Falls Are Much More Serious Than Most Seniors Realize … or Admit

Falls are one of the most frequent, dangerous and avoidable causes of death, disability and dementia among people age 65 and older.

Every year, one out of three older people falls, but fewer than half tell their doctor. Falling just once, even if you don’t hit your head or break a bone, doubles your chances of falling again.⁽¹⁾ Will this be your year?

Part 1 of 4 – Alarming Statistics

●  One out of five falls causes a serious injury such as broken bones or a head injury. These injuries can make it hard for a person to get around, do everyday activities, or live on their own.⁽¹⁾

• Each year, 2.5 million older people are treated in emergency departments for fall injuries. Nearly 1,800,000 are treated and released.⁽¹⁾
• The remaining 700,000 are hospitalized because of a traumatic head injury (TBI) or hip fracture that’s a direct result of their fall.⁽¹⁾
• 2 out of 3 are hospitalized for TBIs.
• 1 out of 3 are hospitalized for hip fractures.
• Falls are the most common cause of TBIs.⁽¹⁾ The severity of TBIs range from concussions to repeated vomiting or nausea, convulsions or seizures, an inability to awaken from sleep, slurred speech, weakness or numbness in the extremities, loss of coordination, and increased confusion, restlessness, or agitation.⁽²⁾TBIs can be very serious, especially if the person is taking certain medicines (like blood thinners). An older person who falls and hits their head should see their doctor right away to make sure they don’t have a brain injury such as bleeding in their brain.⁽¹⁾
• According to the CDC, trauma to the brain was the cause of death in 41% of fall fatalities among seniors in the year 2010.⁽³⁾
• More than 95% of hip fractures are caused by falling, usually sideways.⁽¹⁾ Nearly 1/2 will never walk again.^(4,5) 1 out of 3 will die within one year after they fall.^(4,5)
• Many people who fall, even if they’re not injured, become afraid of falling. This fear may cause a person to cut down on their everyday activities. When a person is less active, they become weaker and this increases their chances of falling.⁽¹⁾

Scary, isn’t it! Falling can affect older people in so many serious ways. But seniors often minimize the importance of falls for fear of being told they can’t live on their own anymore. Or that they may have to move from their home to assisted living or a nursing home. It’s time for them to make a choice to either:

• Help themselves to the best of their ability — to live safely in their own home for as long as possible; or
• Withdraw into denial and wait for whatever life sends their way — to move into a nursing home or an assisted living facility.

Part 2 of 4 – What Causes Falls?

Many conditions contribute to falling. These risk factors can be changed or modified to help prevent falls. They include:

• Lower body weakness.
• Balance problems.
• Posture problems.
• Difficulty walking. For example: shuffling (scooting their feet along the floor when walking instead of lifting their feet with each step) or foot drop (they cannot lift the front part of their foot, causing their foot to drag when walking).
• Foot pain.
• Poor footwear (wrong size, worn out), sandals, slippers, socks only).
• Not holding on to railings
• Not maintaining good nutrition and hydration.
• Vitamin D deficiency (that is, not enough vitamin D in their system).
• Medications such as tranquilizers, sedatives, antianxiety drugs or antidepressants. Even some over-the-counter medicines can affect balance and how steady you are on your feet. Blood pressure drugs can sometimes lower blood pressure too far and affect balance.
• Reaching for things on high shelves.
• Vision problems.
• Poor lighting.
• Broken or uneven steps.
• Throw rugs.
• Loose cords.
• Uneven flooring.
• No railings along stairs; no grab bars in the bathroom.
• Slippery floors, especially in the bathroom, tub and shower.
• Clutter that can be tripped over.

Most falls are caused by a combination of risk factors. The more risk factors a person exposed to, the greater their chances of falling.

Part 3 of 4 – What You Can Do to Prevent Falls

Falls can be prevented. Here are some simple things you can do.

