Living Well "I knew immediately that we needed a plan."
That's what my assistant Laura recently told me after her grandfather had taken a bad fall.
Thankfully, he wasn't hurt. He's lucky.
But now they have to figure out how to handle another... potentially more devastating fall in the future...
Falls are the leading cause of fatal injuries in folks 65 and older. Twelve million older Americans fall every year. According to the Centers for Disease Control and Prevention (CDC), someone 65 and older dies from a fall every 20 minutes. That's more than 21,000 deaths a year. And emergency rooms see 2.5 million fall-related injuries each year.
In this issue, we're covering the top causes for falls and how to keep yourself and your loved ones safe.
What are the most common reasons for a fall?
The most common reason is simple... As we age, how we walk changes and our balance weakens, as do the muscles in our legs. Footwear can be dangerous as well. Wearing shoes that hurt your feet or are slippery (like leather-soled slippers) all put you at risk. Opt for comfortable, rubber-soled shoes.
Some medications also cause dizziness as a side effect or when mixed with other medications. As we mentioned in our issue on pill interactions, make sure to check all your pills and bring up any concerns with your doctor or pharmacist.
Drops in blood pressure also occur in older folks when they stand up. This drop, called postural hypotension, makes you feel light-headed and faint, leading to a fall. Standing up slowly, staying hydrated, and using compression socks keep your blood circulation normal and help prevent dizziness.
Eye problems, like cataracts or glaucoma, can affect depth perception. Not being able to clearly see objects on the stairs or extra steps can contribute to falls, too. Proper lighting and regular eye exams and treatment can help here.
I wrote about another reason in my issue about nanny-state legislature on salt regulation – hyponatremia. This condition is caused by abnormally low levels of salt in the blood – causing everything from muscle cramps to confusion and nausea. It can affect the nerves and walking. And it's one of the causes for falls in the elderly.
One study from the Journal of the American Geriatric Society reported about 50% of all nursing home residents had experienced at least one episode of hyponatremia. Worse, according to the American Society of Nephrology, people with hyponatremia are 61% more likely to fracture a bone when they fall.
If you take a diuretic, the most common first-line drug for lowering blood pressure, you could be at greater risk. These medications take salt out of your body and thus remove water along with the salt. Combining them with low-salt diets can reduce your salt level too much. If your parent is on a low-salt diet already and adds a diuretic, be sure to have them talk to their doctor about how to prevent hyponatremia. A simple blood test can help measure the level of salt in their system.
What should you and your family plan?
It's easy to get upset and worried if you or a loved one falls... Having a plan in place helps you think more clearly.
First, consider who can assist you or your loved one. Often we hear about couples where the husband falls and the wife can't help lift him. That's what happened to my research assistant Amanda when her grandfather fell. Luckily, she had family nearby who came over immediately to help.
But some folks don't have family nearby. Make a plan in case it happens – talk to your parent's neighbors or close friends and see if they are willing to be your emergency help. Or be prepared for the cost of an ambulance if no one is able to come.
And services like Life Alert that feature wearable devices allow you to call for help if you fall and can't move. If you are interested in wearable devices, make sure to go with a reputable company. Consumer Reports has a good review here.
Finally, you'll want to talk about preventive methods – including exercise, regular vision tests, and making the house safe.
Which exercises help prevent falls?
There are three exercises that help with muscle building and balance – weight lifting, yoga, and tai chi.
Numerous studies conclude strength training increases bone density and improves balance and strength. This leads to a reduction in falls and potential bone fractures.
However, there are dangers to consider when weightlifting. Weightlifting can cause bone fractures and muscle strains, and dropping the weights can cause serious injury. So start out with light weights and be careful. Or better still, work out with a partner or trainer who can help keep you safe.
Yoga and tai chi are low-impact ways to exercise. Several studies have highlighted the benefits of each in terms of improving balance and reducing falls in people over 65. Many senior centers and local gyms offer classes. And you can read my write-up on yoga right here to get started with some easy poses.
How can you make the home safe?
Some of the best ways to prepare the home are simple and affordable. Get rid of or properly secure throw rugs and remove any wires or cords that you can trip over. Make sure hallways and stairs are well-lit and that your parent wears proper non-slip footwear.
Adding handrails to the bathroom also helps, and you may want to consider special equipment such as chair lifts, stair lifts, and walk-in showers. Everyday Health lists nine of the biggest considerations for home modifications.
If you're considering special equipment or home modifications, then make sure you check...
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Does Medicare help at all?
Medicare covers very little when it comes to stair lifts, chair lifts, and bathroom safety essentials. They will only pay for items of "durable medical necessity" so you're probably going to have to pay out of pocket. There are some groups that may help though.
For instance, veterans and their spouses can get assistance with these expenses.
Also, 22 states offer additional assistance for seniors. They may have certain requirements like income limits or specific diseases (like Alzheimer's) but it's worth checking. Check out the list here.
How can I talk about falling?
Admitting to a fall might be embarrassing for some folks. But it's important to know about any falls, even if the person wasn't injured. Slips in the bathroom or a missed step getting the mail might seem harmless but could spell trouble in the future.
Involve your parents or loved ones in an open discussion about risks and prevention. Make a plan together to prepare for the future.
Falls claim the lives of more than 21,000 people a year. Doing what you can to prevent falls and making sure to plan for assistance if a fall happens can help put your mind – and your parent's mind – at ease.
What We're Reading...
- The National Council on Aging tackles the biggest myths about falls.
- Something different: A leak in the attic led one couple to a 400-year-old painting by this famous artist.