Fall Prevention:
“I’ve fallen and I can’t get up!” How many times have we heard comics deliver that line from a now-famous TV commercial?
The truth is that a dangerous fall is no laughing matter. It’s a real worry — for those who suffer from balance dysfunction and for the family caregiver.
Just the fear of a parent, spouse or other loved one falling is enough to give a caregiver chills. And the statistics bear that out.
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A simple thing can change your life—like tripping on a rug or slipping on a wet floor. If you fall, you could break a bone, like thousands of older men and women do each year. For older people, a break can be the start of more serious problems, such as a trip to the hospital, injury, or even disability.
If you or an older person you know has fallen, you're not alone. More than one in three people age 65 years or older falls each year. The risk of falling—and fall-related problems—rises with age.
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Most caregivers are aware of the importance of preventing falls. When a fall occurs, the results can be life-changing. While we all realize the significance of a broken bone that may result from a fall, what we sometimes fail to acknowledge is the broken spirit that may occur after a fall. Many elders who fall never fully regain the confidence in their ability to navigate around their home or near steps. They may experience a fear of falling again that may cause them to limit their activity. They may have a permanent disability—not only from the physical consequences of the fall, but from the emotional consequences as well.
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Among older Americans, deaths from falls are up sharply, dovetailing with a surge in use of medications that increase the risk of falling, researchers say.
Two decades ago, about 57% of U.S. seniors took medications that increased their risk of falls. By 2017, that number had risen to 94%, and deaths caused by falls had more than doubled, a new study found.
The medications are meant to limit harm from serious conditions ranging from high blood pressure to depression. So, how can patients and their doctors find the right balance?
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Not too long ago, I was told that the golden years are not for sissies. Subsequently, this statement was followed with there is nothing golden about growing old. WOW! I was faced with an older adult not too happy about where she was in life.
She was referring to her recent total hip replacement and was dealing with pain and limitations during her daily activities. She required help getting around from her family and was unhappy because she has always been very independent.
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Among elders, more than half have high blood pressure (hypertension). Hypertension leads to the risk of heart attacks, strokes, kidney disease, blindness, dementia, etc. Of equal danger, low blood pressure (hypotension) can result in dizziness, fainting and increased loss of balance. About 10%-20% of elders’ experience hypotension.
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Footwear helps support a person’s balance, which reduces the chances of slipping, tripping, and falling.
According to a new study, up to 83% of older people wear the wrong type of shoes, including not using the correct size. This results in foot disorders, pain, and increased risk of falling.
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Every day, I see many elders in my practice. Some of them are experiencing the usual mental difficulties of old age, like forgetfulness or poor attention span. Yet others somehow manage to remain mentally sharp, even well into their 80s. I call these people “superagers”; those whose memory and attention is well above average for their age, on par with healthy, active 20 and 30-year-olds.
So, why do some elders remain mentally agile while others descend into dementia? There are several reasons:
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Around a third of people aged 65 and over and half of those aged 80 and over experience a fall each year. As a result, there are over 250,000 emergency admissions of elders to hospitals for falls every year. This is unfortunate, since many falls and fractures can be avoided by simple exercises that improve people's strength and balance.
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Avoiding Falls by Keeping Your Brain Fit
As a person gets older, changes occur in all parts of the body, including the brain:
• Certain parts of the brain shrink (such as the prefrontal cortex and hippocampus); both areas are important to learning, memory, planning, and other complex mental activities.
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Falling and winding up in the hospital is a problem for elders, many of whom have complex health conditions. The most common conditions leading to falls and hospitalization include:
• Urinary tract infections
• Adverse medication reactions
• Poor disease management
In many cases, these conditions are preventable by family caregivers. A family’s involvement in identifying and acting on potential warning signs, and keeping loved ones healthy and safe is an important role.
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In my health care practice, I see many elders who are ‘superagers’. These are people typically in their 60s and 70s (occasionally in their 80s) who exercise hard every day; some run or lift weights, others swim or bicycle. Consequently, the physical agility of superagers isn’t merely above average for their age, but is on par with healthy, active 50-year-olds. But superagers have one health concern in common; they tell me that their balance isn’t what it used to be, in fact, it has become quite wobbling. As we age, balance declines. There is no single reason for this, but weakening eyesight and muscles, and physical changes in the brain, all play a role.
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Although most people prefer to remain in the familiar surroundings of their own homes, home can be a hazardous place for an older person to live. According to the Centers for Disease Control and Prevention over 12,000 older adults die from falls at home each year and more than 1.6 million people over 65 need emergency medical treatment for fall-related injuries.
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If your older parent complains about chronic knee pain he or she may be a good candidate for a knee replacement.
Knee replacements are one of the most common surgeries performed in the United States. Every year more than 300,000 people – mostly over 65 – undergo surgery to replace knees that have become stiff and painful after years of wear and tear.
Most people who have had knee replacement surgery are pleased with the results. They can now walk, climb stairs, and enjoy activities they had to give up because of unbearable pain.
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Family members of older adults living at home often worry that their relative may fall – and rightly so. Falls are a leading cause of emergency room visits and a major cause of disability and death in people over 65. Most falls occur at home – either inside or outside the house. Older people often restrict their activities simply because they are afraid of falling.
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