Unexpected falls create some of the most discouraging and frustrating moments seniors face each day. At 57, I’ve not yet reached “senior status” but my recent heart valve surgery gave me a realistic glimpse into the frustrating and worrisome realm of poor balance and the imminent threat of falling.
The statistics relating to falls by seniors are very sobering: more than one third of persons 65 years or older fall each year, and half of those falls are recurrent. About 1 in 10 falls results in a serious injury such as a hip fracture, other fracture, significant head injury, or other serious soft tissue injury (back pain, leg pain or neck pain – for example). And, the rate of falling and the prevalence of risk factors for falling increase steadily after the age of 70.
A two-pronged approach is best to address the serious health concern that falls represent in the senior population:
1. Taking pro-active steps to try and minimize or eliminate risk factors that can lead to falls.
2. Maximizing one’s personal health status to try to reduce the risk of serious injury should a fall occur.
A comprehensive inventory of your personal risk factors for falls is needed to identify areas of focus to improve or compensate in planning for fall prevention. That inventory includes the following:
• Physical Impairment: Gait and balance problems are extremely common findings among seniors for falling.
• Visual Difficulties: Blurred vision, diabetic retinopathy, glaucoma, cataracts, macular degeneration, depth perception difficulty, and visual field cuts bring greater risks of falling.
• Hearing Loss: Inability to hear warnings or follow verbal directions.
• Errors in Judgment: A failure to remember to use assistive devices such as canes or walkers; your denial of any need for support; poor safety judgment.
• Medical Conditions: Irregular heartbeat, blood pressure drop with changes in position, blood sugar fluctuations, seizure disorders, and chronic pain disorders bring greater risks of falling.
• Medications: Certain types of medications, either through direct effect, side effects, or adverse reactions, or interactions with other medicines can have a significant impact on an individual’s risk for falling. Some examples of these types of medications include pain relievers, narcotics, cold and sinus preparations, antihypertensives, cardiovascular agents, anticoagulants, diabetic medications, diuretics, sleep preparations, and anti-anxiety, antidepressant, and antipsychotic medications. Ask your doctor to review regularly your medication to look for possible drug interactions, and be sure your doctor knows about any over the counter medicines that you take.
• Environmental Factors: Wet floors, poor lighting, throw rugs that can slip, improper footwear and cluttered pathways bring greater risks for falling.
• History of Falls: Once a resident falls, the odds are great that the resident will fall again doing the same or similar activity that caused the first fall.
Good health maintenance is essential in trying to reduce the risk of serious injury that can occur from a fall. Some of the important things you need to consider are:
• Regular medical follow up with your personal care physician and ophthalmologist.
• Maintaining a daily walking or mild exercise routine to strengthen bones and keep joints mobile.
• Assuring good nutritional status and drinking adequate fluids daily.
• Adhering to treatment recommendations for arthritis and osteoporosis both of which conditions can cause bone weakening.
Arcadia’s annual “check-ups” for our resident population (the annual geriatric functional assessment) offer a terrific opportunity, among other measures, to take a look at one’s fall potential. With our average age at Arcadia being 85 years, review of one’s fall potential, at least annually, is a good investment.
Once your fall-risk factors have been reviewed and analyzed, you and Arcadia then have the opportunity to create a fall prevention plan. Such a plan is created by considering the following:
1.Your risk and history of falls, including discussions with family and prior caregivers.
2.Thorough medical evaluations by your personal physicians.
3.Developing individualized interventions.
4.Continually reassessing your physical and mental condition and changes in your risk profile for falling.
5.Working with Arcadia’s Interdisciplinary Team.
It is important to understand that there is no panacea or fully preventive plan to preclude falls. The best we are able to do is to recognize the problem, review the risks, and intervene as best we can to limit the number of falls and injuries that inevitably will occur in senior living.