you should use, you know, your role later today. And I and I think this program is really good for caregivers to kind of recognize the sign because we're taking the medications.

01:01:30:15 - 01:02:20:18
Unknown
And like you said, it can take a few weeks before we as the patient notice any type of mobility changes or even the dizziness. But our caregivers or our friends and family might notice it sooner and can alert us. We make sure that we're then talking with our medical providers right. Let's see. So are there programs? So like you mentioned, even you mentioned Taichi in your program, like does that also work on because I think of those us, we've had treatment and now we have a lot of other, you know, permanent damage internally which can affect our mobility and maybe, you know, the scoliosis that wasn't as pronounced Pre-cancer now is really pronounced post cancer

01:02:20:18 - 01:02:44:13
Unknown
because a lot of our movement, even our posture and how we sit can be affected. What are ways that we can work on that or what are questions we should ask our providers? Yeah, I think the biggest question is can you give me a referral for physical therapy? Number one, because they're going to be able to look at your unique situation and make specific recommendations for you.

01:02:44:15 - 01:03:05:18
Unknown
But generally, when you look at all the evidence, you know, movement is still important and whatever capacity we can write, like even if we are working with a dementia patient who's in a bed, we can still practice with them as the caregiver. You can practice some of those ankle rolls and things with them that whatever amounts that we can just make it a little bit easier is important.

01:03:05:18 - 01:03:28:12
Unknown
And the other benefit is we don't want our caregivers to go down from a fall either and be out of commission, right? And so for them to be practicing their mobility as well, one side of the patient is is super important and valuable as well. But I think, you know, scoliosis, whatever, you know, postural changes, all of those things can can be looked at with physical therapy and can certainly benefit from some type of movement in most cases.

01:03:28:14 - 01:03:49:21
Unknown
And just the what would you say from the occupational therapists point of view? No, I agree with everything. Yes, movement is important. Right. And I do think that caregivers taking on an active role in doing things with the patients definitely makes all of the difference. Right? Because it's like, okay, I know exactly what you need to do because I've done it too, right?

01:03:49:21 - 01:04:07:18
Unknown
So I can help you in times where at home and it's like, okay, well, let's practice this together. Let's do this together. Let's get you moving because there's only so much improvement that can happen in a facility, right? That has to be transferred at home as well. Like we have to do, take those steps in order to see the changes.

01:04:07:18 - 01:04:34:15
Unknown
Right? Absolutely. And then we'll ask this one last question here and then we will wrap it up. I appreciate y'all staying on. What do you think about water aerobics exercises for seniors? And I can tell you all right now, I've actually been I've had aquatic therapy. I just finished five weeks of that actually last week. And it has been a huge change in my posture and how I stand.

01:04:34:15 - 01:04:56:20
Unknown
So it's not hurting as badly. So I did want to give a shout out to like aquatic therapy for any age has been amazing. But let's let's leave this out with this question. Yeah, I concur. I have older adults in some of my programs that say it's wonderful. I don't worry about falling when I'm in the pool so they can get in those movements for flexibility and mobility.

01:04:56:20 - 01:05:20:17
Unknown
But they're concerned about, if I start exercising, my going to fall is kind of taken away. I love it. I think that's a wonderful thing. Need to jump in. You have anything else to add? no. That was all. Thank you for allowing me to speak here. And, you know, bringing awareness for preparedness. Well, thanks for asking about do you have to actually fall?

01:05:20:19 - 01:05:40:13
Unknown
I've seen some very innovative parties offer programing at Trampoline Parks, where they actually practice having people fall. I don't see that very often because of some of the liability that comes into play. You don't have to actually fall as you practice. You are tied to you. If you practice those hard cross hemisphere movements, you're going to get the benefits and you're going to set up that pattern in your brain that's going to be protective.

01:05:40:15 - 01:06:13:09
Unknown
And then also, yeah, and to also prepare like making sure when you fall, you know, like don't tense up when you fall because everyone's right. Like, thank you, Aiden and Javier. This is very informative and thank you to everyone who attended. We appreciate it. So make sure to check out shares, upcoming educational programs and groups. We've got an upcoming podcast from our busy life coming up and for our MBC life coming up.

01:06:13:09 - 01:06:41:12
Unknown
And please take a moment to complete the survey. After the webinar, it'll pop up as soon as we end this. We really do read those and that helps to drive our content and what we produce for you in these programs. And again, we will send this out once it's ready, you'll get notification back. This is on our website and we'll make sure to get some of those slides about what to do, how to get up that John Janvier whenever as well.

01:06:41:12 - 01:06:50:00
Unknown
So thank you everyone. Have a great rest of your day and a great weekend. Thank you. John Beer and Aiden.

00:00:00:00 - 00:00:34:04
Unknown
Hello, everyone. We are doing another recording of the Occupational therapist, Jean the place for Star. Based off of the survey feedback we received. People wanted to see her presentation in full, which includes how to get up safely, Summer, a fall and how to fall safely. So Jean carefully Sportster the screen is yours. Thank you so much, Megan. Claire.

