adult-care-elderly-748780-1024x707 (1)

Simple Tips to Prevent Falls for Older Adults

Falls are common and are the leading cause of injury for adults aged 65 and older. Over 14 million, or 1 in 4 older Americans, report falling every year. Falls can lead to serious consequences including injury, disability, death, and the inability to remain independent. They can also result in fear of falling again, limiting one’s activities or social engagements. Fall injuries often cause bone fractures, pulmonary embolisms, infections, and other problems, which severely impact the quality of life for elderly people, affecting the lives of the whole family. The good news is that falls can be prevented by taking simple precautions such as doing appropriate exercises, making your home safer, getting regular health checkups, and more.1

Why Do Older Adults Fall?
The most common causes of falls in the elderly and the risk factors that contribute to a fall are divided into the following categories:2,3
Physical Risk Factors – impairments, chronic conditions, and medications
Environmental Risk Factors – hazards in and around the home
Behavioral Risk Factors – activities or decisions made by an individual

Physical Risk Factors

  • Declines in Physical Fitness: Many adults become less active as they age. Without regular physical activity, one loses muscle strength, balance, coordination, and flexibility. This inactivity leads to instability which increases the risk of falling, and the inability to break the fall effectively. It also increases the chances of a serious injury and a more difficult recovery.
  • Impaired Vision: Age-related eye diseases make it difficult, sometimes impossible, to detect fall hazards, such as steps, slippery surfaces, and thresholds. Conditions like glaucoma or cataracts limit vision. Poor vision can increase the chances of falling.
  • Chronic Conditions: There are numerous chronic health conditions that can put a senior at risk of falling. Some of the common conditions include:

o   Heart disease – heart failure, low blood pressure, and arrhythmias can lead to fainting.
o   Brain disease – epilepsy, Parkinson’s disease, Alzheimer’s disease, and other cognitive disorders.
o   Diabetes – poorly managed diabetes can lead to visual impairments, leg numbness, and in extreme cases, diabetic coma.
o   Osteoporosis – a disease in which bones become less dense, resulting in weak bones that are more likely to break.
o   Inner ear problems – the most important organ for our sense of balance is in our inner ears; issues with it can cause vertigo.
o   Alcoholism – alcohol abuse, especially when combined with certain medications, can easily cause a fall.

  • Medications: A wide variety of medications can increase the risk of a fall. Side effects, such as drowsiness, dizziness, dehydration, and low blood pressure, can all contribute to an accident. Sedatives, antidepressants, antipsychotics, opioids, and some cardiovascular drugs are among the most common, causing these side effects. Additionally, over-the-counter medications and dietary supplements can have powerful side effects and collaborative effects, also.

Environmental Risk Factors

  • Unsafe home conditions – obstacles in the home like cables in pathways, poor lighting, clutter, loose carpets, or slick floors.
  • Hazardous conditions outside the home, like clutter in the yard, uneven ground, or ice and snow.
  • Poor or no personal aid equipment like canes, walkers, or grab bars.
  • Uncomfortable or poor shoe ware.

Behavioral Risk Factors

  • A person’s fall risk is influenced by the types of activities they engage in, the level of physical demand, and their willingness and ability to adapt their routine for enhanced safety. For example, laundry is a normal activity for many people, but it can require a lot of exertion for a senior, especially if they must carry a heavy basket throughout their home. This task can be risky on its own, but without taking proper precautions such as wearing secure footwear or attempting to navigate stairs with the basket, they put themselves at greater risk. Failing to modify behaviors to adapt to new or challenging activities is a serious contributing factor for falls.
  • Rushing to the bathroom, especially at night when not fully awake or when lighting may be inadequate.
  • Being distracted by multitasking and failing to notice an environmental hazard, such as a curb or step.

Preventing Falls in Older Adults

Following some simple steps will significantly reduce the risk and consequences of falls in the elderly and help keep seniors happy and independent for as long as possible. If a caregiver is involved, fall prevention must be a team effort.4,5
Step 1: Get Educated

  • Learn about the impact of falls on the elderly and ways to prevent them.
  • Read CDC’s Stay Independent brochure. This contains a questionnaire to determine an individual’s level of risk.
  • The National Council on Aging (NCOA) leads the National Falls Prevention Resource Center to provide awareness and education on falls and promotes evidence-based falls prevention programs and strategies across the nation. Here you can explore desired topics and find the latest webinars.

Step 2: Speak Up

  • Talk openly with your healthcare provider about fall risks and prevention.
  • Inform your provider if you fall, worry about falling, or feel unsteady.
  • Review all your medical conditions and medications with your provider and discuss any side effects like feeling dizzy or sleepy. Some medicines, even over-the-counter medicines and herbal supplements can increase fall risks. As one ages, the way medicines work in the body can change. Ask your provider about taking vitamin D supplements to improve bone, muscle, and nerve health.
  • If you get dizzy or lightheaded when transitioning from seated to standing position, read CDC’s Postural Hypotension brochure, which has information to manage these symptoms.

