Prevent Falls: Live Longer

Prevent Falls: Live Longer 

Lori Hauge, Better Life Homecare

One in every three people over the age of 65 will fall within the next twelve months.  Although that may not sound like a huge problem, accidents are the fifth leading cause of death in people over 65 and two-thirds of these accidents are a result of falls.  For every elderly person who is admitted to the hospital after a fall, only 50% will be alive one year later.  Those are pretty powerful numbers , which makes the problem of falls a problem for all of us. 

The consequences of falls in people who are elderly are enormous and generally fall into four categories:  financial, medical, psychological, immobility

Financial: It is estimated that falls in people who are elderly cost our nation over $12 billion dollars each year.  Falls dramatically increase the rate of institutionalization (nursing home placement), which is expensive, and falls increase elderly patients’ use of health care overall.

Medical:  Medical consequences of falls can include relatively mild cuts and bruises to Subdural Hematomas (brain bleeding), to fractures.  For every 20 people who fall, 1-2 will fracture something,  and 10 will end up in a long term care facility.

Psychological: Let’s face it.  Falls are scary.  Once a person falls one time, they are likely to fear falling again.  This fear of falling can lead to a loss of confidence, depression and social withdrawal.

This withdrawal almost always leads to decreased physical activity which leads to decreased ability to perform activities of daily living, such as eating, dressing and bathing.  This often leads to increased dependency…something most of us want to avoid, at all costs!

Immobility: Finally, falls and fear of falling often lead to immobility with decreased overall conditioning and decreased joint mobility.

Risk Factors

Seven major factors put people at risk for falls:

·         Generalized weakness.  Overall weakness increases the risk of falling by five times.  In addition to recognizing that one in every three folks over age 65 will likely to fall within the next year.  The generally weak person is five times more likely to be one of those three!   Weakness sneaks up on us: after the age of 30, if we do not work to maintain our muscle strength, we lose an average of ½ pound of muscle mass each year!

·         Gait and balance problems. The second most frequent cause of falls is a problem with gait and balance…basically that means steadiness on your feet.  People may have gait and balance problems due to lack of fitness, arthritis, inner ear problems, etc.   Gait and balance problems increase the likelihood of falling by 3 times!

·         Low Vision. People with visual impairments are twice as likely as others to fall.  As we age, we are at higher risk for low vision from presbyopia, cataracts, glaucoma and macular degeneration. 

·         Depression.  People with depression are twice as likely to fall as other folks.  It is important to recognize that depression is NOT a normal part of aging and seek help when you need it.

·         Postural Hypotension. Postural hypotension is also called orthostatic hypotension.  It increases a person’s risk of falling by 2-3 times.  It occurs when a person’s change in position, usually from sitting to standing, causes a temporary decrease in blood flowing to the brain.  This leads to lightheadedness and sometimes even blacking out. 

·         Cognitive Impairment.  Cognitive impairment, such as dementia or stroke, increases a person’s risk of falling by 2-3 times. 

·         Medications and Polypharmacy.  There are certain medications that make it probable that an elderly person will fall.  These are medications that are used to affect the mind, emotions and behavior.  In particular, long acting benzodiazepines increase the likelihood of a person falling by 30 times! Examples of these medications include: Dalmane, Librium, Tranxene, Valium, Klonopin, Doral, Pazipam.  Polypharmacy is the use of multiple medications.  People who take 4 or more medications have an increased risk of falling and the risk increases with each passing year.

Preventing  Falls

Falls are scary, expensive and dangerous.  Falls can negatively impact all aspects of our lives, so what can we do to prevent falls.

·         Exercise. The number one way to prevent falls is to stay strong and fit by exercising regularly.  Exercise also improves your balance and coordination. If you already exercise, keep it up.  If you don’t, get started, but start slow and check with your health care professional about the best way to begin.  Remember, a brisk walk is an easy and inexpensive way to get some exercise, enjoy the outdoors and if you take a friend, catch up on the gossip!  But keep in mind that it is very easy to build exercise into all aspects of your day:  park a block or two from your destination, do your own housework and yard work, walk your dog. 

·         Treat underlying illnesses. Hypertension, hearing problems, vision problems, orthostatic hypotension, diabetes, etc.

·         Learn adaptive strategies. If you have illnesses or weakness that cannot be cured, talk with your health care team about equipment and strategies you can use to compensate and reduce the risk of falling, canes, walkers, reachers, etc.

·         Reduce environmental hazards. 

 

Lori Hauge, MA, CCC-SLP is a certified homecare administrator for A Better Life Homecare.  Her family’s company, Bios, has been supporting people with disabilities for 19 years.