00:00:34:06 - 00:01:00:20
Unknown
So for those who may not know. My name is Janvier Forester. I am currently a doctoral student at the New York Institute of Technology, and I'm pursuing a degree in occupational therapy. Throughout my schooling experience, we have various clinical settings that we go into in practice. And while practicing, I've come into contact with a lot of patients who need help in terms of our prevention getting up from the fall.

00:01:00:22 - 00:01:11:16
Unknown
So I've kind of collected all that information that I've given to patients, to caregivers, to family members, and provided it here for you today. So I'm going to go ahead and share my screen

00:01:11:16 - 00:01:37:05
Unknown
Okay. There we go. So today I'm going to be talking about a fall action plan. And this plan can be used by clients, patients, caregivers, family members, anyone who has cancer and is at risk for falling, especially due to cancer treatment. So this is how to fall safely after cancer diagnosis during treatment and in survivorship.

00:01:37:07 - 00:01:56:09
Unknown
So I want to preface this by saying that it is a safe space. So it's no secret that falling can make you feel clumsy, especially when it is frequent. It kind of makes you feel like you have less control over your body. Right. And that that feeling is natural. And the frustration and the fear that comes with that is very natural and is very valid.

00:01:56:11 - 00:02:22:23
Unknown
So along your journey, you will probably fall. More than likely you will. And that's okay, right? As long as we're equipped with the information to prevent ourselves from falling so it doesn't happen often and to get up safely and so safely. Right. And remember that you're not alone in this journey. So you're continuing to heal. And health care professionals, the cancer community, your family, we're here to support you.

00:02:23:01 - 00:02:49:00
Unknown
So first, I want to speak about side effects and sensitivities, because those are the main reasons why falling may occur. Right. So the medications or therapies like chemotherapy, radiation hormone therapy used to treat breast cancer can have side effects that result in losing sensation in your feet, making it difficult to walk, making you dizzy, making you confused, creating brain fog.

00:02:49:02 - 00:03:14:20
Unknown
Right. So these side effects and our sensitivity levels to them increase our risk of falling. So, for example, blood thinners, which is a medication that prevents our blood from clotting, can affect our ability to heal properly. It may cause us to bruise exponentially when we fall, right? So it increases our risk of bleeding out if we do get a cut when we fall.

00:03:14:21 - 00:03:33:19
Unknown
So say we hit our head and there's a cut on the side of our head. We may not be able to stop the bleeding as quickly because our body is affected by those medications that we take. So we need to be mindful of that and careful of that and see at the end. Right. So Sharon did a webinar on CIPA.

00:03:33:19 - 00:03:51:17
Unknown
And if you would like to learn more about that in depth, you can definitely check it out on their website. But that's damage to the peripheral nerves which alters our sensation. So when I was talking about the feet before, lack of sensation in our feet can make it difficult to walk, right? Because we may not be able to feel the ground or we may not feel a steady right.

00:03:51:17 - 00:04:15:10
Unknown
And that instability could possibly lead us to fall, especially when we're walking on uneven surfaces. So how are we going to protect ourselves when we're falling? The number one step that I like to stress exponentially, like it's very important, is to protect your head, Right? Because everything that is vital to us is up there. I like to call it prime real estate.

00:04:15:12 - 00:04:36:04
Unknown
So when we're falling, our number one thing is we need to protect our head. We need to protect that prime real estate. So the medications that I was talking about before, and as I said before, it can increase the risk of bleeding. So if we do develop head trauma or if we have a cut on our head, which made me, we might not be able to stop it as readily as we want.

00:04:36:04 - 00:04:54:07
Unknown
If we wait on those medications such as chemotherapy or the anticoagulants. Right. So we're at greater risk for bleeding and bruising. And that doesn't just mean external bleeding. So bleeding that we can see. We can also be at risk for internal bleeding as well.

00:04:54:09 - 00:05:15:01
Unknown
And another consideration is hair, right? So no matter what stage we are in the process, if we're in the preparation stage where we may be removing our hair, if we're in treatment and we're experiencing hair loss, if we're in survivorship and our hair is just starting to grow back, that's a barrier that some people may not think about consciously, right?

00:05:15:03 - 00:05:39:05
Unknown
So that lack of protection that we may be used to having is gone and we need to accommodate for that. So that accommodation looks like using your arms and your hands as a shield, Right? So if we protect ourselves using our cells, we can reduce the incidence of head trauma, bleeding cuts. And that's as simple as it sounds.

00:05:39:06 - 00:06:02:06
Unknown
As I said before, you're just shielding your head. So I'm actually going to do it, and I hope that we can do it together at home. You're following along. So the first step into protecting your head effectively is to lower your head by tucking your chin down into your chest. Yes. Perfect. Make it clear. Place both hands at the side of your head with your elbow directly in front of you.

