Take Steps Against the High Risk of Falling

By Clare Noonan March 15, 2013 12:00

It may seem contradictory that as you age the best way to prevent falls is by being active. But that’s the consensus among experts on a topic that is affecting a growing portion of the population as baby boomers age.

One in three people 65 or older fall each year in the U.S. In 2010, 2.3 million people in that age group were treated in emergency rooms for nonfatal falls, according to the Centers for Disease Control and Prevention.

Among those 50 and older, falls are the leading cause of death by “unintentional injuries” in the U.S., claiming 24, 414 lives in 2010, the latest year for which CDC statistics are available. Nearly twice as many in this age group die in falls than motor vehicle-related accidents.

Studies have shown that the most effective way to prevent falls is by increasing flexibility, strength and balance, says Jan Migliaccio, 72. The retired physical therapist lives in Volcano and is in charge of training and supervision for Foothill Fitness classes conducted at seven sites throughout Amador County.

She spoke of the camaraderie among class participants, noting that many people find it easier to exercise in a group. For older adults unable to get to a class, simple exercises at home can do the trick (see Fall-Prevention Program in Krista Howell’s Spring 2013 column, Fitness First.)

Walking erect improves balance, Migliaccio says, adding that stretching should be part of any routine – “ankles, hips, low back, shoulders and neck.” And strengthening your legs helps prevent falls: “When you start to fall backward, the muscles in the front of your legs pull you forward.”

“The goal is to get yourself in as good shape as possible,” she adds. “Take responsibility for your own health.”

Dr. Matt Personius agrees. He owns Sonora-based Sierra HouseCalls Medical Group and, in addition to house calls, visits patients in nursing homes. “Be proactive,” he advises. “To maintain independence and capabilities, stay active, exercise regularly and eat well.”

Seniors need to determine their risk of falling, he continues. Of course, anyone can fall, but in particular peril are seniors who are frail, have chronic medical conditions, have cognitive impairment or have fallen in the past.

“As we age, our balance lessens,” says Personius, and problems with balance cause many falls. Other causes include medications, arthritis (“the bane of old age,” he calls it), stiffness, lack of flexibility, and poor vision.

He suggests that fall-prone seniors review with their health-care provider all medications they’re taking. Some drugs can cause dizziness, light-headedness and low blood pressure, all of which can lead to a fall. In addition, Personius says, some medicines can interact. So medicines that seniors take on an as-needed basis, such as sleep aids, painkillers or anti-anxiety drugs, can increase the risk of falling.

A senior may need a walker or cane, the doctor points out, but deciding which one is best should be made with the help of a physical or occupational therapist.

The important thing for seniors is to maintain their current levels of activity, Personius says. “At 60, most people are able to continue to do the things they’ve always done,” including driving, cooking, shopping or taking out the garbage.

“At 80,” he continues, “some of those things that you’ve taken for granted become potentially risky behaviors.”

The adult children of seniors often tell Personius they’ve been urging their parents to go outside and walk every day. That’s a good idea if it’s already in the senior’s daily regimen, Personius says, but he is pragmatic. “A person who was never an exerciser is not going to become an exerciser.”

More important, he says, is to keep moving.  “What can we do that’s reasonable?” he asks.

If the person is homebound, don’t encourage him or her to stay in an easy chair by serving dinner there. Encourage movement, even if it’s only from the bedroom to the living room to the bathroom and back, Personius says. “You want them to do more than what’s easy for them.”

He suggests that seniors have their eyesight checked annually, as poor vision can lead to falls.

Once exercise and health issues have been addressed, having a safe home is crucial to preventing falls. Gina Fox, with the Area 12 Agency on Aging, notes that slipping on ice or snow is a concern for seniors living in the five counties served by the agency: Alpine, Amador, Calaveras, Mariposa and Tuolumne. But, she says, “In most cases, it’s a fall in the home.”

Avoid that by doing a fall-prevention survey of your home, advises Christina Clem, an AARP spokeswoman in Sacramento. Then, take steps to reduce any hazards (see “Fall-proof your home,” below).

Despite taking all precautions, falls still can happen.

“If you feel like you’re going to fall,” Clem advises, “take quick steps.” And if you’re going down, try to “drop and roll.”

Once you’re down, physical therapist Migliaccio has advice on getting up.

“On your hands and knees, crawl to a sturdy chair. Put your strongest leg in a half-kneeling position” and slowly pull yourself up.

“Even if someone is there, do this,” she continues, pointing out that the would-be rescuer can be injured by hefting 100 percent of the senior’s weight.

What Dr. Personius has learned from his patients is that they want to stay as independent as possible. “You don’t want to go from here to a higher level of care,” he tells them.

“Most people agree with that.”



Fall-proof your home

Christina Clem, an AARP spokeswoman in Sacramento, offers these tips on fall-proofing your home:

  • In the bathroom, use a nonskid mat. The toilet and bathtub should have a grab bar that’s mounted horizontally, not vertically. Use a booster seat on the toilet and install a sturdy seat in the bath or shower.
  • Replace any torn carpeting and consider getting rid of throw rugs. If you decide to keep throw rugs, use double-sided tape to secure them to the floor. Do not use such a rug in an entryway.
  • Make sure there’s adequate lighting throughout the home, particularly on stairs and at the outside entrance.
  • If there are steps up to the home consider a nonskid ramp and railings. Have a bench near the entrance, to put things on or to rest on.
  • Use night-lights in the bathroom and other rooms that might be accessed in darkness.
  • Replace round doorknobs with lever handles that push down to open.
  • Use C- or D-shaped handles on drawers and cabinets rather than the harder-to-use round ones.
  • Walk through your home and clear clutter from entryways or high-traffic areas. Make sure coffee tables and furniture don’t impede movement.
  • No cords should snake across the floor. Keep them close to outlets.
  • Outside the home, check for and repair cracks or uneven spots on paths or walkways. Tree roots are a common culprit.

 © 2013 Friends and Neighbors Magazine



By Clare Noonan March 15, 2013 12:00
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