Don’t be just another fall guy (or gal)…
Do you ever think or worry about falling?
Have some close friends who have recently fallen?
Do you find this to be a challenging and sensitive subject?
Do you limit social participation due to fear of falls?
Please know that you are not alone.
The Centers For Disease Control and Prevention estimates that roughly 1 in 3 Americans aged 65 years and older fall annually, but this number is likely underrepresented. Roughly half of older adults will not inform their family or health care providers of a fall. Unfortunately, a common reason as to why there is such underreporting is that individuals fear that by acknowledging it, it will lead to a loss of their independence.
The CDC defines falls as “an inadvertent coming to rest on the ground, floor or other lower level, excluding intentional change in position to rest in furniture, wall or other objects”. We know that most falls occur in the home environment and that they happen at ground level and not from an elevated surface. There is a prevailing notion that with our increasing lifespan that falls are just bound to happen. This is simply untrue.
Falls are not inevitable.
There are many steps that we can take to greatly reduce the risk for future falls.
As you can imagine the consequences of falls can run the gamut. Near or minor falls might leave you shaken up or maybe lead to a bad bruise or a bruised ego. Some of the scarier statistics reveal that every 11 seconds an older adult is treated in an ER due to a fall and every 19 minutes an older adult dies from a fall. Falls account for 87% of all fractures in older adults and 95% of hip fractures. Unfortunately 50% of all older adults are unable to return to their homes after this type of injury.
Some of the less dire consequences is the overall loss of independence. Individuals who did not require any assistive devices may now need to rely on canes. Those who used canes might have to transition to more supportive devices like walkers. There may be increased need for adaptive equipment to dress, bathe, and use the bathroom and an increased reliance on help from loved ones. There are also many instances where this loss of independence might mean the difficult transition from living in your own home to living in an assisted living facility.
Nothing is more scary than not being able to trust your own body or not being able to take care of yourself.
It is very common for those who have fallen to worry about future falls. This worry is not unwarranted. People who have fallen are 5x more likely than their aged match peers to sustain an additional fall. Falls can lead to reduced social and activity participation. Increased social isolation is correlated to increased levels of depression and less activity. Sadly when individuals become less active, they become weaker and more deconditioned thereby increasing their fall risk. This is a vicious cycle. Concerning? Yes. However, we all have the ability to turn this fear into action and self-efficacy.
Fall risk variables that we cannot change include advanced age (older individuals are more prone to falling), sex (females are more prone to falling), race (Caucasians are more prone to falling), and conditions such as diabetes, stroke, Parkinson’s disease, and orthostatic hypotension.
The risk factors above are largely outside of our control but there are others that we have the capacity to improve if we are willing to put in the work and/or ask for help. These include:
- Chronic conditions
- Poor vision or hearing
- Sedentary lifestyle
- Pain
- Incontinence
- Vestibular disorders
- Excess alcohol use
- Using 4 or more medications
- Standing on unsteady chairs to reach for higher objects
- Not using medically recommended assistive devices (or using them improperly)
- Having a cluttered and unsafe home environment with fall and tripping hazards
Here are 4 simple things that you can do right away to help improve your safety.
Step 1.
Tell a provider right away if you have fallen, worry about falling, feel unsteady, or catch yourself from falling. Have your physician review your medications, even over-the-counter ones. Ask your physician about taking vitamin D supplements to improve bone, muscle, and nerve health.
Step 2.
Have your eyes checked by an eye doctor at least once a year and be sure to update your eyeglasses as needed. Also have your hearing and your feet checked making sure to wear supportive shoes with adequate traction. You may also consider having an annual physical therapy consultation to assess and improve your strength, balance, flexibility, and gait.
Step 3.
Make your home safer. Get rid of clutter, throw rugs, and other things that you can trip over (dog toys, shoes, loose wires). Make sure to improve the lighting in your home, install railings on your stairs, and add grab bars near your toilet and bath/shower.
Step 4.
Exercise! Exercise is a holistic, evidenced based treatment that reduces pain, improves strength, and can improve balance. Research has shown that community based Tai Chi classes significantly reduce fall risk for the elderly. If you want to exercise but are unsure of what to do, request physical therapy. Here at Agile Physical Therapy, we will work collaboratively to help achieve your goals by designing a program to build strength, improve balance, restore flexibility, and improve walking mechanics.
Try not to be overwhelmed by the fact there seems to be a lot to do. Let’s reframe that thought to emphasize that there is a lot we can do! Feel empowered that there are so many different courses of action to help improve your quality of life. Just remember to take it one step at a time. And if you have any questions, you can always seek the expert advice of your local physical therapist!
Scott is a licensed physical therapist and strength coach who earned his Doctor of Physical Therapy (DPT) degree from Columbia University after graduating New York University with his Bachelor of Arts in Economics. Out of over 250,000 licensed PTs nationwide, he is one of 15,000 who are board certified with the distinction of being recognized as an Orthopaedic Clinical Specialist (OCS) by the American Board of Physical Therapy Specialties. Additionally Scott is a Certified Strength & Conditioning Specialist (CSCS), Graston Technique Therapy Specialist (GTS), Select Functional Movement Assessment Certified (SFMAC) Functional Movement Screen Certified (FMSC), Certified Kinesio Taping Practitioner (CKTP), and an APTA Credentialed Clinical Instructor.
Scott is passionate about health and fitness and strives to provide highly individualized and evidenced based treatments for his patients. He seeks to listen more than he talks. In his free time he enjoys strength training, biking, running, hiking, playing basketball, and playing tennis.
References
https://www.americashealthrankings.org/explore/senior/measure/falls_sr/state/U.S.
https://www.cdc.gov/injury/features/older-adult-falls/index.html
https://www.cdc.gov/mmwr/volumes/65/wr/mm6537a2.htm
https://www.cdc.gov/steadi/pdf/STEADI-FactSheet-RiskFactors-508.pdf
https://www.ncoa.org/news/resources-for-reporters/get-the-facts/falls-prevention-facts/
https://nfsi.org/nfsi-research/quick-facts/
https://www.who.int/publications-detail/who-global-report-on-falls-prevention-in-older-age?ua=1