00:06:02:07 - 00:06:22:15
Unknown
Right. So it's kind of like we're on our ears. Yeah, Perfect. Just like that. And when we're falling. Right. So this is the basis. We're protecting your head. When we're falling, we're going to turn our head in our arms to the side, just like that. So when you're falling, you want to make sure that you're landing on this cushioned area of your arm.

00:06:22:17 - 00:06:44:05
Unknown
Perfect. Yes. So that it can bear all of the impact or most of the impact. Right. So that reduces the risk of head traumas and broken bones, the cushion parts, the best parts. And if you find yourself falling backwards, that's just a simple adjustment of the arms and hands. Right. So we're going to go further back to protect the back of our head, right.

00:06:44:07 - 00:07:06:23
Unknown
Because we don't want our head to hit the ground because that's a lot of a lot of damage that can occur. So we're going to protect our head by placing our hands right at the back or the base of the skull. And it's our hands are going to take the brunt of the impact. Right. And if you can still try to go for the side, but if you have to fall on your back, that is fine as long as you're protecting the head.

00:07:07:01 - 00:07:25:13
Unknown
And if you are on those medications that I mentioned before, make sure that you contact your provider because they may want to know about that fall and they definitely should know about that fall. Right. Because they may want to check up on you, make sure you have no internal bleeding, no head trauma, nothing that can really cause later side effects.

00:07:25:15 - 00:07:43:13
Unknown
Okay. So we've protected our head already, right? So now we're going to try for the side. And like I said, when you're protecting your head, you automatically want to turn to the side. So it's natural for us to try to catch ourselves when they're falling. I know that I do it to you. We kind of put our hands out and we're like, hold on, I got it.

00:07:43:15 - 00:08:09:22
Unknown
And might not be as bad if I try to catch myself, but we can actually make it worse if we do. So in order to reduce that, we want to try for the side. When we put our arms and our hands out, we're at greater risk for broken bones. Specific to our hands, our wrists. We may dislocate our shoulder and we call those injuries so foolish as falling on outstretched hands.

00:08:10:00 - 00:08:31:09
Unknown
Right. So if you put your hand up and you feel the base of your palm right above your wrists, you can feel how bony is, right? So not a lot of cushion there, not a lot of tissue. So when you hit the ground, that impact is going to go directly onto hard surfaces, which are the bones which will lead us to breakage.

00:08:31:11 - 00:08:48:05
Unknown
Right. And we want to avoid that as much as possible. So we want to protect our head and go for the side. We want to go for the cushion part of our arms where there's more tissue for the impact to go. Third. So the best way to prevent or reduce injuries is to get into a fetal like position when we're falling.

00:08:48:07 - 00:09:20:14
Unknown
So protecting our head and kind of how babies are in the womb. Right. We're going to curl and bring our knees up and we're going to go for the side. So this technique works in most situations. I know that a lot of clients have concerns about hip fragility, right? So if I fall in the side, I may be more likely to break my hip or I have a hip replacement and I'm worried or concerned about having that type of impact on the device that's in my head.

00:09:20:18 - 00:09:42:16
Unknown
Right. So we could use different techniques. A lot of times when that concern is brought up, I like to say go for the butt, right? So let's try to fall backwards so that we fall in that cushion area instead of our arms. But you can always speak to your therapist or whoever is providing your fall prevention techniques to see what works best for you, right?

00:09:42:20 - 00:10:03:12
Unknown
Because a lot of times we have to tailor it specifically to clients. And this is just a general way of falling safely. Okay, So we've tucked in our head and we've tried for the side. The next important step is to be loose. So the fear and the shock of falling can cause you to tense up. And that is natural, right?

00:10:03:12 - 00:10:29:08
Unknown
Because we're like, my gosh, it's going to be painful. When I hit the ground, I want to protect myself. But we have to remember that Tensing up increases our likelihood of becoming injured. Right? So broken bones, sprains. We want to make sure that we're breathing and we're going with the motion. Right. Because the more you relax. So if you sit back and take a deep breath and let it out, you can kind of feel the tension moving from your body.

00:10:29:08 - 00:10:52:15
Unknown
Right. So the same way with the fall. So if you stay loose and you allow your body to relax, your body will be able to absorb the shock better. And when you're not tense, you're less likely to become injured. So I like to say be loose as a goose. And this is my little goose reminding you to be, you know, kind of loose, kind of flexible.

00:10:52:17 - 00:11:22:09
Unknown
So we've protected ahead. We've tried for the side we're breathing and we're making sure that we're loose. And next we're going to make sure we roll and don't bounce. So roll it out. Now, that a silly thing to say and I don't mean roll continuously like downhill but the games, many of us probably play as children. But this technique, we maybe do it like once or twice, right, to prolong our fall and that prolonging can help our body absorb the impact better.

