The medical journal American Family Physician reports that falls are the leading cause of injury-related emergency department visits and the primary cause of accidental deaths in adults ages 65 and older. In fact, according to the National Council on Aging, approximately one in three adults ages 65 and older falls every year. It is no surprise that fall prevention in the elderly has become a priority for most caregivers.
“Injury from a fall is definitely a concern as we age,” said Timothy Kirkpatrick, MD, an emergency department physician. “The core becomes weaker, balance degenerates, reaction time slows, vision dims, and we cannot compensate quickly when off-balance. Falls can have serious repercussions, including hip fractures and head trauma.”
Some signs that you are or a loved one is at risk of falling include an unsteady gait or a gait that includes a lot of shuffling. You also want to pay attention to how many steps can be taken without assistance. This may be the primary step to assess any fall-related risks for injury prevention in the elderly.
Fortunately, there are a number of risk factors that can be modified or managed.
“It’s important to have your vision checked frequently, including assessing for potential cataracts and macular degeneration,” Dr. Kirkpatrick said.
He continued: “You also want to be aware that certain medications can make you dizzy. Pain medications, especially if new to you, can make you loopy, fatigued and less aware of your surroundings. Pay careful attention to how you feel any time you start a new medication such as antibiotics, blood pressure medications or blood thinners, or any time the dosage of one of your medications is adjusted. Even some over-the-counter medications can affect how steady you are on your feet, such as antihistamines like Benadryl or medications marketed as sleep-aids.”
Additional risk factors, according to the United States Centers for Disease Control and Prevention, include:
- Lower body weakness (one sign of this is needing to push with your hands when standing up from a chair)
- Vitamin D deficiency (that is, not enough vitamin D in your system)
- Foot pain, numbness in your feet or poor footwear
- Needing support – such as from a cane or walker – when walking
- A history of falling - people who have already fallen once are more likely to fall again.
- Home hazards or dangers such as
- broken or uneven steps,
- throw rugs or clutter that can be tripped over,
- no handrails along stairs or in the bathroom, and
- dimly lit doorways, steps and stairwells.
Most falls are caused by a combination of risk factors. The more risk factors a person has, the greater their chances of falling.
Dr. Kirkpatrick recommends taking the following actions to help the risk of a fall or injury from a fall:
- Remove throw rugs.
- Provide good lighting.
- Remove or secure carpet and treads on stairs.
- Ensure all cords are out of the way/never crossing a footpath.
- Refrain from rearranging furniture, as people are more likely to bump into or trip over things if the layout they are familiar with changes.
- Eliminate clutter – keep kids’ toys picked up, and don’t stack things like magazines and papers near a doorway or stairway where they might be knocked over into the footpath.
- Install hand rails where needed – ensure they are secure and don’t wobble by bolting them into studs rather than anchoring into drywall.
- In the winter, ensure all outdoor walkways are kept thoroughly shoveled and well salted.
- Get rid of any glass-topped tables
- Install non-slip tread strips or bath appliques on bathtub and shower floors.
It is important to note that some fall-related injuries actually occur when people are struggling to get back up from a fall, Dr. Kirkpatrick said, and can even occur without a fall.
“When a hip breaks,” he said, “it is often not the fall that breaks it but the act of getting back up or twisting/turning when standing, and hips can even break from the simple action of getting up from a seated position. To reduce the risk of breaking a hip, chairs for the elderly shouldn’t be too soft and deep, and of course they should not be unstable. Also consider installing handrails to help get off the toilet or out of the shower.”
It is possible to reduce the risk of breaking a hip as described above and to modify the overall risk of a fall/fall injury by developing or improving good self-care habits.
Dr. Kirkpatrick recommends eliminating or reducing alcohol consumption, and exercising regularly to improve balance and strengthen the core. The CDC especially recommends Tai Chi to improve balance. You also can talk with your doctor/advise your loved one to talk with his or her doctor about fall prevention.
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