Falls

WEEKLY COMMUNICATOR (300 x 100 px) (200 × 100 px) (1)

FACTS

  • 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.

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