00:11:22:11 - 00:11:49:03
Unknown
Right? So it's spreading it out over the body instead of coming to an abrupt stop. So say we fall on our right side, right, instead of just hitting the ground. And that being the only point of impact, I hit the ground, I roll on my back and rolls where the other side, I'm spreading that force out, Right? So I'm less likely to have major injuries on this side because the force is going over a greater area.

00:11:49:04 - 00:12:12:22
Unknown
And that's the technique that can be used when there's a clear path, right? So if we're on soft surfaces like the grass and there's a clear path ahead of you, roll it out. If you're at home and you're on the carpet, roll it out. Just don't roll into anything. That's like a tip I like to say, because that just puts you at greater risk for other injuries.

00:12:13:00 - 00:12:36:14
Unknown
So we have protect the head. Try for this. I'd be loose as a goose and roll that. And there's a lot to remember and I am very aware of that. So I like to say let's be real and remember the most important part, right? And that will be protect the head and meet with meat. So if all else fails, remember to meet with the most cushion parts of your body.

00:12:36:16 - 00:12:59:03
Unknown
Right? So whether that's the butt and that's the arms, the side of your arms, if that's your thighs, wherever you have the most meat on your body will most likely be the safest place for you to fall with minimal injuries. Right. And as as a last resort. Right. You have to practice other steps and techniques to learn how to fall safely so it can become second nature.

00:12:59:05 - 00:13:20:09
Unknown
But if you don't remember anything, remember protect the head and meet with me. So you fall in. What do you do now? First, we're going to check for injuries, right? So if we do a quick body scan, whether that's looking visually looking or if that's just feeling, if we move a little and we feel that we're hurting, we're going to stay there, right?

00:13:20:11 - 00:13:49:10
Unknown
We're going to contact emergency services, contact our caregivers or our support system, whoever we need to contact so that we can get services to us quickly. If we feel like we can get up, we're going to get up. Right. And I have steps on how to get up safely as well. But I always say whether you are there and you can't get up or you can get up, you need to notify someone and, you know, just let them know like, hey, I fall in, I need help or have fallen.

00:13:49:10 - 00:14:08:21
Unknown
Just letting you know so that you can check in on me later. And that brings me to my next point of programing, emergency numbers into your phone. It's very important, right? Because there could be a few that could save you a few seconds. Right. Of people getting to you faster and you reducing the likelihood of passing out or further injuries.

00:14:08:21 - 00:14:31:12
Unknown
Right. So whether that's programing nine one into your phone or programing your caregiver into your phone, if they're not home, just pressing that one button can be the difference between you staying on the floor a little too long. So I would always say make a spare key, right, so that they can get to you in time, because that also reduces the time that you're laying on the floor.

00:14:31:13 - 00:14:49:17
Unknown
And there's a variety of spare key hider. So don't just leave the key in the mailbox, Get something to protect it, right. So that no one can just into your home so you can get like a rock, a lock box and let that person know where the spare key is. Right. So an action plan on how to get into my home or what to do if I fall right.

00:14:49:22 - 00:15:14:15
Unknown
And you can also let emergency services know like, hey, I've fallen, I can't get up right now. I need your help. There's a spare key here so that you can easily access my house and get to me. It just makes it a lot smoother. Right? So how are we going to get up so we fall in safely? We've contacted whoever we need to contact, whether that's emergency services, our caregiver.

00:15:14:17 - 00:15:33:04
Unknown
But if we've contacted our caregiver and we think that we can get out right, we don't detect any injuries. This is how we're going to do so. So first, you should already be on your side if you follow the action plan. Right? But if you forgot to follow the action plan, all the steps are gone and you met with meet.

00:15:33:04 - 00:15:54:13
Unknown
That is perfect. We're just going to get onto our side and we're going to make sure that we're getting on the strongest side, right, Or the side that may not be affected by the side effects of cancer treatment. So the side that may not have lymphedema, the side where we may have more feeling. Right. So you can slowly roll on.

00:15:54:13 - 00:16:19:02
Unknown
So whichever your side, whichever side of the body, you feel it stronger. Right. And if you have sippin or if you have lymphedema on both sides. Right. You want to roll on the side of your dominant hand because you're more likely to be stronger with that arms for that hand. So you're going to push yourself up using your arm to a side sitting position, kind of like the girl in the corner.

00:16:19:04 - 00:16:38:08
Unknown
You're going to crawl and scoop to a solid piece of furniture or a structure that can support your body weight, such as a couch or an outside railing. And I want to make it clear that in between step two and step three, you can take a break, right? So you want to make sure that you're not dizzy. You want to make sure that you have stability.

00:16:38:12 - 00:17:02:08
Unknown
Right. Because if we move too fast, we can actually pass out because of the difference in our pressure. So we want to make sure that we're taking a break and we're doing things slowly, so we're pushing ourself up to our arm in a sitting position. We're going to crawl or scoot to a solid piece of furniture, right. And make sure that it can support your body weight, because if it doesn't, you are more likely to get injured from falling through that piece of furniture.

