Fall risks increase with age; learn to protect yourself

By Deidre Blake, MD

Falls are the number one cause of injuries and deaths from injury among older Americans. The vast majority of those falls are from a standing height and most frequently cause broken wrists, hip fractures and head injuries. In many cases, the injuries have long-term health consequences that limit mobility and may require hospitalization and nursing home care.

Falls are the top reason for calls to 911 in Tompkins County. A 2011 fall prevention study led by the Health Planning Council of the Human Services Coalition of Ithaca showed falls accounted for nearly 1,300 emergency calls, or 13 percent of all 911 calls. Of those calls, almost 700 resulted in emergency room treatment and 200 hospitalizations. The cost of medical care was estimated at nearly $4 million.

While the financial cost of falls for seniors is substantial, the consequences of a fall are often life-changing. Many seniors never recover the level of health they had before a fall. Recovery from a broken hip requires weeks of 24-7 care that makes at-home care impossible for those without a strong support network. After they recover from a fall, most seniors will need a walker or cane when walking. The impact of fall injuries prompted the National Council on Aging to develop Fall Prevention Awareness Week from Sept. 22-28.

The risk of fall injuries increase after age 65 and the risk rises with age and declining health. An estimated one in four seniors fall each year. Falling once doubles the chances of falling again. That is why health care providers regularly ask older patients during medical visits about any recent falls.

Among the major risk factors for falls in older adults are reduced muscle strength, increased inactivity, chronic health conditions, and increased use of prescription medication. Fall injury rates are almost seven times higher for older adults with poor health than for those with excellent health. Home hazards such broken or uneven steps, throw rugs, clutter, or pets that can be tripped over are also risk factors. Most falls are caused by a combination of risk factors, and the more risk factors a person has, the greater their chances of falling.

What activities put seniors at risk for falls?

A large proportion of falls for seniors happen at night. Waking up to use the bathroom and not turning on a light to illuminate fall hazards or barriers is particularly risky. When getting up at night, always turn on a light. Sit on the bed for a few minutes to allow your blood pressure to normalize so you are not feeling woozy, and then carefully get up. Standing up from a sitting position can also affect blood pressure. Extra care and slow transitions when rising from a sleeping or sitting position to standing are important to reduce fall risks.

Vanity causes many falls. If you need to use a cane or walker, use it. And, be careful with your pet. Many people trip over a pet, get tangled in a leash and fall. Thinking about falling is a good thing. People who are worried about falling are more likely to be attuned to the risks and avoid them.

What can you do to reduce your fall risks?

Talk to your physician about falls and fall prevention and report if you’ve had a recent fall. Although one in four older Americans fall each year, fewer than half tell their doctor.

Urinary tract infections can cause balance problems for seniors and increase the risk of falls. These infections can go unnoticed, so ask your doctor for a urine test at every annual physical exam or more often if you notice symptoms such as increased frequency, urgency, or discomfort with urination.

Have your eyes checked by an eye doctor once a year. Update eyeglasses as needed. Improve your balance and strengthen your legs with exercise classes. Several local organizations can help you find exercise and balance classes: Cayuga Center for Healthy Living, (607) 252-3590; the Tompkins County Office for the Aging, (607) 274-5482; and Lifelong, (607) 273-151.

Where can you get information on fall risks in your home?

The Tompkins County Office for the Aging provides home assessment information to reduce fall risks. In-home assessments showed the leading home hazards were the presence of scatter or throw rugs, lack of grab bars or sturdy railings, and household clutter. For information on reducing fall risks in your home, call the county office for aging at (607) 274-5482.

What should you do if you fall?

Stay as calm as possible and take several deep breaths to relax. Remain still on the floor or ground for a few moments. This will help you get over the shock of falling.

Decide if you are hurt before getting up. Getting up too quickly or in the wrong way could make an injury worse. If you think you can get up safely without help, roll over onto your side. Rest again while your body and blood pressure adjust. Slowly get up on your hands and knees, and crawl to a sturdy chair.

Put your hands on the chair seat and slide one foot forward so that it is flat on the floor. Keep the other leg bent so the knee is on the floor. From this kneeling position, slowly rise and turn your body to sit in the chair.

If you are hurt or cannot get up on your own, ask someone for help or call 911. If you are alone, try to get into a comfortable position and wait for help to arrive. Carrying a mobile or portable phone with you as you move about your house could make it easier to call someone if you need assistance. An emergency response system, which lets you push a button on a special necklace or bracelet to call for help, is another option.

Dr. Deidre Blake is board-certified orthopedic surgeon who did her fellowship training in joint revision surgery at Weill Cornell’s Hospital for Special Surgery. She serves on the medical staffs of Cayuga Medical Center and Schuyler Hospital and can be reached at Orthopedic Services of CMA at (607) 272-7000.

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