JUNE POPULATION HEALTH FOCUS: Falls and Injuries
The UPMC Western Maryland June Population Health Focus is falls and injuries. The following information has been compiled from the National Institute on Aging.
A simple thing can change your life—like tripping on a rug or slipping on a wet floor. If you fall, you could break a bone, like thousands of older men and women do each year. For older people, a break can be the start of more serious problems, such as a trip to the hospital, injury, or even disability. If you or an older person you know has fallen, you’re not alone. More than one in three people age 65 years or older falls each year. The risk of falling—and fall-related problems—rises with age.
Many Older Adults Fear Falling
The fear of falling becomes more common as people age, even among those who haven’t fallen. It may lead older people to avoid activities such as walking, shopping, or taking part in social activities. But don’t let a fear of falling keep you from being active. Overcoming this fear can help you stay active, maintain your physical health, and prevent future falls. Doing things like getting together with friends, gardening, walking, or going to the local senior center helps you stay healthy. The good news is, there are simple ways to prevent most falls.
Causes and Risk Factors for Falls
Many things can cause a fall. Your eyesight, hearing, and reflexes might not be as sharp as they were when you were younger. Diabetes, heart disease, or problems with your thyroid, nerves, feet, or blood vessels can affect your balance. Some medicines can cause you to feel dizzy or sleepy, making you more likely to fall. Other causes include safety hazards in the home or community environment. Scientists have linked several personal risk factors to falling, including muscle weakness, problems with balance and gait, and blood pressure that drops too much when you get up from lying down or sitting (called postural hypotension). Foot problems that cause pain and unsafe footwear, like backless shoes or high heels, can also increase your risk of falling.
Confusion can sometimes lead to falls. For example, if you wake up in an unfamiliar environment, you might feel unsure of where you are. If you feel confused, wait for your mind to clear or until someone comes to help you before trying to get up and walk around. Some medications can increase a person’s risk of falling because they cause side effects like dizziness or confusion. The more medications you take, the more likely you are to fall.
Take the Right Steps to Prevent Falls
If you take care of your overall health, you may be able to lower your chances of falling. Most of the time, falls and accidents don’t “just happen.” Here are a few tips to help you avoid falls and broken bones:
Stay physically active. Plan an exercise program that is right for you. Regular exercise improves muscles and makes you stronger. It also helps keep your joints, tendons, and ligaments flexible. Mild weight-bearing activities, such as walking or climbing stairs, may slow bone loss from osteoporosis.
Have your eyes and hearing tested. Even small changes in sight and hearing may cause you to fall. When you get new eyeglasses or contact lenses, take time to get used to them. Always wear your glasses or contacts when you need them If you have a hearing aid, be sure it fits well and wear it.
Find out about the side effects of any medicine you take. If a drug makes you sleepy or dizzy, tell your doctor or pharmacist.
Get enough sleep. If you are sleepy, you are more likely to fall.
Limit the amount of alcohol you drink. Even a small amount of alcohol can affect your balance and reflexes. Studies show that the rate of hip fractures in older adults increases with alcohol use.
Stand up slowly. Getting up too quickly can cause your blood pressure to drop. That can make you feel wobbly. Get your blood pressure checked when lying and standing.
Use an assistive device if you need help feeling steady when you walk. Appropriate use of canes and walkers can prevent falls. If your doctor tells you to use a cane or walker, make sure it is the right size for you and the wheels roll smoothly. This is important when you’re walking in areas you don’t know well or where the walkways are uneven. A physical or occupational therapist can help you decide which devices might be helpful and teach you how to use them safely.
Be very careful when walking on wet or icy surfaces. They can be very slippery! Try to have sand or salt spread on icy areas by your front or back door.
Wear non-skid, rubber-soled, low-heeled shoes, or lace-up shoes with non-skid soles that fully support your feet. It is important that the soles are not too thin or too thick. Don’t walk on stairs or floors in socks or in shoes and slippers with smooth soles.
Always tell your doctor if you have fallen since your last checkup, even if you aren’t hurt when you fall. A fall can alert your doctor to a new medical problem or problems with your medications or eyesight that can be corrected. Your doctor may suggest physical therapy, a walking aid, or other steps to help prevent future falls.
What to Do If You Fall
Whether you are at home or somewhere else, a sudden fall can be startling and upsetting. If you do fall, stay as calm as possible. Take several deep breaths to try 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.
Keep Your Bones Strong to Prevent Falls
Falls are a common reason for trips to the emergency room and for hospital stays among older adults. Many of these hospital visits are for fall-related fractures. You can help prevent fractures by keeping your bones strong. Having healthy bones won’t prevent a fall, but if you fall, it might prevent breaking a hip or other bone, which may lead to a hospital or nursing home stay, disability, or even death. Getting enough calcium and vitamin D can help keep your bones strong. So can physical activity. Try to get at least 150 minutes per week of physical activity. Other ways to maintain bone health include quitting smoking and limiting alcohol use, which can decrease bone mass and increase the chance of fractures. Also, try to maintain a healthy weight. Being underweight increases the risk of bone loss and broken bones. Osteoporosis is a disease that makes bones weak and more likely to break. For people with osteoporosis, even a minor fall may be dangerous. Talk to your doctor about osteoporosis.
For More Information About Falls and Falls Prevention
Centers for Disease Control and Prevention (CDC)
National Resource Center on Supportive Housing and Home Modifications
National Falls Prevention Resource Center