September is Falls Prevention Month, and this is one of my favorite subjects. As you may have read recently, I lost my father in 2014 as a result of a fall. So, while most people think “oh, it’s just a fall,” they are not realizing that a seemingly simple fall can lead to devastating consequences.
If you or an older adult in your life has fallen, you’re not alone. More than one in four people aged 65 or older fall each year. The risk of falling, and fall-related problems, rises with age. In fact, the Centers for Disease Control and Prevention has pegged falling as the leading cause of injury and death among adults age 65 and older.
We fall when an event challenges either our balance or our strength. When we’re young and healthy, we tend to have a better ability to stay upright. Meaning that if we stumble, we can often catch ourselves and recover without fully falling. But even then, a big enough knock off balance will send anyone of any age sprawling. There’s just a less likely chance of it causing severe injury or being life-threatening. The opposite is true as we age, and hip fractures are one of the most devastating injuries to older adults. Illness or weakness reduces anyone’s ability to stay upright, also regardless of age. This is why so many falls actually happen in hospitals! We all underestimate the power of sickness, even in ourselves.
Many older adults fear falling, even if they haven’t fallen before. This fear may lead them to avoid activities such as walking, shopping, or even taking part in social activities. This can create a downward spiral where they become less socially engaged, experience more physical decline and weakness, and become depressed.
Falls threaten an older person’s independence. As a result, many will not tell their doctor that they have fallen!
To prevent dangerous falls in an aging adult, be proactive about getting the right kind of medical assessment. A fall can be a sign of a new and serious medical problem that needs treatment. It could be something as “simple” as dehydration or a urinary tract infection causing the person to be weak.
Older adults who have fallen are also at a higher risk for falling again. And older patients often don’t get recommended care. Making sure things are not overlooked is crucial; for example, some medications can lead to worsened balance.
There are many risk factors that can contribute to falls, such as muscle weakness, vision problems, medical conditions, medications*, foot problems (including improper footwear), and environmental hazards.
*I put an asterisk beside medications because this one often goes unaddressed. Medications are one of the biggest reasons for falls in patients! The most common ones that can increase the risk of falling are ones that affect the brain (psychoactives), stabilize blood pressure, or that lower blood sugar. And as you probably are aware, many older adults are taking three or more medications – so that just ups the ante on risks.
Make sure the doctors have checked all the things that could have contributed to the fall, not just addressing injuries suffered from the fall. In addition to some of the concerns already mentioned, be sure to check blood pressure and pulse readings when sitting and when standing. Also ask to have blood tests done that check sodium levels, anemia, and so forth. Review gait and balance, podiatry, and vision. Evaluate for underlying heart conditions or neurological conditions, and absolutely check home safety.
To boost home safety, simple changes like removing throw rugs and marking hazardous thresholds or steps with glow tape can make a huge difference. Adding LED lights along the floor in the bathroom, grab bars in the shower and by the toilet, voice-activated electronics like alarm clocks, and window coverings that minimize glare on floors are all good extra measures.
Staying active is important to keeping your body healthy and actually helps to prevent falls. Focus on strength and balance training with regular and sustainable exercise. Tai Chi is an excellent balance training form of martial arts, often recommended for older adults and Parkinson’s patients. Gait training and walking are always good ways to exercise as well. Just remember to drink plenty of water, ensure good posture, do not overdo it, and slowly increase the duration of your exercises when starting out.
There are also ways you can sneak exercise and balance training into your day! Here are a few things you can do while making dinner or even while brushing your teeth:
- Stand with your back against the wall to align your posture
- Shuffle side to side, once then three times on each side
- Sway side to side, simply by shifting weight and keeping body in line with leg lifting
- Sway front to back and hold each position, as if a straight line is going through your body
- Toe walks
- Heel walks
- Balance on one leg at a time
- Marching in place with legs at hip height
- Toe touches to the front, side, back, then in circles
- Wall push-ups
Of course, there may be loved ones in your life that cannot gain strength and work on their balance. They may not be able to have medications reduced or changed. They may be in that pool of patients who are always going to be at high risk of falling. This is not something to play around with! While medical alert devices or security cameras may give families peace of mind, they cannot prevent a fall. If a fall knocks someone unconscious – or worse – a medical alert device is completely useless. The only way to truly keep the devastation from happening is to try to prevent the falls from happening altogether.
You cannot be a caregiver to a loved one around the clock. This is where Care Advantage comes in! Let us work with you to determine where your loved one’s highest needs and highest risks are. Are there certain times of the day when the falls tend to happen? Is non-compliance with meals, medications and hydration a concern? Are there hazards within their home that we, as a non-relative and unbiased third-party expert, might be able to convince your loved one to remove? Trust me when I say that I understand all too well the dynamics of being a daughter trying to tell a parent what to do and having them resist my recommendations!
Allowing our caregivers to assist your loved one during their highest risk times can alleviate a lot of stress for you and for them. While they may be stubborn and not want help at first, we find that after a few visits the help is greatly appreciated, and people realize that our help ensures they maintain their independence and safety in the home of their choice. Because that’s what aging in place is all about.
The best way to recover from a fall is to prevent it happening in the first place! That peace of mind is priceless, and so is the life of your loved one!