00:17:02:08 - 00:17:29:18
Unknown
Right. Or falling back down. So using that solid furniture structure, bring yourself to a kneeling position with your stronger leg closer to the furniture. Right. So if the stronger leg is your right leg or the stronger leg is your left leg, bring that leg closer to the furniture. Slowly slide the foot of the stronger leg towards towards the towards a forward side so that it is flat on the floor.

00:17:29:18 - 00:17:49:09
Unknown
Right. So you want that stronger, like to be flat on the floor because that's the leg that you're going to push the body weight through. Right. You're going to push it through your hands and also through that leg. So put your hands on the piece of furniture or other structure and push both of your hands down. Right. And the stronger foot to slowly raise your body off the ground.

00:17:49:11 - 00:18:08:07
Unknown
And the next you're going to sit down. And that on that piece of furniture, the nearest piece of furniture, if you weren't by furniture and make sure that you're not dizzy, make sure that you're not experiencing pain, risk for injuries. Right. That you may not have seen or felt before. And I know this a lot is like, well, I can't visualize that.

00:18:08:07 - 00:18:31:16
Unknown
Right? So I've added some visual guides here and it will take you through step by step, like if you can get up, if you can't get up, if you're a caregiver and you witness of all, what do you do? You can find that in both of these documents. Right. And these are from government websites so that, you know, it's, you know, legit.

00:18:31:16 - 00:18:52:13
Unknown
This is what I should do. This is what I can do to protect myself. And it has visual instructions so that the things that I said, you can visually see someone sliding their foot forward, someone putting their hands on the couch. It just makes it easier, right? Because me saying it may not resonate as well as you see.

00:18:52:14 - 00:19:20:07
Unknown
And I've also provided visual steps on how to fall safely. Right. So there's a lot of resources on this information. The ladder is definitely provided by government sites, but this one, it's kind of difficult to pick which ones are reliable resources, but always go for verified or trained professionals, right. Or organizations. So if it's an occupational therapist or physical therapist.

00:19:20:07 - 00:19:44:17
Unknown
Right, or health care provider explaining how to file safely, those are reliable resources. If it's organizations such as AARP or the New York Gov. Right. And they're providing ways on how to file safely. Those are reliable resources. And if you don't like the resources that I provided, you can definitely check out others. You just type in step by step of how to file safely.

00:19:44:19 - 00:20:08:10
Unknown
So what are the takeaways from this presentation? First and foremost, protect your head and is prime real estate Meet with me. Right. So if all else fails and we don't remember anything else, meet with the cushion parts of our body. Expect bruising, especially what we talked about earlier, the side effects and sensitivities. If we are on medications, then our blood bruising is going to be natural.

00:20:08:12 - 00:20:31:11
Unknown
If we're concerned about the amount of bruising. Right. Or we're not comfortable with the fact that there are bruises, we can always speak to our provider and maybe they have some options for us, but it is natural. And so we should expected and not be surprised if it does happen, have an emergency contact plan and make sure that the people who are part of that contact plan know that they're part of the contact plan, Go through it with them.

00:20:31:14 - 00:20:52:23
Unknown
Right. So that they know where the keys are, so that they know when you call what to do, who they should call, how they should get to you. And lastly, practice makes perfect. So when I say practice, I don't mean go out and just fall. I mean practice two steps, right? Whether you're sitting down, relaxing on the couch, maybe just going through the motions.

00:20:53:01 - 00:21:12:11
Unknown
Right. This is how I would feel, right? Meet with me thinking about it. When we think about things and we practice them more, right? Even if it's just sitting on the couch, we tend to remember it better, right? So in those instances where we do fall, it becomes like an agent. It's like, let me protect my head, right?

00:21:12:13 - 00:21:55:02
Unknown
So always practice. And if you have someone with you who can help you, you know, get up from a fall, I say practice that as well. Right. And those are tips and techniques on how to get up safely from fall. So thank you so much, Janvier. Really great information and really appreciate all of those tips and acknowledging, you know, some of the physical limitations that cancer patients can potentially have and for DEMA or chemo and peripheral neuropathy.

00:21:55:04 - 00:22:28:21
Unknown
So let's get into just a few more questions that people asked in our survey. Can you explain the difference between physical therapy because aid and physical therapist versus occupational therapy? Because I think a lot of people don't necessarily think of occupational therapy or O.T. initially. So what is that difference? Yes. So I love to explain it as physical therapy gets you from point A to point B, Right.

00:22:28:21 - 00:23:01:07
Unknown
So they're working on mobility, they're working on ambulation, which is walking. They're working on flexibility, core strength, just basically movement, right? Getting you to move, whereas occupational therapists help you do the things you want to do, need to do and, you know, basically have to do to live from point A to point B, So whether that's activities of daily living, which we call grooming, bathing, dressing, right.

