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People of all ages fall, but falls are more common for older people and more dangerous. One out of three seniors over the age of 65 falls each year. Falls are the number one cause of death from injury among this age group. The death rate from falls among seniors has risen sharply over the past decade and is expected to grow as the population ages.

Losing balance and falling down is the most common accident that happens to older adults. Although most younger people are not usually harmed if they fall, the more falls an individual has, the greater the chance of injury. If you do get hurt the result can harm your health, your sense of well-being, and your independence - which has a serious effect on a person’s dignity.

Why do seniors fall?

Falls are due to a combination of unstable health conditions, taking too many medications, and environmental hazards in the home. In most of cases, falls can be prevented. In order to stop falls from happening, it helps to understand who is at greatest risk. The following conditions can increase the risk of a fall.

1. Urinary Incontinence: Up to 50% of older people have urinary incontinence (an inability to control the bladder). Incontinence may be caused by physical (heart disease, urinary infections, constipation, etc.) or mental disorders (dementia), or by decreased mobility. Persons with walking and balance problems may have control of their bladder but be unable to reach the toilet in time which leads to incontinence. Often these individuals need help getting to the toilet.

2. Osteoarthritis: Arthritis of the knee and/or hip joints, in particular, can limit the ability to walk and transfer effectively and safely. Persons with osteoarthritis generally have weakness of their upper legs (thighs) as well, which makes walking and maintaining balance much more difficult.

3. Diabetes: Persons with diabetes (a disorder affecting blood sugar) can develop nervous system complications that result in unsteady balance when walking. Diabetics can also develop either low or high blood sugar which may lead to dizziness and falls.

4. Poor Eyesight: This can keep people from seeing hazards and objects in their path, and lead to trips or slips. Common eye conditions include cataracts, macular degeneration and glaucoma. When combined with poor lighting and balance problems, eye disorders interfere with safe mobility and increase the likelihood of falling. Seniors can also suffer from depth perception where a few concrete stairs may appear to be a flat surface to them.

5. Use of Medications: Taking too much medication or the wrong combination of drugs can sometimes affect judgment, coordination and balance.

6. Walking and Balance Problems: Disorders such as stroke, arthritis, diabetes, Parkinson’s disease and other nerve and muscle diseases may affect muscle strength and reaction time. As a result, balance may not be quite the same as it was and lead to falling.

7. Inactivity: Inactivity (and a lack of exercise) results in weakened muscles and lack of flexibility. This can change someone’s balance, the way they walk and climb stairs, the way they get in/out of the bathtub/shower or get on/off the toilet.

Many of the causes of falling are preventable, but only if you take action. To help prevent falling, here are 3 important steps:

1. Visit your doctor: identifying the cause of falling (or a balance problem) and what treatment options are available is crucial. Some people who experience falls have an obvious health condition such as diabetes or Parkinson's disease that is the source of the problem. In other individuals however, falling (or balance problems) can be an early indication of an underlying disease condition yet to surface.

In addition, reviewing medications, both prescription and over the counter that may be detrimental to one’s balance, is vital.

Even after your visit it’s important to keep your doctor informed about any falls or balance problems you may be experiencing. The doctor may want to check you out for any medical conditions.

2. Make Your Home Safer: At least half of all falls happen at home and generally take place when doing ordinary things like walking on stairs, getting up from bed or going to the bathroom. The best way to deal with any threats to safety in the home is through prevention. It’s a good idea to check your home for hazards that frequently cause slips, trips, or falls and eliminate as many potential trouble spots as possible. By making your home safe now, you can avoid a fall later.

  • Lighting: Keep lights on in rooms that you are walking through. The lighting in your home must be bright so you can avoid tripping over objects that are not easy to see.
  • Consider a nightlight for dark passageways. During the day, open curtains and shades to let more sunlight in.
  • Install extra lighting along the pathway from bedroom to bathroom, by steps and stairways.
  • Floor Surfaces: Sliding Throw Rugs - Check all rugs and mats to make sure they are slip-resistant. Consider either buying new rugs with non-slip backing or applying nonskid matting to backs of existing rugs to make them secure.
  • Up-ended/Curled Carpet Edges: Use carpet tape to keep carpet edges from curling up.
  • Cluttered Pathways: All pathways should be clear of objects and furnishings.
  • Steps and Stairs: Make sure stairs are well lit and free of clutter. Use stairway handrails for going up or down steps. Pick up things on the stairs. Always keep objects off stairs and steps.

3. Stay Active: A regular program of physical activity (or exercise) is one of the best ways to decrease your chances of falling and improve your sense of well-being and confidence.

A tool to consider is the iStand Falls Prevention Exercise Program. It is an at-home exercise program, combining strength and balance exercises to help prevent falls in older people. It is a good way to increase (or maintain) balance. It includes:

  • A set of leg muscle strengthening and balance retraining exercises progressing in difficulty, and a walking plan.
  • Tai Chi exercise for balance. Originally developed in ancient China for self-defense, tai chi is a self-paced form of exercise and stretching. To do tai chi, the individual performs a series of rhythmic postures or movements in a slow, graceful manner. Tai chi improves balance by strengthening the muscles and joints surrounding the hips and legs.

The exercises take about 30 minutes to complete. Individuals are expected to exercise three times a week and go for a walk at least twice a week. The exercises can be performed at home with a caregiver and/or a physical therapist.

(This article originally appeared on the Caregiver Partnership blog. About the author: Rein Tideiksaar, Ph.D., has been active in the area of fall prevention for over fifteen years. He has directed numerous research projects on falls and has developed fall prevention programs in community, assisted living, home care, acute care, hospital, and nursing facility settings. He is President of FallPrevent, LLC, a company that provides educational, legal, and marketing services in connection with fall prevention in the elderly. Dr. Tideiksaar obtained a doctorate from Columbia Pacific University and a physician assistant certification from the State University of New York at Stony Brook.)


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