The 80-year-old man was by all measures relatively fit, maintaining a three-mile-a-day treadmill regimen. So no one was more surprised than he when he began falling, finally breaking his hip.
It puzzled Melissa Banta, doctor of physical therapy, too, when she began treating the aging athlete. “I discovered that the ankle opposite his repaired hip had poor strength,” something that can be addressed with an ankle brace, says Banta, who works at Sheltering Arms Physical Rehabilitation Hospital in Richmond, Virginia.
Leading cause of elder injury
Falls are the leading cause of injuries to older people in the United States, and the resulting broken bones often set off a downward spiral in health. But despite their frequent occurrence, falls are not an inevitable outcome of aging.
A fall can be a dramatic turning point for an older person. According to the Centers for Disease Control (CDC), up to 25% of people who lived independently before their hip fracture have to stay in a nursing home for at least one year. About 50% of the elderly who sustain a fall-related injury will be discharged to a nursing home rather than return home.
What you can do
Making sure the living environment is safe is only half the battle when it comes to fall prevention. Ensuring an older person is in the best possible physical condition goes a long way toward making sure falls never happen.
First things first: Get all physical systems checked. According to the American Academy of Orthopaedic Surgeons, there are lots of medical problems that lead to falls, including:
- Impaired musculoskeletal function, gait abnormality, osteoporosis
- Irregular heartbeat, blood pressure fluctuation
- Depression, Alzheimer’s disease and senility
- Arthritis, hip weakness or imbalance
- Neurological conditions such as stroke, Parkinson’s disease, multiple sclerosis
- Urinary and bladder dysfunction
- Vision or hearing loss
- Cancer that affects bones
A doctor should review all medicines – use of more than four is often associated with increased risk of falling, and out-of-date drugs, wrong dosages or side effects can all cause problems. Other potential causes include the need for oxygen, or having vertigo. Treatment can prevent many of these from turning into a fall. For example, with vertigo, “we can often treat that with physical therapy, doing maneuvers to reposition the inner ear,” Banta says. Good health also means maintaining a diet with adequate dietary calcium and vitamin D and avoiding smoking or excessive alcohol. Next, encourage your parent to exercise regularly. The CDC’s National Center for Injury Prevention and Control recommends engaging regularly (e.g., every other day for about 15 minutes each time) in exercise designed to increase muscle and bone strength, and to improve balance and flexibility. Many people enjoy low-impact activities such as walking and swimming. Lastly, it’s important to remember that how you move matters. Consider discussing the following fall-prevention techniques with your parent:
- Take your time getting up. Getting out of bed quickly can cause blood pressure to drop, triggering fainting and a fall. Before getting up, a person should sit up for a moment, and then stand up slowly.
- Push up, don’t pull. It’s best to push up from the seat surface, rather than grabbing a walker or other object positioned in front.
- Use a walker or rollator in the house, not just outside. Walkers can be outfitted with seats or hooks to transport things around the house. “If you use a walker there is more chance to catch yourself,” says Banta. “Get good training with the walker.”
- Reach smarter. “Don’t stand on a chair or table to reach something that’s too high — use a “reach stick” instead,— advises the National Institute on Aging. “Reach sticks are special grabbing tools that you can buy at many hardware or most medical supply stores.”
- Grab on. The Institute also recommends holding the handrails when using the stairs. “If you must carry something while you’re going up or down, hold it in one hand and use the handrail with the other.”
- Learn how to fall. “What hits first gets the most damage,” says Banta. An aging parent “should try to curl up and not put an arm out, or fall on the bottom instead of side. But often people who have fallen say they have no idea they were falling until it happened, so that can be difficult.” Home monitoring systems are useful to summon help should a fall occur.
Most falls do not result in serious injury, the CDC says. “However, there is often a psychological impact. Approximately 25% of community-dwelling people 75 or over unnecessarily restrict their activities because of fear of falling.” Preventing a parent from becoming one of these statistics means taking action before that first misstep.
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