Monday, December 9, 2013

Falls Are Life Changing Events

25% of elderly who fracture a hip due to a fall 
will die within 6 months of the injury.

The Facts are Frightening: 

  • Falls are the leading cause of death from injury for people 65 years and older.
  • The risk of falling increases with age. One-third of 65 year old people fall annually.   Half the people over 80 year old people fall every year.
  •  Two-thirds of those who have taken a fall will fall again within six months.
  •  The elderly account for over 75% of deaths that result from falls.
  •  Over 95% of hip fractures are caused by falls.
  •  Although the risk of falling is greater for women than men, men are 40% more likely to die from a fall than women.
  • Falls almost always lead to loss of independent functioning for elderly and most require life-long nursing care.
  •  Medical costs, due to falls involving the elderly, runs over $30 billion annually.
  • Even falls that do not result in serious injury have a psychological effect among elderly as they unnecessarily restrict their activities due to fear.
Although there isn’t one single reason an elder might take a fall, there are basic risk factors that often contribute to falls.  The more risk factors present in an elder’s life, the more likely they are to take a fall.  With falls being the number one threat to an elder’s independence, it is amazing that more people are not aware of these risks and the fact that they are mostly preventable.

Risk Factors to Falls:

·         Osteoporosis Porous bones are less resistant to strain and break easily.  Osteoporosis is the primary cause of fractures in older adults, especially among women, and is caused by hormonal changes, calcium and vitamin D deficiency and lack of physical activity.  Brittle bones can be prevented by getting enough calcium in the daily diet, sunlight or Vitamin D supplements and regularly doing weight-bearing exercises.

·         Lack of Exercise – Not having a regular exercise program results in poor muscle tone and loss of muscle strength.  Bone mass as well as general flexibility are also lost.  Regular physical activity increases muscle and bone strength and improves balance and flexibility.  With as little as 15 minutes a day, even those of advancing years can gain back lost muscle strength and decrease their risk of falls.

·         Impaired Vision – Many age related vision diseases can increase the chances of falls.  Cataracts and glaucoma change an elder’s depth perception, visual acuity, peripheral sight and vulnerability to bright light.  These limitations deter their ability to safely move in their environment.  Yearly checkups with an ophthalmologist will determine if any age-related diseases require medical attention.  Also using contrasting colors will help accent balance-aids making grab bars and handrails more noticeable.  Sometimes something as simple as daily cleaning of eyeglasses can make a dramatic improvement in vision and is an easy preventative measure.

·         Medications – The elderly usually take quite a few different medications and many of these can contribute to falls.  Sedatives, anti-depressants, and anti-psychotic drugs reduce mental alertness, cause dizziness and drops in blood pressure.  People who take multiple medications always have a greater risk of taking falls because the meds affect their balance and gait.  Knowing the common side effects of medications is a good place to start, but for the elderly it is wise to discuss ways of reducing fall risks with the physician or pharmacist.  Ask for an assessment of medications from the physician. Taking the lowest effective dosage, knowing the interactions between various medications and over the counter drugs and getting rid of out of date medications is also necessary. Also consider using walking aids while taking medications that impair balance.

·         Environmental Hazards – Most falls happen at home and the majority of those are due to tripping over something on the floor, such as throw rugs or electrical cords.  Poor lighting, lack of grab bars and cluttered environments also play a role in these falls.  To reduce the possibility of falls do a walk-through of the home looking for problem areas or have an occupational therapist look at the home and assess areas of risk.  Age proof the home as a preventative measure against falls and other accidents.  For practical tips on age proofing the home see HomeAid Health Care Elder Topics Blog

For the elderly, falls are life changing events.  Beyond the pain and fear resulting from falling, the majority of elders who are injured are not allowed to return to their previous lives.  Injuries mean long stays in hospitals, rehabilitation centers and hours of physical therapy.  Fears and concerns over repeat falls often mean moving to an institutionalized setting and dramatic loss of independence.  For many, the injuries resulting from a fall is the trigger than starts a decline that leads to death.  Preventative intervention to reduce risk factors will greatly reduce opportunities for falls and fall related injuries and can be the key element that maintains an elder’s quality of life.

Kate McCarthy is Director of Operations for HomeAid Health Care which provides services for the elderly who wish to remain safe and independent at home.  HomeAid is sister company to Prairie Home Assisted Living which has served the physical, spiritual, mental and health needs of their Residents since 1999.  Together the two family owned companies provide comprehensive care for the elderly in the Fox Valley of Wisconsin.

“Falls Among Older Adults: An Overview” by Center for Disease Control & Prevention. Accessed 11/21/13. 
“Fall prevention: 6 tips to prevent falls” by Mayo Clinic staff,  Accessed 11/21/13.
“Preventing Falls in the Elderly” by K.R. Tremblay Jr. and C. E. Barber, Accessed 11/21/13.