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Falls in the elderly-Morpurgo

Avoiding Trips and Falls

By Andrew Morpurgo, M.D.


People over the age of eighty-five make up the fastest growing age group in the United States. While the “oldest old” account for only 1.5 percent of the general population, they use more health care services than any other sector of the population.


One of the most common injuries this age group suffers is broken bones as a result of falling down. For every 1,000 people over age eighty-five, twenty-nine will suffer a hip fracture in any given year. Hip fractures have a major impact on quality of life and mortality among this population; healing can take from a few weeks to more than a year, depending on the nature of the fracture and the health of the individual. And one-quarter of the seniors who suffer hip fractures die from complications within a year of the accident.


Because falls among the elderly can have such serious consequences, it’s important to take positive steps to decrease the chances of falling and to mitigate possible injuries should a spill occur. These positive steps fall under three general headings: prevention, common sense, and safety.


Prevention: Use it or lose it


Once we reach the age of sixty-five, there really is a “use it or lose it” physiology that takes hold, and our ability to do certain things diminishes if we don’t stay active. All of the recent research shows that regular exercise, a well-balanced diet, and nutritional supplements are a good way to counteract weakness and frailty in older adults. Moreover, exercise gives us confidence and prepares us physically to recover if we do fall.


Regular weight-bearing exercise, such as walking, helps to maintain bone and muscle strength and improves coordination. I also recommend tai chi, which is an ancient form of gentle exercise that improves coordination and balance for people of all ages. If you have painful arthritic joints or trouble keeping your balance, pool exercise is a safe, comfortable way to remain active. (Just be sure to wear your pool shoes to reduce the risk of slipping.) Island Health and Fitness is one of the local sites that offers classes in tai chi, as well as pools for both aquatics and lap swimming.


Prevention includes seeing your doctor


Illness and confusion resulting from medication cause close to 20 percent of falls. See your doctor once a year to make sure your medications are up to date, your blood pressure is under control, and your heart is healthy. Have your vision checked and request bone-density screening for osteoporosis. If you have osteoporosis, take your medication as prescribed to maintain bone health.


Use common sense


If your doctor has prescribed a cane or walker for you, be sure to use it: a cane will not prevent you from falling if it is sitting in the closet. It’s also a good idea to run errands and complete chores, such as taking the garbage to the curb, during daylight hours. Avoid standing on chairs with wheels when trying to reach the top shelf. This advice may seem self-evident, but we do see broken hips due to falls from chairs more often than we’d like.


Think about safety issues


Forty percent of all falls are caused by tripping. For this reason, I am a firm believer in automatic light timers that come on at dusk because they light the way for you when you arrive home after dark. Place night lights strategically in the bedroom, bathroom, and hallways. Get rid of throw rugs and extension cords that cross the floor. Keep the doorway of your home free of snow and leaves, as these pose a major slipping hazard. Adapt your tub and shower with grab bars and a seat or small bench.


More and more people are remaining healthy and active into their nineties. Exercise and proper nutrition, regular check-ups, and making your living environment as safe as possible will help keep you on your feet as you age.


Dr. Morpurgo is a physiatrist, specializing in rehabilitation and physical medicine. He is the medical director of rehabilitation services at Cayuga Medical Center.












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