Falls are among the most common and serious problems affecting seniors today. At least 30 percent of adults over age 65 living at home fall at least once per year with 60 percent of these falls being fatal. A gait imbalance is not an inevitable accompaniment of old age though gait disturbances like those in Parkinson’s disease and diseases associated with immobility, falls can markedly impair your quality of life and even cause traumatic brain injury in some individuals.
Have you ever started to lose your balance or feel as though you have a gait issue? What about a slip or even a fall? If it was due to muscle weakness, previous studies have found this to be a major risk factor for fall prediction. Often we may just stumble or trip over an item on the floor or on an outdoor surface, miss a step, or may just not be paying attention or watching what we are doing as we move hurriedly throughout our seemingly busy day. Falls don’t just happen to seniors; I have a personal story for another column – my own falls for no apparent reason; finally a diagnosis of a rare autoimmune disease.
With financial issues becoming increasingly important due to the cost of care for seniors in a volatile economy, and in some instances decreasing insurance coverage and government benefits, fall prevention awareness should be enhanced through an overall increase in observation, reporting, and communication. Concerns about independence should remain in the forefront of our minds as our nation’s seniors struggle to be on their own – in their own homes trying to balance a quality of life that they value. As a first step, be sure to check the following areas in your home for possible hazards: floors, stairs and steps; the kitchen, bathrooms, bedrooms, and lighting. Many detailed inspection check-lists are available to help you to identify environmental issues in your home.
According to the National Council on Aging, nearly 60 percent of falls happen at home and even when injuries are minor, experiencing a fall can have a significant impact on an older adult’s sense of well-being, safety and independence. One out of three seniors in the U.S. experiences a fall each year and every 18 seconds an elder is treated in an emergency room for a fall. Unintentional falls are the leading cause of injury deaths and nonfatal injuries for those 65 years of age and greater. It has been reported that more than 500,000 of these patients were hospitalized in 2009 with more than $19 billion spent for non-fatal injuries. By 2020, the annual direct and indirect cost of fall injuries is expected to reach a staggering $54.9 billion according to the Centers for Disease Control and Prevention.
Although the rate of fatality is certainly of critical concern, non-fatal injuries that lead to a hospital stay or even more alarming a nursing home placement, restriction on activities, or decline on functioning or activity level are also significant If an individual sustains a hip fracture from a fall, about one out of five patients dies within a year of their injury, but up to one in four adults who had lived independently before their hip fracture has to stay in a nursing home for at least a year after their injury. A reduced quality of life and premature death have been documented.
Certain subgroups are at an increased risk for both falls resulting in injury according to recent studies. There is an increase of danger with age and at a higher percentage and seriousness for women. Non-fatal fall-related injuries disproportionately affect older women with injury rates occurring 40-60 percent higher than men of similar age. Accordingly, hospital admission rates for fall- related injuries in older women are 81 percent higher than admission rates for men of the same age.
A fall can certainly happen to any one of us; with some of the most common injuries from falls being of a serious nature— i.e., fractures of the spine, hip, forearm, pelvis and even traumatic brain injuries. We put ourselves at risk by moving too quickly and not being in good physical condition.
Often although many people may have a fall, even those who are not injured can develop a fear of falling. This fear may cause them to limit their engagement in activities. Unfortunately, this often results in loss of strength and a downward cycle of decreasing activity and vitality – which can in itself, lead to increased risk of falling.
The best steps to take in maintaining your independence and reduce the risk of falling is by educating yourself about fall risks and participate in community exercise programs to increase strength and balance. Continually review your medications to reduce side effects and interactions, and check your home to evaluate if you may need modifications to reduce fall hazards (risk factors). The health care community needs to participate in the prevention at the outset by being responsive to the needs of adults in our community, thus helping to provide such services as:
- Individualized health assessments in individual’s homes to identify fall risk factors.
- Educating physicians throughout various communities about fall prevention.
- Reducing risks through such means as monitoring changes in medical conditions, vision testing, medication use, social support, physical functioning and most importantly, facilitate fall prevention efforts through existing medical care and adjusting home environments.
By paying attention to common risk factors, falls can be avoided and injury from falls can be minimized. Please, watch your step!
Paula Camposano Robinson, RN, is co-founder and owner of Sanitasole Senior Health Services. In healthcare for more than 30 years she and Jason Mark Young, MS, Director of Activities and Mental Health at Sanitasole will be discussing critical issues facing seniors and those who care for them. This is an information-only column and is not intended to replace medical advice from a physician. Email me or email@example.com or visit www.sanitasole.net for more information. Phone: 239.394.9931.