Fall Awareness Week corresponds to the beginning of fall (autumn) each year and is sponsored by the National Council on Aging (NCOA). It seems like common sense — everybody falls, no matter what age. However, for many older adults, an unexpected fall can result in a serious and costly injury. The good news is that most falls can be prevented. Information in this blog comes directly from the NCOA downloadable guides to falling entitled 6 Falls Prevention Steps to Help Your Older Loved Ones and Debunking the Myths of Older Adult Falls.
Where to Look for Common Factors that Lead to Falls
Did you know that one in four older Americans falls every year? Falls are the leading cause of both fatal and nonfatal injuries for people aged 65+. Falls can result in hip fractures, broken bones, and head injuries. And even falls without a major injury can cause an older adult to become fearful or depressed, making it difficult for them to stay active. If you have an aging parent, grandparent, or neighbor in your life, helping them reduce their risk of falling is a great way to help them stay healthy and independent for as long as possible. The good news about falls is that most of them can be prevented. The key is to know where to look. Here are some common factors that can lead to a fall:
Balance and gait: As we age, most of us lose some coordination, flexibility, and balance— primarily through inactivity, making it easier to fall.
Vision: In the aging eye, less light reaches the retina—making contrasting edges, tripping hazards, and obstacles harder to see.
Medications: Some prescriptions and over-the-counter medications can cause dizziness, dehydration, or interactions with each other that can lead to a fall.
Environment: Most seniors have lived in their homes for a long time and have never thought about simple modifications that might keep it safer as they age.
Chronic conditions: More than 80% of older adults have at least one chronic condition like diabetes, stroke, or arthritis. Often, these increase the risk of falling because they result in lost function, inactivity, depression, pain, or multiple medications.
6 Steps to Reducing the Risk of Falls
Here are six steps you can take today to help your older loved one reduce their risk of a fall:
1. Enlist their support in taking simple steps to stay safe. Ask your older loved one if they’re concerned about falling. Many older adults recognize that falling is a risk, but they believe it won’t happen to them or they won’t get hurt—even if they’ve already fallen in the past. A good place to start is by sharing NCOA’s Debunking the Myths of Older Adult Falls (see next section). If they’re concerned about falling, dizziness, or balance, suggest that they discuss it with their health care provider who can assess their risk and suggest programs or services that could help.
2. Discuss their current health conditions. Find out if your older loved one is experiencing any problems with managing their own health. Are they having trouble remembering to take their medications —or are they experiencing side effects? Is it getting more difficult for them to do things they used to do easily? Also make sure they’re taking advantage of all the preventive benefits now offered under Medicare, such as the Annual Wellness visit. Encourage them to speak openly with their health care provider about all of their concerns.
3. Ask about their last eye checkup. If your older loved one wears glasses, make sure they have a current prescription and they’re using the glasses as advised by their eye doctor. Remember that using tint-changing lenses can be hazardous when going from bright sun into darkened buildings and homes. A simple strategy is to change glasses upon entry or stop until their lenses adjust. Bifocals also can be problematic on stairs, so it’s important to be cautious. For those already struggling with low vision, consult with a low-vision specialist for ways to make the most of their eyesight.
4. Notice if they’re holding onto walls, furniture, or someone else when walking or if they appear to have difficulty walking or arising from a chair. These are all signs that it might be time to see a physical therapist. A trained physical therapist can help your older loved one improve their balance, strength, and gait through exercise. They might also suggest a cane or walker—and provide guidance on how to use these aids. Make sure to follow their advice. Poorly fit aids actually can increase the risk of falling.
5. Talk about their medications. If your older loved one is having a hard time keeping track of medicines or is experiencing side effects, encourage them to discuss their concerns with their doctor and pharmacist. Suggest that they have their medications reviewed each time they get a new prescription. Perhaps a spreadsheet can help keep track of medications and schedules, or adding a timed medication dispenser that notifies you or your loved one of refills will promote their peace of mind and allow for an adherence to a prescribed regime. Also, beware of non-prescription medications that contain sleep aids—including painkillers with “PM” in their names. These can lead to balance issues and dizziness. If your older loved one is having sleeping problems, encourage them to talk to their doctor or pharmacist about safer alternatives.
