We’ve probably all seen the commercial for Life Alert. An elderly woman has fallen, no phone is nearby, and she can’t get up to call for help. Isn’t that everyone’s worst nightmare for their parents or grandparents?
People of any age can fall accidentally. But when patients tell me that walking feels as though they’re balancing on a fallen log, they can’t feel their feet, or they have to touch or hold on to the wall or furniture, it’s time to put some preventative measures in place.
But first, let’s look at what puts someone at risk for falling.
According to the Centers for Disease Control (CDC) many problems can lead to increased fall risk for those over 65.
- Problems with balance
- Use of medications that can cause dizziness such as tranquilizers, sedatives, or anti-depressants.
- Problems with vision
- Foot pain or improper footwear
- Lower body weakness
- Vitamin D deficiency
People with diabetes particularly those with peripheral neuropathy have additional fall risks including:
- Decreased or no sensation in the feet
- Impaired sweat and oil production which can place abnormal pressure on the bones and joints when walking
- Muscle weakness
- Painful foot problems such as bunions or hammertoe can cause pain that makes walking difficult.
While 25% of older adults fall each year, 39% of adults with diabetes do.
But are falls really that problematic?
Falls are the leading cause of both fatal and non-fatal injuries for those 65 and older. One out of 3 adults over 65 falls each year and every 15 seconds an older adult is treated in an emergency room for a fall. Unfortunately, as we age the chance of falling increases the older we get.
Falls can be particularly bad for older adults with osteoporosis or severe bone loss . Patients at risk for falling who also have osteoporosis are much more likely to fracture a hip and end up in a nursing home. Women ages 65-69 are 5 times more likely to die within a year if they break a hip than those that don't.
How to Prevent Falls
Fortunately falls can be prevented. Because I've heard so many devastating stories about seniors who have fallen, assessing all my patients over 65 for potential fall risk has become an essential part of my podiatry practice. Those found to be at risk receive a “complete fall assessment”, which looks at 12 parameters to better understand and reduce fall risk.
If determined to be beneficial, patients are cast for a Moore Balance Brace. Referral to a physical therapist specializing in balance disorders may also be made.
Other recommendations patients receive to prevent falls include:
Making home safer – many adjustments can be made to the home to prevent falls.
Minor home repair - Sound Generations offers minor home repair for eligible senior including placement of grab bars and handrails.
Exercise classes to improve strength and balance.
Physical therapy exercises (check out the video at the top of the page).
Chair yoga - Two Dog Yoga and other studios around Seattle offer yoga classes to seniors
Tai chi - tai chi has been shown to improve balance. Check out Embrace the Moon's classes in Seattle.
A word about preventing osteoporosis and fractures from a fall
As mentioned above people with osteoporosis are at particular risk for injury when they fall. Women are at greater risk than men for developing osteoporosis. Bones begin to thin as people age but for women this thinning process accelerates during menopause due to lack of estrogen. Thin women, women who are Caucasian and Asian, or are predisposed due to heredity also place women at higher risk for this condition. To prevent osteoporosis and potential injury from a fall women over 50 need to:
- Have a bone mineral density test to determine if your bones are thinning.
- Engage in weight bearing exercises - exercises such as walking, climbing stairs, running, or dancing will help build bone. Weight lifting adds even more weight to your body. You can start with 5 pound free weights and build up from there. Make sure you talk to your doctor before starting any new exercise program.
- Supplementing with vitamin D and calcium - getting enough vitamin D and calcium are essential for preventing osteoporosis. You'll need to use supplements to get enough vitamin D, particularly in an area like Seattle where there is little sun.
- A healthy diet containing lots of leafy greens, fish with bones, milk, and other foods are probably enough to provide the calcium you need.