LeadingAge November/December issue. Article
“My doctor has told me that if I fall and break a hip, I could die, and many people do,” says McDonald, a 77-year-old resident of Youngsville, North Carolina.
Each year, one of three adults aged 65 and older in the United States will suffer a fall, and 20 percent of those will be seriously injured, according to the Centers for Disease Control and Prevention.
Falls account for more than 95 percent of hip fractures, and those who fall once are two to three times more likely to fall again, the CDC says.
About 27,000, Americans over the age of 65 die each year from falls, says Kathleen Cameron, director of the National Falls Prevention Resource Center.
“That’s one every 19 minutes,” Cameron says. “It’s a major health problem.”
With an aging population and increases in chronic conditions such as diabetes and arthritis, injuries and death from falling will likely increase, Cameron says.
But it doesn’t have to be that way. Older Americans are fighting back as new programs spring up nationally to prevent falls.
McDonald is part of that movement.
Although she is in good health, McDonald is starting to notice the effects of age on her balance.
“Some mornings when I get out of bed, I find that I am not as steady as other mornings,” she says.
She started taking twice-weekly Tai Chi classes at a community senior center. An ancient martial art, Tai Chi is slow and focuses on balance, says McDonald, who practices at her home between classes.
“It makes you more aware of the steps you take and how you take them,” McDonald says. “You move forward and backwards and you are on one foot often, you are turning on one foot often.”
There is one Tai Chi move that is like a pivot, which helps McDonald maneuver in her kitchen.
“I’m in a small area, going from the stove to the sink, and I pivot,” she says.
Tai Chi is one of many strategies older Americans can deploy to prevent falls, Cameron says.
She advises anyone who has fallen or is worried about falling to first consult their doctor for advice.
Medical conditions that cause falling such as vertigo and low blood pressure are often treatable, Cameron says.
Medications that affect the brain, such as those to increase sleep or reduce anxiety, depression and pain, can have side effects such as dizziness that increase the risk of falling, she adds.
“It’s really important to have medications reviewed,” Cameron says. “Many older adults are seeing multiple doctors. And sometimes, no one is coordinating to make sure there’s not duplication of therapy. The pharmacist can also help with that.”
Annual vision and hearing checks are always a good idea. Foot problems and improper shoes can also lead to falls as can Vitamin D deficiencies.
There are a variety of simple exercises that can be done daily to improve balance that don’t require joining a class or even leaving the house.
“When you’re brushing your teeth, stand on one leg, and then switch legs half-way through,” Cameron says.
Simple changes to the home, including removing clutter, scatter rugs, tucking away loose cords and changing burned-out light bulbs can greatly reduce falling, experts say. Mats and grab bars in the bathtub can also help. Broken steps and lack of handrails can be dangerous, too.
And then there is the issue of what to do if you fall.
Judson Park Retirement Community in Des Moines, Wash., developed a program called “Get Up” that teaches residents how to safely stand up after falling. One technique is to literally move on your hands and knees to the nearest piece of furniture or other solid object, which you grasp and then pull yourself up.
That is exactly what Joan Ekern, a Judson Park resident, did when she fell while stepping off an elevator shortly after completing the class.
A growing body of research reveals how the fear of falling can compound the risk of falling, by causing older adults to limit their physical activity.
“It’s always in the back of your mind,” says McDonald, the North Carolina Tai Chi enthusiast. “We were in downtown Raleigh last year for some shows, and I noticed that the sidewalks were not in the best of shape. I notice tree roots when I am in my garden every day. It makes you think.”
Many of the fall-prevention workshops held across the United States are increasing their focus on reducing the fear of falling. A Wisconsin program, “Stepping On,” aims to make older residents confident to leave their homes by educating them on fall prevention.
A Maine program called “A Matter of Balance” includes eight two-hour sessions in which participants exercise, learn to view falls as “controllable” and how to make their homes safer, and set goals for increasing their physical activity.
While confining activity due to the fear of falling can be harmful to a person’s health, the opposite is true for those who make the effort to reduce their risk of falling. In addition to improving her balance, Tai Chi has also helped improve McDonald’s arthritis, she says.
“It’s very comfortable and it’s fun,” McDonald says.
Even learning the moves of Tai Chi helps keep her memory sharp, McDonald adds.
Some fall-prevention programs are proving to be enormously effective.
The Otago Exercise Program, developed in New Zealand in the late 1990s, is often supervised by a physical therapist in the home, and uses 17 strength and balance exercises and has been shown to reduce falls between 35 and 40 percent.
“Unfortunately, many older adults still feel that falling is just a part of growing old,” Cameron says. “It doesn’t have to be. We’re trying to educate older adults that we know what the risk factors are for falls and we can intervene and reduce those risk factors.
Cameron’s advice is simple: “Go out and fight it. Take control.”