Step 3: Get Eyes, Ears and Feet Checked Annually

  • See your eye doctor to have your eyes examined. Update your eyeglasses as needed and always wear your prescribed glasses. Ensure that you have no eye conditions that can limit vision, like glaucoma or cataracts.
  • Have your ears analyzed to eliminate the possibility of any problems with your inner ear that may make you feel dizzy. Wear your hearing aids if you use them.
  • Have your healthcare provider check your feet and discuss proper footwear. Ask whether seeing a foot specialist is advised.

Step 4: Exercise to Improve Your Balance and Strength
Exercises that improve balance, coordination and increase muscle strength lower your chances of falling. It also helps one feel better and more confident. Tai Chi is a good mind-body activity which helps with balance and strength. Discuss with your healthcare provider about an exercise program that’s best for you.

Step 5: Make Your Home Safer

  • Remove clutter, like clothes or books, from places where you frequently walk.
  • Ensure rugs and carpets are secure and use double-sided tape if needed to keep them in place.
  • Keep items that you regularly use in places where they can easily be reached.
  • Have grab bars in the shower/tub and near the toilet. Consider using a shower chair.
  • Use non-slip mats in the bathtub and on shower floors.
  • Improve the lighting in your home. As people get older, they need brighter lights to see well. Get lighter window treatments or remove them altogether.
  • Have handrails and lights installed on all staircases.
  • Wear well-fitting shoes with good support when inside and outside the house.
  • Get help when needed: don’t put yourself at risk in challenging situations. Get someone to help instead of climbing ladders and stools yourself.
  • Consider positioning fall mats next to the bed, in the bathroom, or other places where falls may be more common so that they can cushion the fall.
  • Medical alert systems can benefit and give the elderly peace of mind that help is at the push of a button. Furthermore, automatic alert systems can detect a fall without requiring a button to push.

New Applications Being Studied to Help Prevent Falls and Fall Injuries

  • Wearable airbags – a Chinese company has designed a vest to protect the head, shoulders, back, and hips when a fall occurs. On top of accomplishing the necessary materials, they determined an algorithm that predicts whether a sudden movement will result in a fall, promising to deploy the airbags within milliseconds for active protection of the wearer before they reach the ground. The company has spent five years working on this system and it continues to be upgraded. If perfected, it could soon reach the entire globe, helping to save lives and reduce harm among an already vulnerable population.6
  • Smartphone app – researchers at Binghamton University have developed an app to help study and prevent falls in older adults. The phone can be used not just for evaluation, but for delivering intervention. The study began in June 2022 and set out to investigate the body’s ability to maintain balance while standing and walking. Among the study is a Computerized Dynamic Posturography (CDP) system, which measures “postural sway” by analyzing foot pressure, force, and motor reactions while the user stands in a harness on a locked or moving platform. Using this specialized motion-capture gear, the researchers examined gait speed and balance. Improvements, especially in gait speed, have been shown to reduce the risk of falls. If participants show an improvement after utilizing the smartphone-based program, the intervention could be seen as clinically effective.7 

The Importance of Transitions of Care
The term Transitions of Care (TOC) describes a process of transferring a patient’s care from one setting or level of care to another. Settings of care may include hospitals, long-term care facilities, and rehabilitation facilities. This transition most often involves a patient moving from an acute, inpatient setting to an outpatient care environment. Transitions increase the risk of adverse outcomes due to the potential for miscommunication as care responsibility is given to new parties. Primary care physicians (PCPs) often encounter care gaps that are beyond their control due to factors such as inaccessible patient records, unclear discharge care plans, or limited effort by others to engage the primary care team, the patient, or caregivers. Therefore, it’s crucial to have effective provider communication with patient comprehension of discharge instructions in place for a safe and effective transfer.8

Even though there are many things that can cause a fall, there are even more things that one can do to prevent them. Utilizing some simple precautions will greatly prevent falls and injuries. Staying active and alert will lead to a better quality of life and the ability to stay independent for as long as possible.

References:

1,4 CDC https://www.cdc.gov/injury/features/older-adult-falls/index.html
2,5 Med Alert Help https://medalerthelp.org/blog/falls-in-the-elderly/#:~:text=Falls%20are%20common%20in%20old%20age%2C,it%E2%80%99s%20only%20one%20of%20the%20reasons.&text=Falls%20are%20common%20in,one%20of%20the%20reasons.&text=common%20in%20old%20age%2C,it%E2%80%99s%20only%20one%20of
3 AgingCare https://www.agingcare.com/Articles/Falls-in-elderly-people-133953.htm
6 My Modern Met https://mymodernmet.com/wearable-airbags-elderly-fall-protection/?utm_source=join1440&utm_medium=email&utm_placement=newsletter
7 Newswise https://www.newswise.com/articles/smartphone-app-could-help-prevent-falls-in-older-adults?sc=dwhn&user=10053418
8 Transitions of Care https://transitionsofcare.org/