Fall Prevention
Insight into preventing injuries caused by falls
• Why are falls more likely during the senior years?
• How does lifestyle management affect fall prevention?
• and more…
Today’s society is more active than ever, but inevitably every year
more than two million Americans fall and sustain serious injury,
costing the healthcare system in excess of $3 billion dollars.
Hidden costs affecting the individual include pain, disability,
lawsuits, loss of independence, deterioration in well-being, and the
impact on other family members. Nonetheless, falls are predictable
and preventable, even for older adults.
Why are falls more likely during the senior years?
Falls and the resulting injuries are among the elderly’s most
serious health issues caused by the body’s deterioration through
inactivity and the central nervous system (CNS)’s damaged through
injuries. For example, the sensory cells in the ears’ balance system
gradually decrease and cannot be replaced, as well as the nerves
carrying sensory information to the brain to perform complex brain
interconnections lose fiber and nerve cells. In addition, nerve
endings loose their ability to generate the chemicals responsible
for the transmission of information. This process accelerates after
the age of 50.
Many diseases affect the CNS and sense organs too. Also, muscle
strength gradually decreases with age, joint tendons and ligaments
lose their flexibility and limit motion. The combined ravages of
bone and joint injury, arthritis, and inactivity can result in a
body that cannot carry out motion commands initiated by the brain.
Hardening of the arteries is probably the worst. It is accelerated
by high blood pressure, smoking, and diabetes. Although artery
hardening gradually increases during middle age, there is a point at
which a slight additional decrease in blood flow causes serious
vascular impairment such as stroke.
Head injuries, sometimes caused by falls, can damage the sense
organs in the inner ears, or the brain itself. Therefore, physical
activity is very important for injury recovery to the sensory
systems. The general debility of aging can negatively affect
recovery if it results in a decreased level of activity. Often,
injuries to the knees, hips, and back do not completely heal,
leaving some limitation of motion.
The worst disability occurs when both sense organs and CNS
structures are damaged simultaneously, as is the case with
Alzheimer’s Disease. Also, arthritis can cause permanent, crippling,
nonreversible effects and osteoporosis can lead to bone weakness and
increases the probability of serious injury from a fall or a
spontaneous fracture that might lead to a fall.
How can medications affect my sensory functions?
In this time of specialization, it is possible for one patient to
receive prescriptions from several physicians that might have
additive side effects on the brain and sensory function. Therefore,
patients should keep a complete list of all their medications and
dosages, and make this list available to each physician they
consult. Coordination of all medications through a single primary
care physician would help avoid adverse drug reactions to the brain
and sensory functions. The list should include:
• Over-the-counter medications, such as antihistamines, sleeping
medications, analgesics, and cough suppressants.
• Medications used to treat high blood pressure, heart disease,
allergy, insomnia, stomach acidity, and depression.
• Medications listing alcohol as an ingredient since it affects
movement and judgment and adversely interacts with many medications.
How can I recover from an injury caused by a fall?
Rehabilitation
• A thorough and complete evaluation of sensory, CNS,
muscles/joints, and balance function should be performed. This
includes a search for causes of dizziness, such as inner ear
diseases; an evaluation of the inner ear balance system, which might
be adversely affected by certain drugs (such as a class of
antibiotics known as aminoglycocides); trauma; and the aging
process.
• Tests of higher mental function are important since falling may be
a sign of serious mental deterioration.
• A careful review of all medications (both prescription and
over-the-counter) is very important. If medication for anxiety or
depression is used, switching from a long acting drug to one that is
more quickly passed from the body seems to decrease the risk of
falling.
• All correctable problems should be treated. Visual correction with
proper eyeglasses, improvement of hearing by hearing aids,
adjustment or elimination of medications, and any other disease,
which could impair balance must be accomplished.
Rehabilitation includes increasing the range of motion as well as
physical strength. A very important part of rehabilitation is
overcoming the fear of falling and thus avoiding further injury.
Walkers and canes can aid stability, while simple changes in the
home, such as installing hand holds in bathrooms or along walls,
could decrease the likelihood of falling and increase confidence.
But keep in mind, drastically changing a familiar environment often
hampers recovery. As soon as possible, rehabilitation should include
family members and home support groups. Rapid return to physical
activity and social interaction with family and community can often
stop the vicious spiral into inactivity, reclusiveness, and
progressive deterioration that falls and injuries cause.
How does lifestyle management affect fall prevention?
As many of the problems responsible for falling develop during early
and middle age, initial efforts to prevent injuries should begin at
a younger age. Many of the changes in muscle, bone, and the central
nervous system are not inevitable results of aging, but are brought
on by inactive lifestyles and self-inflicted damage from smoking,
poor diet, and lack of exercise. Although hardening of the arteries
is occasionally hereditary, in most cases it can be reduced by diets
low in cholesterol and saturated fatty acids, as well as regular
physical exercise.
Tips to prevent falls among seniors
Health
• Have hearing and vision check-ups regularly. If hearing and vision
are impaired, important cues that help maintain balance can be lost.
• Get up slowly. A momentary drop in blood pressure can cause
dizziness when standing up too quickly.
• Use a cane or walker to help maintain balance on uneven ground or
slippery surfaces. Wear sturdy, low-heeled shoes with wide, nonslip
soles.
• Exercise to improve your strength, muscle tone, and coordination.
Walking is a good form of exercise.
Home
• Remove raised doorway thresholds in all rooms. Rearrange furniture
to keep electrical cords and furniture out of walking paths. Fasten
area rugs to the floor with tape or tacks.
• Never stand on a chair. Use nonskid floor wax
and wipe up spills immediately.
• Be sure stairways have sturdy hand rails.
• Install grab handles and nonskid mats inside and outside your
shower and tub.
• Use shower chairs and bath benches to minimize the risk of
falling.
• Put a light switch by the bedroom door and by your bed so you
don’t have to walk across the room to turn on a light. Night lights
in your bedrooms, halls, and bathroom are a good idea.
