People’s lives can change in an instant due to a fall. As we age our risk of a fall increases. This is due to a number of factors including weaker muscles, arthritic joints, taking multiple medications, and loss of balance as we age. In Wisconsin, other factors like ice on walkways markedly increase risk. There are things we can do to reduce risk.
It is reported that one out of three Americans over the age of 65 fall every year. In 2013 there were about 2.5 million emergency room visits with 734,000 hospitalizations due to falls. There were about 30,000 deaths due to falls with the majority of the deaths due to traumatic brain injury. Falls commonly break bones. Breaking a large bone is a big deal. Studies show that only 20% of elderly folks who break a hip survive for one year and 9% die in the first 30 days. The bone can be fixed but the stress of the surgery along with the other factors, including age and medical problems associated with recovery, increase the death rate.
Young people have bones that are stronger and more able to bend. I think of their bones like a branch of a tree that is alive. As we age the bones become more brittle. This would be similar to a branch of a tree that is dead and can snap more easily than a live branch. Also, as we age our gait tends to become slower and stiffer increasing the risk of a fall.
Otherwise healthy elderly people tend to be independent and stubborn. They tend to try risky things like climbing up on a chair to get their dishes down from the cupboard. They tell me they don’t want to use a cane or a walker because it makes them look old. I get that, but one slip or fall can take away their independence forever.
So, how can the risk of a fall be reduced? First of all, I tell people they need to use their head for something more than just a place to hold their hat. Think about things before you do them to assess the danger. Don’t climb up on ladders, chairs, or roofs if you don’t have to. Move the dishes or other articles that you use to a level you can reach without climbing up on something. Consider asking someone else to get things for you that are up high. Try to avoid stairways, especially ones without railings. If you need to go on stairs, don’t have your hands full or carry things that could throw you off balance. The ability to see obstacles in the way can be improved by turning lights on at night and having your vision checked to see if that can be improved with glasses. Also, pick up rugs or other articles off the floor that could cause a fall. Be careful about animals that could get underfoot and cause a fall. Hand rails or grab bars can be installed in the bathroom or by the steps. Be especially careful when getting in and out of a vehicle. Also, be wary of icy or slippery conditions. Don’t be afraid to use a cane or walker to improve mobility and stability.
In addition, there are other strategies that can reduce fall risk. Talk to your provider to review medications that can cause loss of balance, dizziness, or a drop in blood pressure. Avoid alcohol over consumption since that commonly causes loss of balance and leads to falls. Also, a regular exercise program can help improve strength and balance to lower fall risk. Falls are a leading cause of preventable disability and death especially for the elderly. Take precautions to avoid a fall and stay healthy my friends.
By: P. Michael Shattuck, M.D. – Community Health Network Family Physician
