Fall Risk And Prevention In Older Adults – Medical Update

Falls are a leading cause of disability and death in adults over the age of 65. Statistics show that every 20 minutes, an older adult dies from a fall-related injury and many more are injured. While most falls do not cause harm, 1 out of 5 falls result in a serious injury, such as a fracture (broken bone) or bleeding into the brain. When an older adult gets a fractured bone, it limits his/her ability to perform daily activities and often leads to severe disability, which can be stressful for both patient and family. Also, even if no injury occurs, someone who has had a fall may experience a fear of falling, which tends to limit their mobility. This starts a vicious cycle wherein they get weaker (because they are not moving around as much) and increases their tendency to fall even more.

Several conditions are associated with an increased risk of falling. Lack of Vitamin D, arthritis or any condition that leads to difficulties with walking or balance, taking certain medications, problems with eyesight, and weakness of the lower body are just some of the conditions that can predispose to a higher tendency to falls. Environmental factors such as poor lighting in the home, increased clutter and trip hazards, and lack of railings and grab bars, also play a role in increasing fall risk. It is usually a combination of multiple factors that lead to a major fall in most adults over 65 years old.

What can you do to reduce your risk if you or a loved one is over 65 and is at risk for falling (or may have already fallen)? Here are some tips:

1. GET ANNUAL PHYSICAL EXAMS. Get your eyes checked every year, and see your primary care provider so that they can identify medical conditions or medications that can increase your risk of falling. If you have Medicare, take advantage of the Annual Wellness Visit that it offers.
2. SPEAK UP. Tell your healthcare provider if you have fallen, if you are afraid of falling, or if you are unsteady on your feet. Most patients do not tell their healthcare providers about a fall unless they have sustained an injury, but you would not want to wait until that happens.
3. STAY ACTIVE. Most experts recommend activities that help with strength and balance, such as Tai Chi. As with any exercise regimen, consult with your healthcare provider before initiating a new program to see if it is right for you.
4. CHECK YOUR HOME. Most falls happen at home. Fall-proof your home by doing the following:
a. Keep your floors and stairs free of clutter.
b. Make sure wires and cords are close to the walls and not in areas where you can walk over them.
c. Remove rugs that you do not need or make sure that they are secure to the floor (use double-sided tape if you have to).
d. Make sure every room has good lighting. Make sure you can easily reach a light switch or a lamp from your bed (in case you have to get up at night).
e. Add grab bars in the bathroom – one next to the toilet, and another in the shower or tub. Place non-slip mats on the floors in the bathroom.
f. Add railings and lights to all staircases (lights at the top and bottom of each staircase). The railing should extend the length of the entire staircase and there should be a railing on both sides.
g. Repair any loose or torn carpet.
h. Fix loose or uneven steps.
i. Keep the items that you use frequently within reach (so you do not have to use a step stool). Never use a chair as a step stool.
j. Put a phone near the floor in case you fall and cannot get up (so you can use it to call for help). Keep numbers in large print near each phone. Have your loved ones check on you regularly to see if you are doing well (especially if you live by yourself).

Falls affect a lot of people each year – whether it is an older person or their family who may be burdened when their loved one cannot be independent anymore. Take these simple steps to reduce your fall risk. Do not underestimate your risk – fall-related injuries are costly, dangerous and lead to significant disability.
By: Sasha Acelajado, MD