Falls

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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