00:23:01:07 - 00:23:22:07
Unknown
Which can be difficult, especially if we're having side effects such as lymphedema, we may not be able to button our shirt as easily as we used to, right. Or lift our arms as high as we used to to get that shirt on. So we help with things such as that, right? So engaging in those occupations and occupations just means anything that you do throughout life, right?

00:23:22:09 - 00:23:50:01
Unknown
So as much as brushing your teeth as an occupation, driving is an occupation. Occupational therapist can help with that too. There's certified driving specialists who help people who have and any impairments get back into driving. We can do idles what you call instrumental activities of daily living so that can be going to the bank, right? If we're having brain fog.

00:23:50:01 - 00:24:06:17
Unknown
Right, or confusion and we may not be able to handle the things that we used to handle with ease any more. Occupational therapists can give us tips and techniques and set up ways that makes it easier or easier for you to do those things right. So like maybe setting up automatic checking, but you don't know how to do it.

00:24:06:19 - 00:24:33:09
Unknown
That visual therapist is there to help, right? So it's just life activities that you want to do. So you are a gardener and you can't garden anymore because you can't lift something anymore. We're just here to ask to help you make accommodations so that you can engage in those activities right? So whether it's providing assistive devices, so say you need like a red shirt to get something off a high shelf, You enjoy cooking and you can't cook anymore because you can't reach anything.

00:24:33:15 - 00:25:17:09
Unknown
Well, we'll give you the Reacher to get off the shelf. Maybe you can't open the can because of the lymphedema or the CIPA you don't have feeling. Well, we'll give you a can opener that's adjusted so that you don't have to have extra movements or you don't have to actually feel the can to open it. So we just provide compensatory strategies, we provide assistive devices, and we help you do the things that you want to engage in that give you quality of life and meaning, you know, I actually did have occupational therapy because I had mentioned in the previous program that we did for this that I am a a breast cancer survivor and actually

00:25:17:09 - 00:25:45:10
Unknown
had a lot of difficulty with my mobility after my surgeries and then with radiation, I had a lot of difficulty. And my breast cancer surgeon actually recommended occupational therapy. And I remember thinking, what is that? You know, and like, why is that different? And I have to say, all of those little tips and techniques for all of the daily like routines that we do in our homes or when we're going out, like those tips really did help.

00:25:45:10 - 00:26:27:00
Unknown
So it helped prevent, you know, potential further injury, helped with, you know, reducing like swelling but still like keeping loose, so to speak. So I just highly recommend cancer patients and those who have chronic illnesses as well to ask about occupational therapy for those like daily living and, you know, assistive devices because they're really helpful. So, you know, with me kind of talking a little bit about my own experience with occupational therapy, like when should a person receive occupational therapy or what should they be thinking out to be like?

00:26:27:02 - 00:26:53:18
Unknown
Maybe aside from physical therapy, I should have occupational therapy. Yes. So I like to say as soon as cancer treatment starts, right, you should be having that conversation about rehabilitation options. Right? You need to fast track it so that you know that you have a plan, right? Once treatment ends or if you can start therapy in the middle of treatment.

00:26:53:18 - 00:27:12:00
Unknown
Right. That is also an option as well. You have to act your provider what they think, what is most suitable for you. But definitely bring that conversation up in the beginning, Right. Say, hey, do you think that I would need physical therapy? Do you think I would need occupational therapy? What are the side effects of the treatment that I'm getting?

00:27:12:02 - 00:27:41:07
Unknown
What is the likelihood that I'll get those effects right? Like if there is a a likelihood that they can provide you with. But I think that it's important that once you start experiencing side effects that impact your ability to go about daily life, occupational therapy needs to come into the conversation. Right? A lot of times providers will refer to occupational therapy if there is limitation with your arms or upper extremities.

00:27:41:07 - 00:28:10:10
Unknown
Right? So if I can't lift my arm because I may have corti, right? So that's the cord that comes up under your arm and it prevents your range of motion. Or you may have lymphedema, right? A lot of providers will refer to certified hand therapists, and those are the occupational therapists who specifically deal with upper extremity impairments. But occupational therapy is so much broader than just certified hand therapist, right?

00:28:10:12 - 00:28:40:10
Unknown
So even though they can help you with the upper extremity injuries, generalists who are OGs can help you with everything else, right? Including the upper extremities. It could just be an addition on to that if you already have it. But yeah, occupational therapists, as should be contracted as soon as daily living activities are inhibited or affected. That's my advice and I totally support that.

00:28:40:10 - 00:29:13:03
Unknown
And especially like bringing bringing that up early in the discussions with, you know, your medical team and then really and truly with your surgeons as you do end that having any type of surgery. Because I really I was surprised by how beneficial my own occupational therapists and the tips that it was a she so that she gave me and actually created like a device.

