Mayor's Tip of the Week

Ten Tips for Preventing Falls
By: Paul G. Vidal, DPT
Owner, Specialized Physical Therapy, LLC

Background
 In the United States, more than 1 third of adults 65 years of age and older will fall each year. Most falls occur in the home. As an individual gets older they are more likely to fall because of age-related physical changes and medical conditions. People 75 and older who fall 4 to 5 times are more likely to be admitted to a long-term care facility. According to the Centers for Disease Control (CDC), falls are the leading cause of injury deaths in older adults1. In fact, falls are the most common cause of nonfatal injuries and hospital admissions for trauma. Most fractures, including hip fractures, are caused by falls. In 2000, the total direct cost of all fall injuries for people 65 and older exceeded $19 billion1. Total costs are expected to reach $55 billion by 20201. According to healthcare professionals, preventing falls and maintaining older adults as valuable members of their communities is becoming a national priority3.

Risk Factors Associated with Falling
What makes a person at risk for falling? Risks for falling can be separated into 3 categories: 1) intrinsic risks, 2) extrinsic risks, 3) environmental risks3. Intrinsic risks relate to the individual, such as their medical history. Patients with acute illnesses, neurological conditions, or other medical problems can be at risk for falling. Extrinsic factors are those that are imposed upon the individual. The effect of multiple medications (i.e.: poly pharmacy) is the most common example. Taking 4 or more prescription medications is associated with an increased falls risk. Environmental risks include factors such as stairs without railings, poor lighting in a room, or loose rugs. A person’s risk for falling increases when multiple factors are present.

How to Prevent Falls and Fall-Related Injury
  1. Make an appointment with your doctor. Tell your doctor any problems you may be having with your balance or any other symptoms that have been bothering you. Many conditions can cause problems with balance. Your doctor can examine you to determine the cause of these symptoms or refer you to a specialist for further examination. You can review all the prescription and over-the-counter medications you take.
  2. Keep physically active. Activities such as walking, water exercise, or tai chi can be part of your fall-prevention program. Maintaining and improving strength, balance, coordination, and flexibility are essential for proper balance. Always consult with your doctor first before beginning any exercise routine. Many times, your doctor will refer you to a physical therapist to perform a comprehensive physical examination and to guide you through an exercise program based on your specific needs. A physical therapist can help determine if you need an assistive device like a cane or walker to help prevent you from falling.
  1. Make sure to have good lighting in your home. Good lighting will help you avoid tripping over objects that are difficult to see. Put night lights in your bedroom, bathroom, hallways, and stairs. This is helpful for when you need to get up in the middle of the night.
  2. When you get up from bed, sit on the edge of the bed for a few minutes to make sure you are not dizzy.
  3. In your bathroom put handrails for bath, shower, and toilet use and place nonskid mats in your bathtub or shower.
  4. Have rails on both sides of your stairs for support.
  5. Remove clutter from walkways. This includes boxes, newspapers, electrical cords, and phone cords.
  6. Make sure rugs are firmly fastened to the floor or have a nonskid backing.
  7. In the kitchen, make sure items are within reach. Don’t store items too high or too low. In this manner, you will not have to use a stepladder or stool to reach for things or have to bend down too far.
  8. Wear shoes with firm nonskid soles. Avoid wearing loose-fitting slippers that may cause you to trip.

References
  1. Centers for Disease Control and Prevention: Falls Among Older Adults: An Overview. Available at: www.cdc.gov/HomeandRecreationalSafety/Falls/adultfalls.html. Accessed: August 8, 2009.
  2. Fall Prevention: 6 Ways to Reduce Your Falling Risk. Available at: www.mayoclinic.com/health/fall-prevention. Accessed: August 8, 2009.
  3. Brewer K, Ciolek C, Delaune M, et al. Fall In Community Dwelling Older Adults: Introduction to the Problem. PT Magazine. 2007; 15(7): 38-46.
  4. American Academy of Orthopaedic Surgeons: Reduce Your Risk of Falling. Available at: www.orthoinfo.aaos.org. Accessed: August 8, 2009
This article was written courtesy of Dr. Paul G. Vidal, DPT, owner, Specialized Physical Therapy, LLC, located in Cherry Hill, NJ. For more information, please call 856-424-0993 or visit the Specialized Physical Therapy website.