Falls are the leading cause of injury and injury death in the United States for the elderly.
One out of four older adults fall each year.
Preventing falls reduces hospitalizations and subsequent medical complications.
CAUSES OF FALLS
Decline in physical fitness
Muscle mass and strength decline 30-50% between the ages of 30 and 80.
Rate of decline after the age of 50 is approximately 12-14% per decade.
Medications
Benzodiazapines
Sedatives
Antipsychotics
Narcotic analgesics
Sedating antihistamines
Muscle relaxants
Drugs that lower blood sugar or blood pressure
Chronic diseases
Impaired vision
Stroke
Chronic kidney disease
Diabetes
Orthostatic hypotension
Surgery
Orthopedic procedures
Environmental hazards
Area rugs
Electrical cords
Behavioral hazards
Irritability
Impulsiveness
UNIQUE CAUSES OF FALLS
Frontal gait apraxia with Alzheimer’s Disease, Frontotemporal Dementia or Normal Pressure Hydrocephalus
Slow short strides
Feet barely clear the ground when stepping
Arms do not swing naturally when walking
Difficulty walking in a straight line
Falling backward
Strokes
Weakness and loss of balance
Parkinson’s
Flexed forward at the hips
Shuffling of feet
Short strides
Arm tremor may increase when walking
Classically fall backward
Peripheral neuropathy
Numbness in the feet which can progress to the ankles, shins, and knees
Uncoordinated gait
Unstable posture or feeling of imbalance
May hear a foot slap when walking
May develop foot deformities
Spinal stenosis
A narrowed spinal canal squeezes nerves to the legs
Weakness in legs
Poor balance
Wide-based gait
Vertigo
A sense of spinning or movement in the head
Poor balance
FALLS PREVENTION
Complete a home safety checklist.
Read the website document Home Safety Assessment Checklist for more information.
Simplify the home setting by removing excess furnishings.
Adjust position of furnishings to keep walkways clear.
Provide adequate lighting especially at night.
Remove area rugs. If area rugs are needed, choose ones with non-skid padding.
Determine if handrails on stairways are present and secure and install or replace as needed.
Ensure chairs have armrests to assist with standing from a seated position.
Consider installing grab bars in the shower and near the sink and commode.
Place brightly colored tape on stair edges.
Place a gate across the top of the stairs if balance and judgement are problematic.
Position electrical items so that the cord does not pass through a walking area. Consider tacking cords to baseboards.
Pets are a tripping hazard. Contain pets at night. Have a pet wear a collar with bells to know where the pet is in the home.
Clean up spills when they happen.
Wear flat, thin soled, fabric topped shoes.
Do not drop a person off at a curb side if there is a risk of falls. Park the car, assist the person out of the car, and walk beside to reduce the chance of falling.
Ask the provider about a handicap parking placard.
Get regular check-ups to evaluate eyesight, hearing, orthopedic limitations, and blood pressure when sitting and standing.
Participate in exercises to preserve and improve strength.
Avoid medications that increase the risk of falling.
Avoid alcohol which can impair balance and alertness.
Consider a fall alert system with GPS technology.
Physical therapy may be ordered for help with improving gait and balance.
Assistive devices such as a stick, cane or walker may be necessary.
