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september fall prevention month for elders

September is National Fall Prevention Month

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September 23 is Fall Prevention Awareness Day. It is the first day of Fall and is a day to increase public awareness on reducing and preventing falls for older persons.

The reasons why older adults fall are complicated. Decreased strength, balance problems, difficulty walking, medication errors, impaired vision, cognition issues, depression, and the effects of multiple health problems—all are linked to increased risks of falls.

Approximately 50% of Falls Are From Extrinsic Factors in the Environment

The first steps to help reduce the risk of Falls is identifying factors that increase the risk of Falls. Some environmental hazards to falls include:

  1. Furniture arrangement, Often furniture can sometimes block pathways.
  2. Lighting. Lighting that is improperly placed or is too low is a risk factor as well as if it is to bright. Too bright can cause objects to be distorted or glared when looked at.
  3. Floors. Floors that are uneven, or changes in floor type, from a slick floor to a carpeted area can be a fall hazard.
  4. Help solve issues Every 17 seconds, an older adult is treated in the Emergency Department for a fall-related injury, and every 29 minutes, an older adult dies from a fall. Far too often older adults are treated for the injury sustained, not for the fall-related cause of the injury. Yet once a fall occurs, the individual is two to three times more likely to fall again and if not already injured, will eventually sustain a significant if not fatal injury.

WHY NATIONAL FALL PREVENTION AWARENESS DAY IS IMPORTANT

“Falls Prevention Day is an opportunity to take a look at the world around us, be aware of falls hazards, and think about how we can make changes that will help our parents, grandparents, aging neighbors, and even ourselves safe from falls,” said Kathy Cameron, MPH, senior director of the National Falls Prevention Resource Center at NCOA.

  1. Our elderly family and friends have so much more life experience than us. For centuries, cultures across the world have looked to the seniors in their community for wisdom and knowledge. They are great at giving us life advice and often they are the first people we go to. Their wisdom and advice is valuable to us and we have much to learn from them.
  2. Our elder citizens give generously. Most of us know from experience that the elderly are much more generous in nature. In fact, they make more charitable donations than any other age group. They have more time to devote to others and volunteer. We appreciate how much they look out for their friends and family and it’s a quality we love in our seniors.
  3. Our elderly give us goodies! Perhaps this stems from their generous and charitable nature, but seniors are very good at making us feel special. Grandparents dote on us and the candy…oh the candy!! Many of us can remember being spoiled a bit by a grandparent. To every grandparent or elderly loved one that has given us candy, or made sure we ate well, or spoiled us, we appreciate you!

Everyone knows someone who has fallen.  Most Seniors also know someone who’s life has been dramatically changed from falling.

Most of the stories you will hear about when someone falls are very similar.  The overwhelming consensus was “I didn’t think it would happen to me” and “I didn’t even realize how dangerous that was in my own home”. These are stories that are told all too often.

Active or Not, Falls Happen

The statistics show that not all falls are due to physical impediments.  Falls can happen to the most active of people. Taking action and being prepared is what makes the difference.

What Can Happen After a Fall?

There are varying degrees of severity when a person falls.  If you’re lucky you can walk away with just a bruised ego.  If you’re not lucky, you could be in for a rough ride.

According to the CDC:

  • Falls represent 40% of nursing home admissions.
  • 300,000 seniors break their hip every year.
  • According  to NBI: After a hip fracture mortality study; Mean follow-up was 3.7 years (range 0-9 years). Overall 1-year postoperative mortality was 27.3% and mortality after hip fracture at the end of the follow-up was 79.0%. During the study period, the risk of mortality in hip fracture patients was 3-fold higher than that in the general population and included every major cause of death.
  • Falls can cause broken bones, like wrist, arm, ankle, and hip fractures.
  • Falls can cause head injuries. These can be very serious, especially if the person is taking certain medicines (like blood thinners). An older person who falls and hits their head should see their doctor right away to make sure they don’t have a brain injury.
  • Many people who fall, even if they’re not injured, become afraid of falling. This fear may cause a person to cut down on their everyday activities. When a person is less active, they become weaker and this increases their chances of falling

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.

Steps to Reducing Falls

Here are some steps you can take today to help your older loved one reduce their risk of a fall:

Clean up clutter. The easiest method for preventing falls is to keep your home neat and tidy. Remove all clutter, such as stacks of old newspapers and magazines, especially from hallways and staircases.

Repair or remove tripping hazards. Sometimes home fixtures can contribute to falls, which can then lead to back pain and other injuries. Examine every room and hallway, looking for items such as loose carpet, slippery throw rugs, or wood floorboards that stick up. Then repair, remove, or replace those items for more effective fall prevention.

Install grab bars and handrails. These safety devices are crucial for going up and down stairs, getting on and off the toilet, and stepping in and out of the bathtub without injuring yourself. Gary Kaplan, DO, founder and medical director of the Kaplan Center for Integrative Medicine in McLean, Virginia, suggests installing grab bars by toilets and bathtubs and handrails in stairways and hallways. Have a handyman or family member help with this if necessary.

Avoid wearing loose clothing. You want to feel comfortable at home, but baggy clothes can sometimes make you more likely to fall. Opt for better-fitting and properly hemmed clothing that doesn’t bunch up or drag on the ground.

Light it right. Inadequate lighting is another major hazard. To create a home that’s more suitable for the elderly, install brighter light bulbs where needed, particularly in stairways and narrow hallways. Robert Bunning, MD, associate medical director of inpatient services at MedStar National Rehabilitation Hospital in Washington, D.C., also recommends adding night-lights in bedrooms and bathrooms for better guidance at night.

Wear shoes. Socks may be comfortable, but they present a slipping risk. Preventing falls at home can be as simple as wearing shoes. You can also purchase non-slip socks that have grips on the soles of the feet if shoes are too uncomfortable.

Make it nonslip. Bathtubs and showers, as well as floors in kitchens, bathrooms, and porches, can become extremely dangerous when wet. To prevent falls on slick surfaces, Dr. Kaplan recommends nonslip mats.

Live on one level. Even with precautions like guardrails, stairs can present a significant falling hazard. “If possible, live on one level,” says Kaplan. “Otherwise be extra-careful when you negotiate stairs.” If it’s not possible to live on one level, try to limit the trips you take up and down the stairs.

Move more carefully. Dr. Bunning explains that many people fall at home by moving too quickly from a sitting to a standing position and vice versa. Preventing falls like this is as easy as taking your time. “All you have to do is pause after going from lying down to sitting and from sitting to standing,” he says. “Also take a pause before using the railing on stairs, whether going up or down.”

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. 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.

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?

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.

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.

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.

My mom had an elaborate spreadsheet to keep track of her medications and schedules. Adding a timed medication dispenser that my sister refilled each month promoted her peace of mind and allowed us to ensure her adherence to the 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.

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.

 

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