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Elderly Woman Fall

Fall Prevention

According to the CDC approximately 36 million falls in the elderly occur every year. Of those 36 million falls, 32,000 will result in death. If that didn’t grab your attention, did you know that there are about 300,000 hip fractures each year? 95% of which are caused by falls. Falls in the elderly are often the start of a long functional decline which can lead to a loss of quality of life, hardship on family members, and costly medical bills. In this article I will be going over fall prevention methods to keep you or your loved ones safe and healthy for as long as possible.

Elderly man preparing to run

1. Stay ACtive

Without a doubt the number one thing anyone can do to prevent falls is to stay active. Falls are often caused by a decrease in strength or loss of balance. Loss of strength (sarcopenia) will naturally occur as we age and begins as soon as we hit 3 years old. It is estimated that those who are physically inactive can lose 3 to 5% of their strength each decade. Strength loss will occur even more quickly once we reach the age of 75. While this sounds bleak it does not have to be. Preventing strength loss can be combated by simply staying active as you age. You also don’t have to be pounding weights in the gym to prevent muscle loss however a strength routine will certainly help. Balance will often go hand in hand with strength. If you stay physically active your vestibular, sensory, and visual system will be constantly working. However if you are inactive those same sensory systems will have no reason to stay as sharp and your balance will suffer as well. Here is a list of things you can do to stay active and physically in shape.

Activities to stay in shape

  1. Walk/jog
  2. Play a sport- basketball, tennis, golf
  3. Lift weights
  4. Join your local silver sneakers program
  5. Join Pilates or yoga class
Vision/Eye exam

2. Proper vision

The three main components which are involved in our balance is our visual, somatosensory, and vestibular systems. We typically rely on our visual system the most. If you have ever gotten up in the middle of the night to go to the bathroom without lights and are stumbling around and losing your balance you will realize just how important our vision is in preventing falls. Falls at night-time are one of the most common times for falls as the visual system is often limited. It is no secret that as we age our vision also tends to deteriorate. If you do not keep up on going to the eye doctor and get prescribed the appropriate glasses or contacts you are increasing your risk for falls. This is one of the easier items to check off- Go see your eye doctor!

Vestibular system

3. Vestibular System

Another crucial part of our balance is our vestibular system. Our vestibular system is comprised of our inner ear and is involved in letting us know where we are in relation to our surroundings. When people are young and are active- walking, running, jumping, hopping, etc.. the vestibular system is being constantly worked and that individual will have very good balance. If you become more sedentary as you age and for example are just looking ahead at a TV screen then the vestibular system will deteriorate and subsequently so will your balance. Our bodies have evolved to be very smart and if you don’t use it, you will lose it. Keeping the vestibular system healthy has a lot in common with just staying active- simply getting out of the house and into the world will give your vestibular system all the work it needs to stay healthy for many years to come. Now if you are having vertigo or dizziness than this will likely be outside of you ability to treat on your own. I would recommend you see a ENT or ear, nose, and throat specialist to be properly diagnosed.

three sensory systems responsible for balance

  1. Visual
  2. Vestibular
  3. Somatosensory
Preparing medications

4. Know your Medications

Adverse reactions to medications are one of the leading causes of not only hospitalization but also being re-hospitalized after being discharged. As we age our bodies tend to break down and medications can serve to keep things in balance. However problems can arise when we are taking so many medications and they have adverse reactions either to themselves or we just do not tolerate them well. If you noticed any changes in your balance or dizziness or vertigo it is imperative that your alert your doctor as quickly as possible. This is not something to brush off or say “I’ll call next week”. Medication interactions is a serious health risk and should be taken care of immediately to prevent a fall or other ailment.

Footwear

5. Proper footwear

I am writing this in the month of December in the northeast United States with the wind howling outside and the air just about freezing. Proper foot wear is important at all times to prevent a fall and in particular during the winter months if you are in an area which gets snow and/or ice. If the forecast calls for any change of snow or ice at all and you must leave the house I would highly recommend you have boots or at the very least shoes with good traction. If it is truly icy out, just stay at home if possible. If you must venture out ask for a friend or family member to assist you to the vehicle. It would also be smart to always have a pair of footwear with good traction in your vehicle just in case mother nature decides to pay you a visit when you least expect it. But the winter isn’t the only time that having on proper footwear is important. Even the simple everyday task of walking onto a tile floor can pose a serious fall risk. If you wear worn down two year old socks which have no traction left onto a tile floor you are asking for a hip replacement. You can find non-slip socks for less than 10 dollars which will be a heck of a lot cheaper than the bill you will get from the hospital after falling and breaking your hip.

