Falls: Causes, Prevention, and What To Do If It Happens

by Dr. Don Rose

INTRODUCTION

A fall can happen to us all. This is true no matter what our age. While falls are not the inevitable result of getting older, the odds go up as one advances in age.

SYMPTOMS THAT CAN LEAD TO FALLS

Dizziness, lightheadedness, and general weakness can all cause a fall, and each condition may be a sign of an underlying medical issue. In addition, a fall may be a symptom of a serious illness, such as a heart attack, stroke, internal bleeding, or pneumonia. Falls may also indicate a drinking problem; alcohol abuse is an alarming trend among more and more seniors.

HOW FALLS OCCUR

As one ages, eyesight and hearing ability often decreases. Slower reflexes and decreased coordination and muscle strength can limit our ability to take action in avoiding a fall when it starts to happen. Medical conditions like heart disease or low blood pressure can affect balance. Medicines or alcohol can cause lightheadedness. Arthritis can throw off balance, and osteoporosis can weaken bones so they break more easily than when one is young. Fortunately, the most preventable factors are usually things in the home; many folks, especially seniors, just aren't aware of the hazards they have in their abodes.

PREVENTION STRATEGIES

The good news is that many falls can be prevented. They are caused by a number of factors; addressing some or all of these can lower one’s chances of a bad fall. Steps one can take to reduce the chances of falling include: regular exercise, making one’s home safer, having your doctor evaluate your medicines, and checking your vision.

START EXERCISING

Exercise increases one’s strength, improves mood, stimulates circulation, and gives a sense of accomplishment. Exercises geared toward improving balance and coordination (such as Tai Chi) are even more valuable to seniors. Ask your doctor and/or a health club or trainer about the various exercise programs you can try, then decide which is best for you, based on your time, budget, and goals.
For many, the easiest and cheapest way to start exercising is to just go outside and walk – around the block, or two blocks, or in a park, etc. Work up to longer distances each week. Then try running instead of walking. Keep striving for more striding. Remember: the journey of a thousand miles begins with a single step.

MAKE YOUR HOME SAFER

The outside world can be a dangerous place, yet about half of all falls happen at home. To make your place a home safe home, try following these rules of thumb:
  • When using a ladder, have someone hold the bottom; avoid standing on the top rung.
  • Remove things you can trip over (such as papers, books, clothes, and shoes) from stairs and places where you walk.
  • Avoid small throw rugs; use double-sided tape to keep rugs from slipping.
  • Keep items you use often in cabinets you can reach easily without using a stool.
  • Have “grab bars” put in next to your toilet, and in the tub or shower.
  • Use non-slip mats in the bathtub and on shower floors.
  • Improve the lighting. Older folks need brighter lights to see well.
  • Have handrails and lights put in on staircases.
  • Wear shoes that give good support and feature non-slip soles.
  • Subscribe to a medical alarm service, so that if you fall and can’t reach a phone, you can summon help.

REVIEW MEDICINES

Have your doctor or pharmacist look at the various medicines you take, even non-prescription (over the counter) items. The reason: as you age, the way some medicines function (and interact) in your body can change. Some medicines, or combinations of meds, can make you drowsy or light-headed -- a common precursor to a fall.

HAVE YOUR EYES CHECKED

Has someone ever told you, “you should have your head examined”? Well, they are right when it comes to the eyes. Poor vision can increase your chances of falling, so have your eyes checked regularly by an eye doctor. Find out if you may be wearing the wrong glasses, or have a condition such as glaucoma or cataracts, since these can cause diminished vision. Also, ask your doctor about taking supplements that have been shown to support eye function; some sources say Lutein is a good supplement for this, while others swear by carrots.

WHAT TO DO IF YOU FALL

If you fall, are badly injured, and can get to a phone, dial 911 and/or someone you know who can take you to a doctor or emergency room. Many seniors should call their health care provider or emergency number after a fall, even if there appears to be little or no injury, just to be safe. Also note that head injuries can be very serious.
Another consideration: a fall may be a symptom of a serious illness. Your health professional can examine you and may order x-rays or other tests, if needed. Also, tell your doctor if you think one or more of your medicines are affecting your balance or causing dizziness.
Lastly, we must consider cases where someone is injured at home and cannot reach a phone. For seniors living alone, the increased odds of a fall means a medical alarm system is a vital step to ensure protection. Just as we use medical insurance to protect our health and assets, a medical alarm system acts as a form of additional insurance when something happens (like a fall) that could be life-threatening when a phone is out of reach. Life Alert can provide this protection; subscribers to Life Alert wear a small pendant which, when pressed, can summon help 24/7 if something happens to you and you cannot reach a phone. See www.lifealert.com for more details.

MORE INFORMATION

Centers for Disease Control and Prevention
National Center for Injury Prevention and Control
http://www.cdc.gov/ncipc/duip/spotlite/falls.htm
Senior Health Advisor, from Fairview Health Services
http://www.fairview.org/healthlibrary/content/sha_index.htm
Life Alert
http://www.lifealert.com
Senior Protection Blog
http://seniorprotection.blogspot.com
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