Every year, over two million Americans suffer serious injuries from falls, resulting in costs exceeding $3 billion. Falls and injuries are one of the biggest health concerns of the elderly. As our senior population continues to grow, the prevalence of falls and their associated consequences is expected to increase.
Causes
To stop injuries before they happen, early attempts must focus on younger age groups, since many problems related to falls start to show up in early and middle age. Many changes in muscles, bones, and the central nervous system are not necessary as people get older. Lifestyles that are not active, such as smoking, eating poorly, and not exercising, cause these changes.
Eating less cholesterol and saturated fats and exercising regularly can help slow down the gene-induced stiffening of the arteries. Not only does regular exercise tone muscles, but it also improves the heart and lungs, which could make this problem a lot less severe. If artery stiffness runs in your family, some medicines can help lower your cholesterol. Early detection and treatment of diabetes mellitus and high blood pressure may slow the development of atherosclerosis. Quitting smoking might also help lower the risk of this problem.
Many medications used to treat high blood pressure, heart disease, allergies, sleepiness, stomach acidity, and depression have side effects that alter brain function and increase the risk of falls. In this era of specialization, patients may receive medications from multiple doctors, potentially leading to cumulative negative effects on their brain and sensory function. Keep a list of all medications and dosages and give it to every doctor.
Eye diseases, including glaucoma and cataracts, reduce visual sensory function and are a typical problem in old age. Knee, hip, and back injuries frequently do not heal fully, resulting in some range of motion limitations. Long-term, severe effects of arthritis are irreversible. Osteoporosis causes bone weakness and raises the risk of serious damage from a fall, or it can produce a spontaneous fracture that leads to a fall. Muscle strength decreases with age. Joint tendons and ligaments decrease flexibility, limiting movement. The combined ravages of bone and joint injury, arthritis, and inactivity can result in a body that cannot carry out motion commands initiated by the brain.
Prevention
- Have your vision and hearing checked regularly. If your vision and hearing are impaired, you may lose important cues that help you maintain your balance.
- Get up slowly. A momentary drop in blood pressure, due to drugs or aging, can cause dizziness if you stand up too quickly.
- Maintain balance and footing. If you sometimes feel dizzy, use a cane or walker to help keep your balance on uneven ground or slippery surfaces. Wear sturdy, low-heeled shoes with wide, nonslip soles.
- Exercise regularly. Regular exercise improves your strength, muscle tone, and coordination. This cannot only help prevent falls, it can also reduce the severity of injury if you do fall. Walking is a good form of exercise.
- Remove raised doorway thresholds in all rooms. Rearrange furniture, if necessary, to keep electrical cords and furniture out of walking paths. Fasten area carpets to the floor with tape or tacks, and don’t use throw rugs.
- Don’t use difficulty to reach shelves. Never stand on a chair. Use nonskid floor wax and wipe up spills immediately.
- Be sure stairways are well-lighted and have sturdy handrails. If you have a vision problem, apply brightly colored tape to the first and last steps.
- Install grab handles and nonskid mats inside and just outside your shower and tub, and near the toilet. Shower chairs and bath benches minimize the risk of falling.
- Put a light switch by the bedroom door and by your bed so you don’t have to walk across the room to turn on a light. Nightlights in your bedrooms, halls, and bathrooms are a good idea.
Rehabilitation:
What about patients who have already fallen? Although rehabilitation is not perfected, much can be done. The first tank is a thorough and complete evaluation of the patient’s sensory, CNS, and muscle/joint function.
- A careful evaluation of the balance function should be performed. This includes a search for causes of dizziness, such as inner ear diseases that cause imbalance; an evaluation of the inner ear balance system which might be adversely affected by certain drugs (such as a class of antibiotics known as aminoglycocides) trauma; and the aging process.
- Tests of higher mental function are important since falling may be a sign of serious mental deterioration.
- A careful review of all medications (both prescription and over-the-counter) used by the patient is very important. If the patient needs medication for anxiety or depression, switching from a long-acting drug to one that is more quickly passed from the body seems to decrease the risk of falling.