00:29:13:05 - 00:29:40:09
Unknown
I never really thought about it, but I still have it actually that goes in my bra for my breast to help with swelling. So it was just I was impressed. So what are some ways that caregivers or friends or family can help in between, say, their work occupational therapy sessions? What are some things that they can do to help the patient or survivor?

00:29:40:11 - 00:30:07:21
Unknown
Yes, of course. So one of the most important things and one of the ways that O-t or any therapy can be most effective, as if there is a reinforcement at home. Right. So the exercises that you may do during your therapy treatment, whether that's physical therapy or occupational therapy, if it's like balance exercises or if it's practicing putting your sock sock on.

00:30:07:23 - 00:30:26:21
Unknown
Right. As easy as it may sound, it's difficult, especially when you have side effects that impair you from doing it, just practicing that. Right. So I like to have the caregivers involved as much as possible in the therapy treatments so that they can see, okay, this is how you do it, this is how I should do it at home.

00:30:26:21 - 00:30:48:04
Unknown
This is how I should make sure that person is doing it. Correct? Right. So just transferring that at home and making sure that we practice whatever we're doing in therapy. Caregivers are very important in that aspect and encouraging the clients or patients to actually do the activities right, because a lot of times it can be like, Well, what's the point?

00:30:48:04 - 00:31:18:16
Unknown
Or I'm not I might not be seeing results as fast as I want to, right? But it takes time. And so reinforcing that actually helps speed up the process of the recovery. And then in terms of falling, right, because that's the topic caregivers can actually do a lot, especially with practicing with the client or the patient going over saying, Hey, like testing you, hey, do you remember what's the most important part of the fall for doc bed, right?

00:31:18:18 - 00:31:52:19
Unknown
Or if you forget all the other steps, what do you do? Meet with me and the resource that I provided on the slide where it's if you can, giving up from afar safely. It actually has a section where it's okay, I've witnessed a fall or I'm a caregiver right? How do I help them get up? And it's step by step on how you can help them get up with illustrations as well, but just making sure that you're there, supporting them, reinforcing what is learned in therapy sessions, encouraging them to practice what is learned in therapy sessions.

00:31:52:21 - 00:32:30:13
Unknown
And yeah, just providing emotional and physical supports, you know, the best options for caregivers. right. And it's so true of, you know, taking from what the sessions you know and keep doing them that that practice makes perfect adage you know so to speak. But that is so true to just be reminded like keep doing the exercises. So we know that the side effects from treatments, as you mentioned, and surgeries and medications can cause the dizziness and then the falls.

00:32:30:14 - 00:32:55:01
Unknown
So when you were talking about the ways to not only fall safely, but then also how to get up safely, I actually I learned some new stuff with that. And I know that was what a lot of the audience really wanted to hear about as well. I never thought about, you know, sometimes that standing up or giving up too quickly and how that makes you dizzy and then you end up falling back down.

00:32:55:03 - 00:33:18:21
Unknown
That was a really good reminder. So I was wondering, what are some other tips for like the home to help limit falling? Of course. So occupational therapist specialize in this as well. Right. So prevention tips, so we can go into the home and say, hey, like you need to add this here at that here. And some examples would be a taping down in rug, right?

00:33:18:21 - 00:33:41:04
Unknown
So a lot of people may not realize that it's actually a tripping hazard, right? So the little corners, our rug may flip up sometimes. And if we trip over it, it could be, you know, pretty painful. So getting some double sided tape and just taping down the corners of the rug or along all the edges is a simple tip until to reduce falling, making sure that we reduce clutter in our home.

00:33:41:07 - 00:34:08:04
Unknown
Right. Because a lot of times we'll just put things places we may not put them in the safest places. Right. So reducing clutter, getting boxes out of hallways, getting like coffee tables out of, I don't know, just the middle of the room, you know, just keeping things in the the keeping a clear path is what happens is I'm sorry, getting rid of cords and wires unnecessarily on the floor.

00:34:08:04 - 00:34:32:15
Unknown
Right. So maybe we put them behind the furniture or maybe we get like those. You ever seen those, like, ordered highlighters? Yes. Yeah. Yes. So putting the cords in that right to reduce or reduce, you know, just them being out, making sure that we're in well-lit areas. I know that sometimes it's not really thought about, but lighting can affect our ability to, of course, see Right.

00:34:32:15 - 00:34:55:02
Unknown
We may not be able to see where we're going and we may trick. So making sure that there's well-lit areas, making sure that when we are going up the stairs, we're holding on to the railing, going up and going down. If we have those carpet things on our stairs, right, making sure they're tight and secured, like if they're loose, that can cause us to trip.

00:34:55:04 - 00:35:26:14
Unknown
Yeah, that's that's like some of the fumes. Yeah. Those are some great tips in someone who recently moved and have hardwood floors. And I did get like some carpet accents. And honestly, I have tripped because I did not think about actually putting something underneath to make sure it's great and stays in place. So I feel like it's lots of really small things that you're not necessarily always thinking about that can actually like literally trip you up.