6. Do a walk-through safety assessment of their home. There are many simple and inexpensive ways to make a home safer. For professional assistance, consult an Occupational Therapist. Here are some examples:
Lighting: Increase lighting throughout the house, especially at the top and bottom of stairs. Ensure that lighting is readily available when getting up in the middle of the night.
Stairs: Make sure there are two secure rails on all stairs.
Bathrooms: Install grab bars in the tub/shower and near the toilet. Make sure they’re installed where your older loved one would actually use them. For even greater safety, consider using a shower chair and hand-held shower.
Debunking the Myths of Older Adult Falls
Many people think falls are a normal part of aging. The truth is, they’re not. Most falls can be prevented—and you have the power to reduce your risk. Exercising, managing your medications, having your vision checked, and making your living environment safer are all steps you can take to prevent a fall. To promote greater awareness and understanding here are 10 common myths—and the reality—about older adult falls.
Myth 1: Falling happens to other people, not to me.
Reality: Many people think, “It won’t happen to me.” But the truth is that 1 in 4 older adults fall every year in the U.S.
Myth 2: Falling is something normal that happens as you get older.
Reality: Falling is not a normal part of aging. Strength and balance exercises, managing your medications, having your vision checked and making your living environment safer are all steps you can take to prevent a fall.
Myth 3: If I limit my activity, I won’t fall.
Reality: Some people believe that the best way to prevent falls is to stay at home and limit activity. Not true. Performing physical activities will actually help you stay independent, as your strength and range of motion benefit from remaining active. Social activities are also good for your overall health.
Myth 4: As long as I stay at home, I can avoid falling.
Reality: Over half of all falls take place at home. Inspect your home for fall risks. Fix simple but serious hazards such as clutter, throw rugs, and poor lighting. Make simple home modifications, such as adding grab bars in the bathroom, a second handrail on stairs, and non-slip paint on outdoor steps.
Myth 5: Muscle strength and flexibility can’t be regained.
Reality: While we do lose muscle as we age, exercise can partially restore strength and flexibility. It’s never too late to start an exercise program. Even if you’ve been a “couch potato” your whole life, becoming active now will benefit you in many ways—including protection from falls.
Myth 6: Taking medication doesn’t increase my risk of falling.
Reality: Taking any medication may increase your risk of falling. Medications affect people in many different ways and can sometimes make you dizzy or sleepy. Be careful when starting a new medication. Talk to your health care provider about potential side effects or interactions of your medications.
Myth 7: I don’t need to get my vision checked every year.
Reality: Vision is another key risk factor for falls. Aging is associated with some forms of vision loss that increase risk of falling and injury. People with vision problems are more than twice as likely to fall as those without visual impairment. Have your eyes checked at least once a year and update your eyeglasses. For those with low vision there are programs and assistive devices that can help. Ask your optometrist for a referral.
Myth 8: Using a walker or cane will make me more dependent.
Reality: Walking aids are very important in helping many older adults maintain or improve their mobility. However, make sure you use these devices safely. Have a physical therapist fit the walker or cane to you and instruct you in its safe use.
Myth 9: I don’t need to talk to family members or my health care provider if I’m concerned about my risk of falling. I don’t want to alarm them, and I want to keep my independence.
Reality: Fall prevention is a team effort. Bring it up with your doctor, family, and anyone else who is in a position to help. They want to help you maintain your mobility and reduce your risk of falling.
Myth 10: I don’t need to talk to my parent, spouse, or other older adult if I’m concerned about their risk of falling. It will hurt their feelings, and it’s none of my business.
Reality: Let them know about your concerns and offer support to help them maintain the highest degree of independence possible. There are many things you can do, including removing hazards in the home, finding a fall prevention program in the community, or setting up a vision exam.