Have you ever fallen? Were you injured? Did you seek medical attention after the fall? Was there a witness to your fall? Were you embarrassed? Have you fallen again?

Unfortunately for many older adults, they answer yes to the above questions and many never tell anyone they have had a fall.

If you are younger and fall, you may bounce right up and look around to see if anyone saw you fall. If you are older and fall, you probably do not bounce right up and you may find that you need help getting up. Is there someone around to call out to for help? Can you reach the phone? How long will it take for someone to call and check in on you?

According to the Centers for Disease Control and Prevention (CDC), one out of four older adults falls each year. If you have fallen once you have doubled your chances that you are likely to fall again.

Why are falls so traumatic for seniors? According to the CDC:

• One out of five falls causes a serious injury such as broken bones or a head injury
• Each year, 3 million older people are treated in emergency departments for fall injuries.
• More than 800,000 patients a year are hospitalized because of a fall injury, most often because of a head injury or hip fracture.
• Each year at least 300,000 older people are hospitalized for hip fractures.
• More than 95% of hip fractures are caused by falling, usually by falling sideways.
• Falls are the most common cause of traumatic brain injuries (TBI).
• In 2015, the total medical costs for falls totaled more than $50 billion. Medicare and Medicaid shouldered 75% of these costs.

Many older adults do not tell their family or physician that they have fallen. Why? For many, the fear of being told they are no longer safe at home keeps them from speaking up.

What can happen after a fall?

Many adults are reluctant to seek medical advice after a fall. Not until they are in pain or cannot walk do they seek medical attention.

One out of five falls can cause a serious injury such as broken bones at the wrist, arm, ankle, shoulder, collarbone and hip/pelvis. Injuries to their teeth can cause problems with eating and drinking, which affects the body in maintaining a healthy weight.

So often, a fall that includes a blow to the head is ignored if there is no obvious sign of injury. A subdural hematoma may form and symptoms occur hours or days later. If the older adult is taking certain medications, such as a blood thinner, a head injury could even lead to death.

Fear from falling again could impair an older adult from performing necessary tasks, such as bathing.

As I write this article, former Miss America (1993) Leanza Cornett died from a head injury sustained from a fall in her kitchen. She was 49. Falls occur to anyone and age does not make a difference on the severity.

In assisted living communities, many have a policy that states if a resident is “On the floor, they are out the door.” Many emergency services personnel are often reluctant to transport a resident who fell to the hospital with no obvious signs of injury. The staff must be advocates for the resident because they are frail, therefore they may have hidden injuries.

What Conditions Make You More Likely to Fall?

There are many conditions that can contribute to falling. These are called risk factors. Many risk factors can be changed or modified to help prevent falls. The CDC has identified several risk factors such as:

• Lower body weakness
• Vitamin D deficiency (that is, not enough vitamin D in your system)
• Difficulties with walking and balance
• Use of medicines, such as tranquilizers, sedatives, or antidepressants. Even some over-the-counter medicines can affect balance and how steady you are on your feet (Benadryl, sleep aides)
• Vision problems
• Foot pain or poor footwear
• Home hazards or dangers such as broken or uneven steps, and throw rugs or clutter that can be tripped over.
• Diseases or conditions such as Parkinson’s, Dementia, Multiple Sclerosis, urinary tract infection (UTI), cancer, Cerebral Palsy (CP) and many other diagnoses can play a role in falls.
• Postural Hypotension: What is it & How to Manage it

Most falls are caused by a combination of risk factors. The more risk factors a person has, the greater their chances of falling.

What can you do to prevent falls?

• Speak to your health care professional. He/She should review your medications and look for side effects that may cause dizziness, low blood pressure or sleepiness. Do you need a vitamin D supplement? A fall risk assessment should also be done. Based on your score, your provider can make recommendations to decrease your fall risk.
• Do strength and balance exercises that make your legs stronger and improve your balance. Tai Chi is a good example of this kind of exercise. Try the Chair Rise Exercise
• Have your eyes checked by an eye doctor at least once a year, and be sure to update your eyeglasses if needed. If you wear progressive lens, this may take you some time to adjust. Glasses can make items appear closer than they are.
• Have your hearing checked, Structural changes occur as we age, which can impair hearing.
• If you use a cane or walker, have your health care provider evaluate if this is still the correct device, then be sure to use it, every time.
• Do you wear the correct type of shoe? Does your foot slip out of the shoe because they are too large? Do you have “hammer toes” from years of wearing high heels? A podiatrist will be able to recommend treatment and appropriate footwear.
• Pay attention to where you are and where you are walking. Falls often occur when carrying items and not using an assistive device.
• Rent or purchase a fall alert system. There are many that provide a live person that responds via a microphone in the pendant that will speak to the person after a fall is detected. If the user does not verbally respond, emergency services is notified by the call center. Be sure and read the reviews.

What can you do to make your home safe?

• Add grab bars in the shower, outside the shower and by the toilet.
• Remove throw rugs
• Add handrails on both sides of the stairs.
• Remove clutter
• Make your home lighting brighter, replace burned out or dull bulbs.

If you have not had a fall, count yourself lucky. For those of us who have fallen, it can be scary and not to mention embarrassing.

As we age, our bodies seem to turn on us and are not as reliable as they once were. We all have seen the commercial where the older female is on the floor and says” Help, I can’t get up!” No one wants to feel vulnerable, yet a fall causes us to feel this way. If an injury occurs, this could change a living situation as well as the ability to care for oneself.

Preventing falls is the first step in staying active and healthy to live life on your terms.

Additional Resources

The CDC has more information and resources online on how you can prevent falls STEADI resources.

These resources include:

Stay Independent Brochure
Family Caregivers: Protect Your Loved Ones from Falling
What You Can Do to Prevent Falls
Check for Safety

Reference

Centers for Disease Control and Prevention, 2020. Home and Recreational Safety. https://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html