Fall Prevention Infographic

Fall prevention Infographic

6. Tidy up the house

If you have junk all over the floor your risk for falls will skyrocket. Having walking pathways which are free from clutter makes it much easier on your sensory systems and thus your risk for falls will be less. If you have electrical cords popping up out of nowhere, old newspapers on the ground, spilled liquid or food on the ground, and a maze to walk through than your sensory systems are overloaded with too much information and your risk for falls will be very high. Here are some things you can do to tidy up your home and remove fall risk hazards.

  • Keep walking pathways clear of any clutter
  • Tidy up electrical cords and oxygen cord so you do not trip
  • Try to get rid of as much junk as possible
  • Remove loose rugs or if not possible tape or tack down rugs so they do not pose as high a risk for falls
  • Use non-slip mats in bathroom and shower
Man helping elderly man with walker

7. Use Assistive devices

There is no shame in using a walker or a cane. While it is good to be as independent as possible at a certain point using a cane or a walker may be the right choice to decrease your risk for falls and obtain a higher quality of life. If you are fearful to go out in public because you may fall but also do not want to go out if you have to use an assistive device than you are setting yourself up for a slow functional decline. This is a common case where one’s pride will get in the way of what is the right decision. What will often happen in this case is the individual will stay at home and not get any physical activity and will gradually deteriorate losing strength and endurance. Than when leaving the home is absolutely necessary such as a doctors visit the individual will have a loss of balance and sustain a fall which will require hospitalization and possibly rehabilitation. This can be avoided by simply using the appropriate assistive device and continuing to stay as physically active as your body will allow. If you feel your balance is deteriorating and are unsure if you should be using an assistive device ask your doctor about seeing a Physical Therapist as they will be able to conduct a balance assessment which will determine what assistive devices are appropriate for you if applicable.

Grab bar in shower

8. Make bathroom safer

If you have ever gotten out of a slippery shower without anything to hold onto you can see how this could spell disaster for the elderly who do not have the strength/balance to catch themselves. Installing grab bars in the shower can decrease fall risk and make the experience less fearful. Grab bars are no longer expensive to install and can easily be ordered on Amazon and installed by those without handyman skills. In addition to grab bars in the shower it is a good idea to have them installed next to the toilet or in front of the toilet as this is a common area where you may need some assistance in standing. Standing up from the toilet when there is nothing to hold onto becomes harder to do as we age and lose strength. A simple grab bar can make the task much easier and improve safety. Also consider placing non-slip mats in the shower to further reduce fall risk. If you have difficulty standing for an extended period of time in the shower a shower chair or bench may be beneficial. These are also much cheaper than they used to be and can be ordered from Amazon.

Helping elderly

9. Don’t be afraid to ask for help

Father time remains undefeated and always will. At some point in our lives our health will deteriorate and so will our balance. While doing all the above will help to keep father time at bay for as long as possible you will need some extra help at some point. Don’t let pride get in the way of your health. If you are going out of the house for groceries or an errand and do not feel comfortable doing it on your own, ask a friend or family member to assist you on the way. Although you might feel embarrassed or that you are putting someone at a disposition that individual likely cares about you and would love to help out. So when in doubt ask for some help when you don’t feel comfortable doing something.

Summary

Hopefully you fine this article helpful in reducing either your or a loved ones fall risk. While some of these are easy to implement such as installing a grab bar or placing a non-slip mat in the shower, overall this is an active process which will require hard work. Staying physically active and ensuring our visual, vestibular, and somatosensory systems are “exercised” on a daily basis can be one of the most beneficial things you can do to not only prevent a fall but to maintain a high quality of life and stay healthy. Be sure to check this article Balance Exercises for Seniors out if you want a list of balance activities that you can do in the comfort of your own home. If you can do this on a consistent basis over time your balance will improve and your fall risk will lessen each time you complete it.

Disclaimer

Although I am a Doctor of Physical Therapy by profession, I am not your personal Physical Therapist nor am I a medical doctor. All content and information on this website is for informational purposes only, does not constitute medical advice and does not establish any kind of patient-client relationship by your use of this website. A patient-client relationship with you is only formed after we have expressly entered into a written agreement with you that you have signed, including our terms to represent you in a specific manner. Although we strive to provide accurate general information, the information presented here is not a substitute for any kind of professional advice, and you should not rely solely on this information. Always consult a professional in the area for your particular needs and circumstances prior to making any professional, legal, medical and financial or tax related decisions.


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Comments

2 responses to “Fall Prevention”

  1. Johnathan Avatar
    Johnathan

    I found that when my aging father got hearing aids his balance improved quite a bit. I’m glad you mentioned that as I found a direct correlation between his him getting hearing aids and his fall rate decreasing.

  2. Sam Avatar
    Sam

    Can you go more in depth on what footwear you would recommend? Special types of shoes and what tread it has?

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