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    Fall Prevention

    Deaconess Primary Care for Seniors 09/04/2014
    Complications due to falls are the leading cause of death from injury in seniors age 65 and older. Prevention of falls in the home is so important. You’re protecting someone’s vitality, independence and life.

    Through my experience helping to coordinate care and services for seniors, I see the effects of serious falls among this group. These are our loved ones—parents and grandparents—and falls are a serious risk to their overall health, as well as their ability to continue living an independent life. 

    Possible Causes
    Falls don't "just happen," and people don't necessarily fall just because of aging. Often, more than one underlying cause or risk factor is involved in a fall. A risk factor is something that increases a person's risk or likelihood of a medical problem or disease.

    As the number of risk factors rises, so does the risk of falling. Many falls are linked to a person's physical condition or a medical problem. Other causes could be safety hazards in the person's home or out in the community, such as stores, churches, etc.

    Risk Factors
    Physicians and other researchers have linked a number of personal risk factors to falling.
    • Muscle weakness, especially in the legs. Older people with weak muscles are more likely to fall than are those who maintain their muscle strength.  Seniors should also work to maintain their flexibility and endurance.
    • Balance and your gait -- how someone walks. Older adults who have poor balance or difficulty walking are more likely to fall. These problems may be linked to a lack of exercise or to a neurological cause, arthritis, or other medical conditions and their treatments.
    • Blood pressure that drops significantly when getting up. This condition -- called postural hypotension -- might result from dehydration or certain medications. It might also be linked to diabetes, neurological conditions such as Parkinson's disease, or an infection. Some people with postural hypotension feel dizzy when their blood pressure drops. Other people may not feel dizzy, even if their blood pressure drops a lot when they get up.
    • Slow reflexes. The increased amount of time it takes to react may make it harder to catch one’s balance if someone starts to fall.
    • Foot problems and unsafe footwear. Backless shoes and slippers, high-heeled shoes, and shoes with smooth leather soles are examples of unsafe footwear that could cause a fall.
    • Sensory problems. If senses don't work well, a person might be less aware of their environment. For instance, having foot numbness may cause a loss of traction.
    • Not seeing well. Trying to adjust between dark and light or depth perception can be a problem.  Something as small as a curb or step can cause a trip. Other vision problems contributing to falls include cataracts and glaucoma. Wearing multi-focal glasses while walking or having poor lighting around the home can also lead to falls.
    • Some medications causing side effects like dizziness or confusion. The health problems for which the person takes the medications may also contribute to the risk of falls.
    • Increasing the number of medications a person takes. People who take four or more prescription drugs have a greater risk of falling than do people who take fewer drugs. You should check with your doctor if you think your medications are causing dizziness or unsteadiness. Your doctor can tell you which drugs, including over-the-counter medicines, might cause problems. Do not change your medications on your own.
    (This information also includes data from the National Institutes on Health)
    Signs a loved one is at risk for falling:
    • A fall, near fall, stumble, or a “sliding down the wall”
    • Swelling in your feet and/or ankles
    • Difficulty breathing or feeling short of breath
    • Dizziness, feeling light-headed, fainting, or passing out
    • A change in your sleep pattern (sleeping more or less than before)
    • Changes in chronic conditions such as diabetes (change in blood sugar readings), arthritis (increased pain or stiffness), or high/low blood pressure
    • Feeling depressed, “down in the dumps”, or sad for more than a few weeks
    • A fear of falling
    • Difficulty doing daily activities such as bathing and dressing
    • Inability to walk at home without holding onto furniture, countertops, etc. 

    When talking with your (or a loved one’s) doctor, here are some question you might want to ask:
    • Do I need to have a vision (eye)/audiology (hearing) evaluation?
    • Am I taking any medications that maybe increasing my risk for falling?
    • Would an assistive device such as a cane or walker be helpful for me now?
    • What types of physical activity to you recommend for me?
    • Would any type of therapy (physical, occupational, vestibular) be helpful for me to reduce my risk of falling at home?
    • Would a personal emergency response system (Lifeline) be appropriate for me? 
    Fall prevention around your home

    • Remove throw rugs or use double-sided tape or a non-slip backing so the rugs won’t slip.
    • Keep objects off the floor.
    • Coil or tape cords and wires next to the wall.
    • Clean up spills right away.
    • Keep stairs clear.
    • Fix uneven or loose steps.
    • Install an overhead light at the top and bottom of the stairs.
    • Make sure carpet is firmly attached.
    • Fix loose handrails.
    • Make sure handrails are on both sides of the stairs.
    • Keep things you use often in the lower shelves (about waist level).
    • If you use a step stool, use one with a bar to hold on to.
    • Use a non-slip rubber mat or self-stick strips on the floor of the tub or shower.
    • Use grab bars inside the tub and next to the toilet.
    • Install a raised toilet seat.
    • Place a lamp close to the bed where it’s easy to reach.
    • Use night-lights so you can see where you’re walking.
    • Use night-lights that come on automatically in the dark.

    • Repair cracked sidewalks.
    • Trim shrubbery along the pathway to the home.
    • Install adequate lighting by doorways and along walkways. 

    Additional steps to preventing falls
    • Stay active. Exercise regularly to improve balance and coordination.  (Talk to your doctor about what exercises or physical therapy might be right for you.)
    • Have your vision checked yearly.
    • Get up slowly after you sit or lie down.
    • Use a cane, walking stick or walker to help you feel steadier. Check devices regularly for worn tips/loose parts.
    • Wear rubber-soled, low-heeled shoes that fully support your feet.
    • Improve the lighting in and around your home and garage.
    • Keep emergency numbers in large print near each phone.
    • Install light switches that glow.

    Facts About Falls
    • Each year, one in every three adults age 65 and older falls. 
    • Every 2.3 seconds, a person over the age of 65 will fall.
    • Complications related to falls are the leading cause of death from injury in persons  ≥65
    • 2/3 of those who fall will fall again within 6 months
    • Every 29 minutes an older adult dies from a fall
    • Every 15 seconds an older adult is treated in an ED for a fall related injury
    Click to learn more about Deaconess Primary Care for Seniors.
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