00:35:26:16 - 00:35:58:05
Unknown
So thank you so much for those tips. And then can you just go into details on the ways to get it from a fall safely? Like, you know, when you mentioned making sure it's like the dominant side that you get at that might be like the stronger side and trying to get to a piece of furniture or something that can like hold your weight, like what happens if it's like the lower extremity that you're having a difficulty with?

00:35:58:05 - 00:36:27:21
Unknown
Are there certain other ways to really use the upper extremity to help you get back up? So what I would say is if you are having difficulty with the lower extremity, you want to put as much weight as you can on the upper extremity. So if we're getting in that position where we're on our side and we need to crawl to a piece of furniture, right, and we may not have a lot of feeling in our lower extremities or we may have a lot of swelling due to lymphedema.

00:36:27:23 - 00:36:44:22
Unknown
Use your arms. Right. Like we're going to crawl. Yes, as much as we can. But we want to make sure that we're safe in doing so because we may not be able to feel those injuries. If we do get injured while crawling, we're going to use our upper extremity. We're going to put as much as much weight on the areas that we can feel as possible.

00:36:45:00 - 00:37:06:11
Unknown
But I always say like, go with your dominant side when you are on when you're by the furniture and you're lifting yourself up, you can put as much weight as you need to in those arms. But if it gets painful, right, we're going to adapt and we're going to put the weight on our foot. We have to trust that we can do it.

00:37:06:11 - 00:37:30:06
Unknown
Like we have to be confident in the fact that we can do it right. Because when we lack that confidence, it's kind of like, well, I don't know, then we make it unsteady. Right? But can I show the actual one of the links that I have and absolutely share my skin? Because I feel like it's a very visual way for us to see.

00:37:30:08 - 00:38:00:21
Unknown
wow. Yeah. So this is my stomach. So this is actually how we can get up, right? So if it goes if you can get up, if you cannot get up and if you are a witness. Right. So for caregivers or that support system. So if we're having difficulty with lower extremity. Right. And we're trying to get into step two where we're crawling, maybe using our arms to propel ourselves forward right.

00:38:00:23 - 00:38:21:04
Unknown
And that all comes into strengthening, right? Strengthening our arms during those therapy sessions. And then you see here in step three, when she's putting her dominant leg or the stronger leg forward to get up. Right. We have to we have to make sure that we're like, okay, this is a stronger leg. Even though I may not be able to feel in both legs.

00:38:21:04 - 00:38:36:15
Unknown
Right? This is the leg that I stand on the most, right? Because, you know, when you stand, sometimes you lean to one side more than the other. Maybe we should go for that side right? If we know that. Okay, this is the side that I may feel strongest on and then standing up for putting all that force to our arms.

00:38:36:15 - 00:38:57:01
Unknown
Right. So we can minimize the amount of force we put through our legs. And then, of course, this is if you cannot get up, what you should do, if you can reach for the phone and make the emergency call. And this is one thing I would like to add in terms of home modifications if you have tables that are lower.

00:38:57:01 - 00:39:13:22
Unknown
Right. So if your telephone is kind of low to the ground, it'll be easier for you to get to. Right. So instead of placing that phone on higher countertops, maybe we should place them on like the bedside table or the couch side little mini table so that we can reach it in the event that we do fall right.

00:39:13:22 - 00:39:37:18
Unknown
Especially if we know that we're at risk for falling. And then this is specifically the caregiver section where the caregiver can help you. If there's someone there with you, it doesn't even have to be a caregiver if it's a stranger. If you know these steps too, you can actually guide them in how to get you up, right? Like, Hey, okay, I need you to be behind me so that you can brace me or protect my back or like, help guide me into the standing position.

00:39:37:20 - 00:39:59:13
Unknown
But yeah, so in short, what I was responding to you about is you can compensate by using stronger extremities, right? So if my legs, I can't feel them or they're swelling, use your arms. Right. And if same with your arms, if they're swelling, can't feel them, use your legs. Right. And if we have both, we have to just kind of trust ourselves.

00:39:59:13 - 00:40:13:20
Unknown
Right. And we have to do what we have to do to kind of get out where it's like, all right, like I'm just going to put the force through it. And then when I sit down, I'm going to check for injuries, see if anything got has gotten worse or I've increased swelling, and then I'll call my provider or therapist from there.

00:40:13:22 - 00:40:45:16
Unknown
Well, Javier, we thank you so much for taking the time to do this. Go through your presentation again so everyone can really like focus on the excellent tips that you have given us today. And we will attach that a diagram of how to get up from a fall safely when we send out the recording of this presentation along with the original one.

00:40:45:21 - 00:41:05:22
Unknown
So again, thank you so much Ranveer and everyone don't forget go to share cancer support dot org to look up upcoming programs, support groups, podcast and additional resources. Thank you John. We're not going.