The document provides a comprehensive guide on how to fall safely for individuals diagnosed with cancer, addressing the increased risk of falls due to treatment side effects. It emphasizes the importance of protecting the head during a fall and offers techniques to minimize injury, such as rolling with the fall and landing on cushioned areas of the body. Additionally, it outlines steps to take after a fall and encourages practicing safe falling techniques to make them second nature.

1. Fall Action Plan:
Janvier Hoist-Forrester, OTS
New York Institute of Technology
Occupational Therapy Doctoral Candidate
How to Fall Safely After Cancer
Diagnosis, During Treatment,
and in Survivorship.

2. Safe Space
It’s no secret that falling can make you feel clumsy. The more frequent the falls, the less control you may feel over your
body. This feeling is natural and the frustration or fear you may experience alongside it is valid. As you progress through
this journey you may fall, in fact you may fall several times, that is OKAY. The information offered in this presentation
will help you stay safe while you continue your healing journey. Remember that you are not alone, the cancer
community and your team of healthcare professionals are here for you every step of the way.

3. Side Effects & Sensitivities
The medications and adjunctive therapies (chemo, radiation, hormone therapy, etc.)
used to treat breast cancer can cause side effects that are potentially long lasting or
debilitating. The bodily reaction to each form of treatment can vary between person
to person due to natural sensitivity levels. These side effects and our sensitivities to
them can lead to an increased risk of falling or a higher chance of injury after falling.
- Blood Thinners:
- These medications are used to prevent clots from forming, but
with reduced clotting properties it is more difficult for your body
to stop a bleed. Can increase the risk of bleeding and bruising.
- CIPN:
- Damage to the peripheral nerves can alter the sensations felt in the hands and feet.
Lack of sensation in the feet can increase risk of falling due to insecurities when
walking; can also increase risk of injury due to decreased ability to detect cuts.

4. Protect Your Head
The most important area of the body to protect when you find yourself falling is your head.
- Hair removal (in preparation for treatment), or hair loss (during treatment)
exposes the head to an increase chance of lacerations.
- Using your arms as a shield for your face and head can reduce
any incidence of head trauma, bleeding, or lacerations (cuts).
- Anticoagulants, oral chemotherapy medications, chemotherapy
infusions, and radiation can increase risk of bleeding and bruising.

5. Steps: Protect Your Head
1. Lower your head by tucking your chin down into your chest.
2. Place both hands at the side of your head, with your elbow directly in front of you.
3. Avoid falling face first by turning your head and arms to the side. This turn will allow the cushion
of the arms to bear the impact of the fall, reducing the risk of head trauma and broken bones.
4. If falling backward, adjust your hand and arm placement by placing your hands on the back center
of your head. Still, aim to turn your head to the side to avoid direct impact with the ground.
5. If you are on medications such as blood thinners and anticoagulants, or have a condition that thins
the blood, call your provider immediately and inform them about your fall.

6. Try For The Side
We may naturally attempt to catch ourselves as we fall. Catching ourselves may
look like grabbing onto the railing as we slide down the stairs or reaching
towards the closest object to help reduce the impact, but more often than not
we try to brace ourselves using our hands and arms.
- “FOOSH” injuries or Falling on outstretched hand injuries.
- The best way to prevent or reduce injuries to the hands and arms is to get into a fetal-like position
when falling.
- This technique can work in most situations. If you have concerns about hip fragility a backwards fall
technique would be more suited. Speak to therapists about techniques that will work best for you.

7. Loose as a Goose
The fear or shock of falling can cause you to tense your body as you
brace for the impact and pain from hitting the surface. Tensing up
during a fall will increase your risk or broken bones and muscle
sprains.
- Breathe as you go through the motions of the fall. This will
help you stay loose and allow your body to absorb the shock
from the fall.

8. Roll don't bounce
Roll it out. As silly as it may sound, going with the motion and/or
prolonging the fall can help with the absorption of the impact by
spreading it out over the body. When rolling it out, you do not
come to an abrupt stop, giving the body an increased chance of
taking on the force over a large area and reducing the likelihood
of any significant injuries. Remember to only roll it out if there is
a clear path.

9. Let’s Be Real
Realistically remembering all the steps to falling safely can be hard, especially in the moment.
With safe and planned practice, these steps can become second nature in the event of a fall at
home or in public. But if you haven’t mastered these steps as of yet, there is a simple tip that
can help minimize the risk of injury. If all else fails, remember to “Meet with Meat”.
- As a last resort, the safest way to fall would be to fall on large areas of your body
that have more cushion than others. This tip will help you to avoid bony areas of
the body that can break on impact. Falling on soft and cushioned areas like your
thighs or butt can offer more protection and absorption.

10. I’ve Fallen, Now What?
- Check for Injuries
- Call for help or notify support system
- Program Emergency Number in Phone
- Make a spare house key and inform your emergency contact of its
location.
- Variety of spare key hiders available for purchase online or in-
stores (rock, lock box, etc.)
- Smart Watch Fall Features
- Alexa, Siri, or Google Home to contact Emergency services or contact

11. If you don't detect any injuries, you can utilize the following plan to get up from your fall.
1. If you follow the action plan, you should already be on your side. If you are not, slowly roll
onto whichever side of your body you feel is stronger (CIPN → roll on the side of your
dominant hand)
2. Push yourself up using your arm to a side-sitting position.
3. Crawl or scoot to a solid piece of furniture or structure that can support your body weight (a
couch, outside railing, etc.).
Getting Up From a Fall

12. 1. -
2. -
3. -
4. Using the solid furniture or structure, bring yourself to a kneeling position with
your stronger leg closer to the furniture. Slowly slide the foot of your stronger
leg forward so that it is flat on the floor.
5. Put both hands on the furniture or structure. Push through both your hands and
stronger foot to slowly raise your body from the ground.
6. Sit down on the nearest seat for a few minutes. If you are not dizzy or
experiencing pain recheck for injuries that you may not feel.
Getting Up From a Fall Cont’d

13. Resources for Visual Steps Getting Up
From A Fall
Standing Up From Falls:
SAHEALTH.GOV
What To Do After A Fall:
Canada.ca/falls

14. Resources for Visual Steps
There are many visual resources available with instructions on how to fall safely. When
choosing videos please ensure they are from verified and trained professionals or
organizations.
How to Fall Safely:
https://youtu.be/e5g4q9_cISc?si=4gMylnwmVzrvdU2b
AARP Visual Instructions:
https://www.aarp.org/health/conditions-treatments/info-2017/how-to-fall-safely.html
Step by step of how to fall safely

15. Take Away
1. Protect your head
2. Meet with Meat
3. Expect bruising
4. Emergency contact plan
5. Practice makes perfect