By Colleen Scott, NYSOFA Advocacy Specialist
Falls are among the top causes of lost independence for older adults annually. NYSOFA data (excluding NYC) shows that 43,806 people (88%) currently being served by our network were at risk of falls and injuries related to falls.
Based on a comprehensive assessment of themselves and their home environment, most older adults would like to stay as independent as possible for as long as possible in their own homes. Falling poses a serious threat to this independence. The fear of falls also increases social isolation and loneliness for many older adults who avoid going out because of these fears.
A simple accident like losing your footing on stairs, tripping over a cord or throw rug or slipping in the bathroom can change the course of an individual’s life, especially for older people who may have underlying or co-occurring conditions that are exacerbated by the results of a fall.
Falls are a major driver for emergency room visits, hospitalizations and nursing home placement and they cost the health system billions of dollars annually. Falls are the second leading cause of unintentional injury deaths worldwide; adults over the age of 60 suffer the greatest number of fatal falls.
Exercise classes are proven to decrease falls risk and reduce the fear of falling. Exercise and strength-based programs are available through NYSOFA’s partnership with GetSetUp, a platform that is available free of charge for anyone 50 and over in New York State. Please also see NYSOFA’s recent livestream with a strength-training expert who specializes in programs for older adults with proven results in increased strength and muscle mass.
Disparities
-
Asian Americans were significantly less likely to fall compared to non-Hispanic whites.
- Individuals with two or more chronic diseases were significantly more likely to fall than individuals with two or fewer chronic diseases.
-
By age 85, approximately two-thirds of all reported injury-related deaths are due to falls.
Prevention
Preventing a fall minimizes your chances of injury and maximizes your chances of remaining independent. Some ways to prevent falls include:
- Gait, balance and functional training.
- Evidence based programs such as Tai Chi, ‘Matter of Balance’ and ‘Stepping On.’
- Home assessment and modifications.
- Reduction or withdrawal of psychotropic drugs.
- Multifactorial interventions (individual fall-risk assessments followed by tailored interventions and referrals to address identified risks).
- Vitamin D supplements for those who are Vitamin D deficient.
As always, individuals should consult with their health care provider when considering any changes to medications, diet or other significant changes.
Environmental risk factors and prevention (Source: Mayo Clinic)
- Make sure stairs and hallways are well lit. Install nightlights to light the path from your bed to the bathroom. Keep flashlights at the bedside in case of power outages.
- Avoid wet floors and use nonskid floor wax.
- Secure area rugs with double-sided, slip-resistant backing, and consider carpeting concrete, ceramic or marble floors to cushion falls.
- Stairs should have sturdy handrails on both sides. Add nonslip treads to hardwood stairs. Avoid using patterned or thick carpets on stairs since these make the edges of the steps harder to see and easier to trip on. Repair loose carpets and floorboards.
- Install grab bars near toilets and showers, replace glass shower enclosures with shatterproof material, and place slip-resistant rugs near the shower for safety. Consider using shower chairs and raised toilet seats.
- Remove clutter, low coffee tables, footrests and electric cords that may cause you to trip. Remove any shaky or damaged furniture.
- Make your bed easy to get in and out of, keep a phone near your bed, and remove any clutter from around the bed.
- Use easy-to-reach and low cabinets. Don't stand on chairs or boxes to reach higher cabinets or shelves. Instead, use a sturdy step stool with handrails for balance.
- Avoid chairs that are too low to get up from easily. Remove unstable chairs.
Patient-specific risk factors and prevention (source: Mayo Clinic)
-
Osteopenia and osteoporosis: Good bone health can decrease the severity of injuries after a fall. Make sure you're getting enough vitamin D and calcium. Also, consider bone mineral density testing, especially after a fragility fracture (spine, hip or wrist). Depending on the results, your health care professional may recommend treatment.
-
Impaired gait: How you walk can affect your risk for falls. Talk with your health care professional about an exercise program to improve your strength and balance. Assistive devices, such as a cane or walker, may reduce risk, too. Gait also can be affected by diseases, such as Parkinson's and inner ear disorders.
-
General health: An annual exam evaluates your overall health and can detect heart and blood pressure problems that may cause unexpected falls.
-
Medications: Be aware of medication side effects, such as making you sleepy or impairing your balance. Make sure medications are clearly labeled and take them according to the instructions.
-
Dementia: Patients with dementia who live at home and alone are at higher risk for injury. Family members with memory issues may need redirecting or reminders to use assistive devices.
-
Vision and hearing: Get annual eye and hearing exams.
-
Nicotine and alcohol: Nicotine in any form decreases bone health. Alcohol can impair coordination and judgment.
-
Shoes: Wear supportive, nonskid shoes that are weather-appropriate and fit properly. Make sure your shoelaces are well-tied. House slippers also should fit well and have good traction. During the winter, watch for icy spots, and salt or request that your snow removers frequently salt areas in your walkway that tend to get icy as snow melts and refreezes.
-
Pets: Beware of tripping over pets or getting tangled in long leashes.
Resources