Preventing Falls: What You Should Know

Falls are the leading cause of home injury among adults age 65 and older. In recent decades the number and frequency of fatal injuries caused by falls among older adults has increased dramatically throughout the world. Each year, more than 4700 Americans aged 65 and older die as a result of falls, and more than a million elderly Americans are admitted to hospital emergency rooms to treat injuries related to falls, according to the Home Safety Council. Falls generally result from an interaction of various risk factors and situations. Frequently, older people are not aware of their risks of falling and often do not recognize risk factors. Although no single factors cause all falls, the greater the number of risk factors to which an individual is exposed, the greater the probability of a fall and the more likely the results of the fall will threaten the person’s independence. Even a fall that does not cause an injury can limit confidence and the ability to be comfortable living independently. Risk factors responsible for a fall are considered to be either environmental (i.e. poor lighting, loose carpets, lack of bathroom equipment) or physical (i.e. leg weakness, poor grip, strength, visual problem, balance disorders). Many of these risk factors are considered to be preventable. As obvious as it may sound, a lack of knowledge about risk factors and how to prevent them contributes to many falls. Come people believe that falls are a normal part of aging, and such are not preventable. However, lack of knowledge leads to lack of preventative action, resulting in falls. For many elderly people, the home can be a hazardous place. Homes with loose throw rugs, runners and mats, curled carpet edges, poor lighting, slippery uncarpeted floors and stairs can turn into “booby traps”. A Yale School of Medicine study of people ages 72 and older living in and around New Haven, Connecticut, found that the most dangerous part of the house was the floor in the living rooms, bedrooms and hallways. Stairways were the second most dangerous zone, according to the study, published in the American Journal of Public Health, which went on to recommend the use of night lights and light switched at the top and bottom of the stairways as well as handrails. Bathrooms were also considered to be dangerous due to the fact that tubs and showers usually lacked non skid mats, abrasive strips and grab bars. In addition to poor lighting, toilets were typically too wobbly or too low for an older person to rise from safely. Kitchens were next on the list, with poor lighting , unstable step stools and storage areas that required an older person to reach high or bend low. Since one-third of all falls in the elderly involve environmental hazards in the home, it may be useful to conduct a walk-through of your home to identify possible problems that may lead to falling. A home visit by an occupational therapist might also be useful in that they are trained to identify risk factors and recommend appropriate actions. Recommendations are specific and comprehensive and often include measures to improve home safety such as the addition of grab bars in the bathroom, removal of loose area rugs, and using alternate colors to denote changes in the surface structures. Some of the reasons seniors tend to fall more often are result of physical changes such as lack of flexibility and muscle strength, especially in their legs. Failure to exercise regularly results in poor muscle tone, decreased strength, and loss of bone mass, which contribute to falls and the severity of injury due to falls. Recent studies have found that physical activity is an effective intervention strategy for preventing falls in older people. A supervised strength and endurance training program prescribed by a physiotherapist has been found to be effective in reducing the rate of falling by more than 30% according to the British Medical Journal. Physiotherapist play a key role in identifying those at risk of falling and providing interventions such as exercise to improve balance and strength, prescription of appropriate walking aids and activities to maximize endurance, fitness and bone density. For people at high risk of falling, they can also intervene to reduce the severity of a fall by prescribing injury- reducing braces such as hip protectors. Recent research has also identified that balance in women begins to decline after the age of 40 due changes in sensation and vision. Exercise programs incorporating vision and head movements can also improve balance in the ‘under 60’s’ to reduce the likelihood of future falls. Exercise groups and activity programs and activity programs designed and implemented by physiotherapist are also effective in optimizing balance and fitness for people with conditions that may restrict participation in general activity programs, such as those with diabetes, arthritis, or neurological dysfunction.