Does it really matter if you or a loved one falls? It’s fine as long as no one was hurt, right? Why are falls so Important?

When it comes to aging in place, one very important factor to pay attention to is falls. Why? No one wants to hear this, but the complications that can result from falls are one of the leading causes of death from injury for adults over the age of 65. Falls are also the most common cause of non-fatal injuries and hospital admissions for the same age group. 95% of hip fractures are caused by falls and falls are the most common cause of traumatic brain injuries. (1)

Did you know that falls are not considered part of the normal process of aging? Many people believe that falls are normal, and therefore they might just ignore falls and not mention them to their doctor. 

Even though falls are not a normal part of the aging process, those of us who are 65 and older have a 27% chance of falling at least one per year (2).

So, how can we reduce the chance of having a fall? 

Since there are many potential causes of falls, it’s important to take a look at all of the possible causes and address them. First and foremost, if you or someone you love has had a fall or has challenges with walking or balance, it is important to consult with a doctor. 

What causes us to fall?

Repeated falls have frequently been linked to a decline in balance, coordination, and/or strength. (2)

Additionally, there are several medical conditions which are associated with an increased risk of falls. These include, but are not limited to:

• Osteoarthritis
• Osteoporosis
• Vision loss
• Motor weakness
• Cognitive impairment
• Delirium
• Urinary incontinence
• Cardiovascular disease
• Cerebrovascular disease
• Diabetes
• Seizure disorders
• Neurological disorders (such as neuropathy, Parkinson’s disease, etc.)
• Vertigo
• Vitamin D deficiency
• Orthostatic hypotension (3) 

Falls can also be increased by other factors such as:

• Alcohol consumption
• Certain medications or the combination of multiple medications taken together
• Issues in your living environments, such as not enough light, uneven floors, uneven stairs, and too much clutter (3)

What can you do to decrease the risk of having a fall?

• Request a thorough exam from your medical provider/doctor
• Consult with a physical therapist (PT) or occupational therapist (OT). Note: You may need to request a referral from your doctor, if one is required by your health insurance in order to see a PT or OT.
• Talk with your doctor about your medications:
  • Make sure your doctor is aware of all of the medications that you are taking and check with your doctor to see if any of them interact with each other in ways that could be harmful
  • As your doctor if it’s possible to reduce or stop taking any of your medications to minimize the risk of adverse drug interactions? 
  • Ask your doctor if you should increase the amount of vitamin D you take. Vitamin D may reduce falls by increasing muscle strength and decreasing the sway of the body while moving/walking; it also reduces the risk of fractures by increasing bone mineral density
• Have your vision tested regularly
• Avoid wearing multifocal lenses when walking and especially on stairs
• Doing exercises that improve your gait, balance, and strength; there are multiple research studies that have shown that Tai Chi can reduce the risk of falls (insert Becki’s online Tai Chi class); In addition, walking and yoga may also be beneficial, as well as fall training/neuromuscular retraining with a physical or occupational therapist
• Make sure that your footwear fits well, has a good amount of grip on the bottom, is relatively flat, and has a good amount of contact with the ground (3)

Home modifications:

There are also changes that can be made to your home and/or work environments that can reduce the risk of falling in those environments. It is best to consult with an OT or PT about environmental modifications to ensure that the changes will be safe and successful in the long-term. Here are a few modifications an OT or PT might suggest:

• Increase lighting
• Remove or secure rugs, floor mats, and bathmats
• Make sure electrical cords are against the wall rather than in the middle of the room
• Minimize clutter
• Rearrange furniture to allow for ample space to get around a room (2, 3)

An OT or PT may also recommend use of some of the following medical equipment. They will determine which equipment is most appropriate to your unique needs. This may include:

• Bedside commode
• Urinal
• Shower chair
• Grab bars
• Railings
• Fall alert buttons (3)

Keep in mind that there may come a time when it is important to consider the need for increased assistance and/or supervision in order to help your loved one stay as independent and safe as possible. This can include medical or non-medical assistance, such as nursing, help with chores around the house, and/or companionship. (3)

Sources: 

1. CDC, 2021. Older Adult Fall Prevention. Facts about Falls. Retrieved from: https://www.cdc.gov/falls/facts.html 

2. Gerontology for the Health Care Professional, 2nd edition. Robnett, R. H. and Chop, W. C.

3. Geriatrics Evaluation & Management Tools, 1st edition. Copyright 2013 by the American Geriatrics Society. Source: Geriatrics Review Syllabus: A Core Curriculum in Geriatric Medicine. New York, NY: American Geriatrics Society
   
   
4. Image of people falling form Upklyak via Freepik