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Preventing Falls Among Older Adults

Author: Helen Dennis, Specialist on Aging

Question: My mother is 72 years old, accomplished and fiercely independent. Unfortunately, she recently had a serious fall causing a concussion and a four-day hospital stay. She also had a car accident and a bad fall in the bathroom. I am the son who lives closest to her and the “first call” when there is a problem. The docs say nothing is wrong, although her balance is poor and strength somewhat diminished. How can I convince her to use a walker to avoid future falls?

Answer: Your concern is a valid one. A simple fall for an older adult can be life changing.

According to a recent article in the New York Times, “In 2005, the last year for which statistics are available, 433,000 people over 65 were admitted to a hospital after falling and 15,800 died as a direct result of the fall.”

The consequences are serious. For example, more than 90 percent of hip fractures are caused by falling. And about one out of five patients with such fractures die within a year of the injury.

Cost is another issue. The Center for Disease Control reports that in 2000, the total direct costs of all fall injuries for those 65 and older was more than $19 billion. And by 2020, that figure is expected to increase to almost $55 billion.

There is more news to cause concern. The probability of an older adult falling is high. One in three adults 65 and older falls each year. Among those who fall, 20 to 30 percent suffer injuries that make it hard for them to get around or live independently.

Falls are frightening experiences. They can shake a person’s confidence in his or her ability to be safe. More than half of older adults who experience a fall restrict their activities because of the “fear of falling.”

I recall hiking in the High Sierras with my cousin, a physician. Upon returning to the roadside from May Lake, he fell. It was like a thunder of silence. He never returned to the Sierras, which he had been hiking for 50 years. Walking became a fearful experience.

Falls are preventable for many older adults. Much attention has focused on the problem.

The Archstone Foundation has funded the creation of several Fall Prevention Centers of Excellence. These Centers train health-care and social-service professionals to prevent falls, creating model programs and best practices in the field. Among the recipients are USC’s Andrus Gerontology Center, Cal State Fullerton and UCLA. Additionally, the Administration on Aging provided grants to 24 states to mobilize aging, public health and non-profit networks to translate research into practice to prevent falls.

Age does play a role in making adults more vulnerable to falling. For example, loss of muscle mass can lead to weakness and loss of balance. Existing medical conditions and medications also play a role; both can cause dizziness or light-headedness.

The first and most important action to take in fall prevention is an evaluation by a physician. After that, the following steps are recommended by the National Institute on Aging:

  • Encourage participation in a regular exercise program. This activity can compensate for normal losses with age by increasing strength and improving in balance.
  • Have vision and hearing tested on a regular basis.
  • Talk to one’s doctor or pharmacist about side effects from drugs being taken.
  • Limit the intake of alcohol.
  • Get up slowly after eating, lying down or resting.
  • If unsteady, consider the use a cane or walker.
  • Wear rubber-soled and low-heeled shoes.
  • When carrying something going up or down the stairs, always keep one hand on the railing.

If your mother does not want to engage in whatever is needed to prevent her from falling, then there is problem. It is always a sobering thought that we cannot make others do what they don’t want to do. I still believe it’s worth a try. Information, caring and hope remain powerful tools.

© Helen Dennis 2010, all rights reserved.

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