For adults over the age of 65, falls happen lightning-quick and can lead to injury, disability or death. Every year, one in four seniors in the United States suffers a fall, and 3 million of them end up in the emergency room from broken wrists or ankles, brain injuries and other trauma. Of the 800,000 who are hospitalized, 95% have suffered a hip fracture.
The incidence of falls rose 30% between 2007 and 2016, as people began commonly living into their 80s and 90s. The Centers for Disease Control (CDC) predict that by 2030, without intervention, there will be seven deaths related to falls every minute.
Credit: Courtesy of Harvard Health Publishing, Harvard Medical School
Why are falls more common as we age? Gradual loss of muscle mass results in weakness and poorer balance. Slower reflexes make it harder to react after a stumble. Long-term health problems lead to unsteadiness or stiffness. Damaged nerves cause numb feet. Mild cognitive impairment impairs alertness.
Four or more of the following risk factors put seniors at high risk for a fall: taking four or more medications daily, depression, dizziness for any reason, a chronic disease (such as diabetes or heart disease), arthritis, and acute infections. Anyone who has fallen once is twice as likely to fall again.
What should you do if you fall? First, take a few deep breaths, rest a moment and let the initial shock pass. Take stock of your situation: Do you hurt anywhere? If you have a cell phone handy or a medical alert device, summon help. If not and you have trouble getting up, roll onto your side, then get on your hands and knees. Crawl to a sturdy chair and slowly move into it. Get to the nearest phone when possible and if hurt, dial 911, then call a family member or friend. Follow up with your medical provider whether or not you were injured.
Credit: Courtesy of CDC, and National Center for Injury Prevention and Control
Organizations including the CDC, the National Institute of Health and the National Institute on Aging agree falls are preventable. Their common-sense recommendations are summarized below:
See your medical provider to consolidate your medications. Multiple prescriptions and drug interaction can result in weakness, loss of appetite and dizziness. Half of patients who have experienced a fall don’t tell their PCP, but they should. Reviewing why and how it happened will help prevent future falls.
Have your eyesight and hearing checked annually. If you can’t see an electric cord strung across the floor or hear your cat meowing behind you, you’re more likely to trip and fall.
Stand up slowly when getting out of a chair or bed to avoid dizziness. Orthostatic hypotension (slight lowering of the blood pressure by standing) can make anyone momentarily lightheaded; for seniors, this often leads to falls.
Invest in well-fitting shoes with good support and non-skid soles. No high heels, no flip-flops, no bare or stockinged feet. If you wear slipper socks, they must have a rubber tread.
Clean up any clutter—60% of all falls happen at home. Apply double-sided adhesive tape to rugs, and repair loose or uneven boards in floors or stairs. Make frequently used items easily accessible. Install grab bars in the shower, tub and near the toilet. Consider a sturdy plastic shower seat or rubber mat for the shower, and an elevated toilet seat. Make sure your home has adequate lighting. Use night lights, and have flashlights available in case of power loss. Bring one (or use the flashlight feature on your cell) when you’re outdoors at dusk.
Keep sidewalks shoveled in winter, and apply ice melt. Be vigilant when going out in bad weather.
Credit: Harvard Health Publishing, Harvard Medical School
Strengthen your legs by walking. Silver Sneakers has easy home exercises specifically for building leg muscles to avoid falling. Sign up for Tai Chi (free at the Pine Plains Free Library).
Hold the handrail(s) when using stairs. You must be able to see your feet at all times, so carry items in a shoulder bag, backpack or fanny pack.
Stop rushing. Try to get enough sleep. Avoid excessive alcohol. Talk to a therapist for depression if needed.
By improving home safety and self-care, you can be confident that your risk of falling will significantly decrease.
Mary Jenkins is recently retired after nearly 40 years as a family practice physician in New York state.