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Family Caregiver Blog

Down for the Count: Preventing Falls

By Sally Abrahms

I’m fit (well, maybe not as a fiddle). I exercise regularly and walk distances daily. And yet, I’ve had four bad falls in
a short period of time. There were 18 stitches in my head from tripping over a make-shift chicken wire fence with a puppy;
a black eye, stitches in my mouth and torn jaw muscles from falling on cement; a very public face plant at the airport
(in front of my son and his wife); and down once again on a raised walkway during rush hour.

A friend with Parkinson’s asks me if I have a good sense of smell. When I tell her I don’t—in fact, it’s bad--she urges me
to make an appointment with her neurologist. Frequent falling and a poor sense of smell can mean Parkinson’s, she says.

Fortunately, the specialist gives me a great diagnosis: rather than Parkinson’s, I am a klutz. Simply put, I am not looking
where I’m walking. She tells me to stop taking the muscle relaxants prescribed by the maxillofacial specialist treating
my jaw (from fall #2). It can make me dizzy and more susceptible to an accident.

The neurologist also advises me to work on improving my balance. Have I considered tai chi or yoga? And, for goodness sake,
focus, and watch where I am walking! Heed those uneven sidewalks and unexpected raised curbs in crosswalks.

I am relieved and motivated. I find a trainer to work with me on balancing exercises and find a tai chi instructor (a Chinese
master, no less). I have not had a fall since I started on my quit-falling campaign. Recently I hiked an unsteady mountain
and did not slip once.

But I understand how easy it is to fall, how it happens in seconds with little, if no, time to react. And I know the fear
of falling again. In fact, that feeling is still not gone.

We should be afraid; falling is the #1 cause of accidental injuries and deaths. More than one-third of people age 65+ fall
each year. What’s more, emergency departments treat fall-related injuries every 13 seconds!

While it’s an equal opportunity hazard—younger people fall, too—the chances increase with age.

Factors for falling

Why do you, your spouse or your parent fall so much? Here are some reasons:

  • Weak balance, poor mobility and motor skills, lack of flexibility and coordination. That’s why strengthening exercises
    and programs that target them are so effective.
  • Fear of falling. If you fall, and then are afraid to fall, you’re likely to get nervous and restrict your activity. That
    can lead to loss of endurance, mobility and muscle strength, making you more vulnerable to a fall.
  • Poor vision. When you’re older, less light gets to the retina so it’s harder to see potential tripping obstacles and
    contrasts of color.
  • House hazards. It may be slippery rugs, electric cords or objects piled up on the floor, poor lighting, lack of grab
    bars near the toilet and shower, inadequate stair handrails or storage that is too low or too high.
  • Medication. Both over the counter and prescription drugs can make you sleepy or dizzy. Wine or other liquor can also
    affect your balance, whether you feel downright tipsy or not.
  • Sleep deprivation
  • Dementia

Minimizing falls

First, ask your – or your parent’s - physician to do a risk evaluation and recommend next steps. (Have them look at Mom’s
medication to see if it could be causing fall hazards—mine did. Does she need her vision checked?

It could be as simple as swapping high-heeled shoes for sneakers, or at least low heels with rubber soles. The shoes need
to provide good support; luckily, there are lots out there that say “fashion” not “fall-proof”.

Increasingly, evidence-based
fall prevention programs nationwide are being offered to older adults. An excellent resource is The National Council
on Aging’s
National Falls Prevention Resource Center. Or, ask your local
Area Agency on Aging
for program and service recommendations.

There are also 10 clinical sites around the country working on a federally funded, five-year
study to find effective fall interventions for older adults. Some major medical centers have fall prevention clinics
to evaluate the risk and help mitigate it.

A physical therapist can help Dad boost his strength and improve balance and gait with targeted exercises. If he does fall,
he’s in a better position to catch himself. While you’re at it, have the therapist teach him how to properly pick up
an item from the floor. Or, would a cane or walker keep him steadier on his feet?

Don’t forget your house. The Centers for Disease Control offers a thorough home
safety checklist. You could also have a
certified aging in place specialist (CAPS) come to your house, evaluate it for safety, make recommendations, and,
if you choose, accommodations. CAPS is a designation developed by the National Association of Home Builders along with
AARP.

You don’t need a pro to tell you that stockings and socks are slippery and that shoes as well as slippers with rubber soles
are safer.

Falling is not a given if you’re older. But it is something that requires vigilance, attention and knowledge. Don’t fall
for anything less.