Falls are the leading cause of fatal and non-fatal injuries for older Americans but falling is not an inevitable result of aging. This September 22 is National Falls Prevention Awareness Day and part of the solution in reducing the incidence of falls is educating consumers and professionals about the risks of falls and how to prevent falls.
I lost both parents as a result of falls. My father recovered from his hip fracture but it greatly hindered his mobility and not only landed him in a wheelchair but put him on a course of hospitalization, rehab, and long-term care placement. My father did not trip or stumble; he simply lost his balance while pivoting and toppled over. My mother’s case was similar in that she lost her balance while turning to reach for something. While living in a retirement home, she had a couple of falls but none resulting in anything more than bruises until the fall that broke her hip. She died within one day of marking the year anniversary of that fall.
My mother’s macular degeneration added another layer of risk to her falling. Balance was altered with this eye impairment. However, she did her best to hide her blindness and would conduct her life at times as though she had full sight, refusing to use her white cane in public. After her first fall I expressed concern that she might fall again without some added precautions. I suggested she meet with the physical therapist who ran a weekly exercise class designed with the mission to help elders prevent falls. She found it a bother and soon told the therapist to take her name off the list of participants. When I questioned her reasoning she confidently proclaimed, “I’ve already fallen and I know what to do and that won’t happen again.” The truth of the matter is that falling once doubles your chances of falling again.
After her first fall, she agreed to wear a lifeline. Although her room was equipped with call bells, when she fell she was not within reach and so was left lying on the floor for a few hours before managing to crawl to the cord of the call bell. However, she soon became annoyed with the cost of the lifeline and promptly decided to cancel it. Again, she felt it unlikely she would fall again. It was impossible to monitor my mother’s daily safety from 600 miles away. She lived mostly independently in the retirement village and had full cognition so her decisions were hers to make.
There were lots of things my mom did right about lowering her risk of falling. She always wore sensible shoes and took care of her feet. She experienced lightheadedness and as a precaution she would take time to remain seated before standing up. She was under the care of eye specialists despite the fact that she did not always want to acknowledge her loss of vision. Throw rugs had been removed, plenty of light added to her room, and a shower chair and grab bars were used. She took a daily calcium and vitamin D supplement as prescribed for treatment of her Osteoporosis and she was habitual at drinking plenty of water. When she went outside her room, she used her walker.
The biggest detriment to my mother was her unwillingness to participate in physical activity. She was safer in her mind by sitting and not moving too far from the familiar surroundings of her small room. She did not participate in the weekly exercise and balance classes that she had once joined in on. Her continued fear of falling limited her activities and social engagements which then resulted in further physical decline.
North Shore Elder Services’ Caregiver Specialists, Kathy Perrella and Pat McMahan, weighed in on the conditions that can contribute to falling and what steps we can possibly take to reduce the risks. “As we age, we see some risk factors for falls increase. Impaired eyesight, hearing, balance and gait can all contribute to someone falling. Chronic diseases that compromise cognitive and sensory functioning have a huge impact on fall risk along with certain medications.”
Kathy Perrella suggests that risk factors and preventive measures should be discussed with the older adult by their family members and caregivers as a safety awareness technique. “Most people think a fall is a fluke and don’t believe it will happen to them but a fall can change your life forever. Adult children and caregivers can help lessen risk factors by overseeing those areas where safety is questionable and may need to intervene for example, by getting rid of scatter rugs and making sure that clutter does not hinder walking.”
Pat McMahan recommends that “if you are concerned about safety issues in the home environment, check with the primary care physician who can order a home safety evaluation through the VNA.”
Kathy and Pat both emphasize that keeping active and moving is important to fall prevention. “You want to do anything you can to strengthen yourself. That is what is so valuable about fall prevention programs like Matter of Balance.” NSES is currently conducting Matter of Balance classes at the Salem Council on Aging on Tuesdays from 1:30pm – 3:30pm for an eight week period. To find out more about participating in these sessions, contact Cate O’Hara, NSES’ Community Resource Coordinator at 978-406-4590 or email@example.com. Check https://nselder.org/what-we-do/live-well-age-well/ for more information.
Another resource to take advantage of is the Council on Aging’s Kiosk for Living Well. There is a Move-Safe Counselor who visits the Kiosks monthly and is available to address falls prevention and safety issues. Check with your local Council on Aging office for the times of those visits.
There is a comprehensive safety checklist https://www.ncoa.org/resources/check-for-safety-a-home-fall-prevention-checklist-for-older-adults/ published by the National Center for Injury Prevention & Control and Centers for Disease Control & Prevention that would be a good reference tool to consult.
As caregivers, we can do our part in keeping our loved ones safe by examining risk factors for falls and putting simple measures in place to ensure a safer environment by which the incidence of falls can be decreased. Falls do not have to be inevitable.