If you are worried about an elderly family member or friend falling, you should be. According to the Centers for Disease Control and Prevention, each year, one in three people over the age of 65 takes a tumble – usually at home – that sends them to a physician or Emergency Department. In fact, each year, people over the age of 65 make 1.8 million trips to their local Emergency Department because of falls and 420,000 are admitted to the hospital. Of those 420,000, about 300,000 are hospitalized with life-altering hip fractures.
Despite months spent in physical rehabilitation therapy, about half of those who experience a hip fracture never regain their former level of independence and mobility. And, of that 50%, about 20% eventually land in a nursing home, where they die within a year.
The irony of all this is that most falls are preventable – if you know the risk factors to be on the look-out for.
Major risk factors for taking a tumble include: poor vision; muscle weakness; low blood pressure (hypotension); foot, balance and gait problems; chronic conditions, such as obesity, diabetes or arthritis, that affect feeling in legs and feet; the use of multiple medications, especially those for pain and depression; the functional impairment that comes with a stroke, Parkinson's disease, Alzheimer's disease or dementia; and advanced age – the older and frailer you are the more likely you are to take a tumble.
That's the bad news.
The good news is that the vast majority of falls are avoidable. “Prevention – taking steps to eliminate or minimize risk factors – is the key to avoiding falls,” says social worker April Vince, the program manager for the Cuyahoga County Board of Health's Home Injury Prevention Program (HIPP).
Step one in preventing falls is to fall-proof the home – the number one place where falls occur.
A call to HIPP (216-691-9602) will get you a free check-off list to get you started. Or you can download check lists and other information from Temple University (www.temple.edu/older_adult/IHSCEng.htm) or the American Geriatric Society (www.healthinaging.org/public_education/falls_index.php).
Step two is to check medications. Some medications—especially antidepressants and pain medications – can make people dizzy says Vince. “To make sure that's not causing the problem, people need to talk to their physician or pharmacist,” she said.
Step three is to have your eyes checked. Poor vision, cataracts and glaucoma all increase the chances of falling.
Step four, is check your foot gear. Shoes worn in the home should be well-fitting and study, and have a non-skid sole and broad, low heel. According to a recent study that ranked the safety benefits of footwear, lace-up athletic shoes – gym shoes – provide the best support, balance, and traction.
Step five is to modify behaviors that put you at risk for a fall. If gait is unsteady, use handrails or a cane. If you are out shopping, use a shopping cart for support. If standing from a sitting position puts you at risk for falling, learn to push off with the chair's arm rests.
Step six – and this works whether you are 65 or 85 – is to participate in a physician-approved individual or group exercise program to build muscle strength and improve balance and coordination. Weight training programs (also called resistance training programs) using one- and two-pound hand and ankle weights or stretch bands have shown excellent results in terms of muscle strengthening. Water aerobics programs and stretching and toning exercises, such as Tai Chi, have been shown to improve balance and coordination.
But that's not all an exercise program does. Research indicates that exercise also promotes better over-all cardiovascular and mental health; better elimination of bodily waste; and better sleep.
Step seven is to increase consumption of vitamin D. A study published in the Journal of the American Medical Association found that those who were taking a vitamin D supplement had 20% fewer falls than those who were not. If you choose to do this, however, consult your physician about the dose that is appropriate for you.
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Eileen Beal, MA, is a freelance healthcare writer specializing in geriatric issues. Successful Aging is provided by Benjamin Rose (www.benrose.org), a non-profit social service agency for older adults.
For more information on fall proofing the home and general fall prevention, consult the following:
The Comfort of Home , Paula Derr, RN and Maria M. Meyer
Home Planning for Your Later Years , W. K. Wasch