Preventing falls can save lives
Dear Doctor: Would you please write about the risks of falls for the elderly?
Dear Reader: Thank you for bringing up a very important topic. Even before the coronavirus pandemic caused enforced isolation, falling had become the leading cause of injury-related death in people aged 65 years and older. About 3 million older adults wind up in an emergency room each year due to a fall. Even people who are lucky enough to get just a sprain or a bruise after falling can experience a marked decrease in their quality of life.
A common risk factor for falling is poor balance. This can be due to difficulty in walking, weakness in the lower body, foot pain, ill-fitting shoes, problems with vision and dizziness brought on by medications. Common hazards found inside the home include clutter, loose floor coverings, wobbly chairs or tables, extension cords, stairs, dim lighting, toilet seats that are too low, and slippery tubs or showers. Outside the house, sidewalk cracks, steep driveways and wet or icy pathways are all common trip hazards. Pets can also contribute to falling, both indoors and out.
Start with an inventory of potential hazards. Be honest about whether your balance is at all compromised. Signs of this include difficulty in rising from a chair or the need to steady yourself against a piece of furniture or a wall when walking from one place to another. If balance is an issue, it's important to ask your health-care provider about using a cane or a walker for added stability. When physical weakness is part of the problem, your health-care provider can suggest strengthening exercises that are tailored to your specific needs and abilities. Keep up with vision appointments, and always wear your glasses. And be aware of the potential side effects of any medications. Sleep aids, pain meds with “P.M.” in the name and some prescription medications can cause dizziness.
Analyze each room in the house, and identify potential dangers. As we mentioned before, area rugs and throw rugs are a common trip hazard. Stairs should have secure handrails on both sides. The stairs themselves should be free of clutter and have slip-proof surfaces. Make sure all parts of your home, inside and out, have adequate lighting. Install grab bars in tubs and showers and near the toilet if needed. A shower chair, along with a hand-held shower head, are also helpful. People who live alone may consider medical alert buttons or a fall-detection device.
Excellent information is available from the National Institutes of Health, at nih.gov. Enter the words "prevent falls" into the search box at the top right.
Eve Glazier, M.D., MBA, is an internist and associate professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and assistant professor of medicine at UCLA Health.