Talk to Your Doctor

• Ask your doctor to evaluate your risk for falling; talk with them about specific things you can do.
• Ask your doctor if you are healthy enough to exercise. If YES, what specific exercises do they recommend:
• to make your legs stronger and improve your balance and posture. (Tai Chi is a good example of this kind of exercise.);
• to overcome shuffling and/or foot drop and other problems;
• and where they recommend you go to exercise. (at a physical therapist or a gym; if a physical therapist, ask your doctor for a prescription — Medicare will probably pay for their services.)
• Ask your doctor or pharmacist to review your medicines to see if any might make you dizzy or sleepy. Make a list for them that includes all of the medications you take (prescription drugs, over-the-counter drugs such as aspirin, antacids, herbal remedies, nutritional supplements — even daily multi-vitamins), dosage amounts and instructions for taking each one (time of day, with food or between meals, etc.); and all food and medication allergies;
• Ask your doctor about taking vitamin D supplements with calcium.
• Ask your doctor about any pain or numbness you have in your feet, ankles or lower legs.

Have Your Feet and Shoes Checked

Go to a podiatrist or independent shoe store (not a self-serve area like those inside like Sears, JCPenney or Walmart), and have your foot size measured accurately by a professional. If you have foot pain, the problem could be simply that your shoes are now too small.

How can that be?

Our feet become longer and wider with age, as the tendons and ligaments that link the many tiny bones lose elasticity. This allows the toes to spread out and the arch of the foot to flatten. Some over-40s can gain as much as one shoe size every ten years. (I’ve gone from 10½-AAA to 12-D over the past 20 years or so.)

Replace worn-out shoes, sandals and slippers. Don’t walk around your house in just socks or hose. If you have stairs, always hold onto the railings.

Have Your Eyes Checked

Have your eyes checked by an eye doctor at least once a year. Be sure to update your eyeglasses if needed.

If you have bifocal, trifocal or progressive lenses, you may want to get a pair of glasses with only your distance prescription for outdoor activities, such as walking. Don’t wear readers when walking. All of these types of lenses can make things seem closer or farther away than they really are and upset your sense of balance.

Part 4 of 4 – Make Your Home Safer

Construct a fall-proof environment: Whether your elderly loved one lives in their own home or with you, there are several things you can do to reduce their risk of falling.

• Make sure the routes your seniors take when walking inside their home are as straight as possible and free of clutter and electrical cords.
• Clear away all clutter in hallways and stairways.
• For better balance, add grab bars in the bathroom toilet and tub (and shower, if separate).
• Add non-skid mats or safety treads inside your tub or on the floor of your shower.
• For difficulty getting into or out of a tub, use a tub transfer bench.
• For greater safety in a shower, use a shower chair and/or a handheld shower head.
• Wear hip protector briefs with impact-absorbing pads over the critical hip fracture area to minimize potential damage that can occur from a fall.
• Move things on high shelves to lower shelves and/or use a reacher/grabber or a non-skid footstool to reach things on higher shelves.
• Put railings on both sides of stairs.
• Make sure your home has lots of light by adding more or brighter light bulbs.

Seniors tend to believe they can save a lot of money by reducing the wattage of their light bulbs. That’s a myth. If they increase their average wattage from 40W to 60W, their average electric bill will increase only $4.06 each month (according to the U.S. Department of Energy, the average residential monthly electric bill was $110.21 in 2013.).

• Remove all throw rugs, especially if they’ve lost their non-skid backing. If that’s not possible, consider purchasing non-skid material to put between throw rugs, area rugs and polished or slick floors.
• Fix uneven flooring and broken or uneven steps.

Encourage exercise: Exercise, particularly weight-bearing exercise can increase a senior’s coordination and strengthen their bones. This can help prevent and/or minimize the negative effects of a fall.

For more home safety information, check out our Home Safety Checklist.

Content Sources:

• ⁽¹⁾ U.S. Department of Health & Human Services, Centers for Disease Control and Prevention, Home and Recreational Safety, Older Adult Falls.
• ⁽²⁾ Traumatic Brain Injury Information Page, US National Institute of Neurological Disorders and Stroke
• ⁽³⁾ For the Elderly, Falls May Prove Deadly, AgingCare.com
• ⁽⁴⁾ A WHO Global Report on Falls among Older Persons
• ⁽⁵⁾ Early and late mortality in elderly patients after hip fracture: a cohort study using administrative health databases in the Lazio region, Italy, US National Library of Medicine, August 5, 2011.

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