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Annual National Falls Prevention Checkup

Saturday was the first day of fall and it was lovely, sunny and warm, here. How about where you live?

Also, in the United States, it was the tenth annual National Falls Prevention Day, sponsored by the National Council on Aging (NCOA) – always a good time to review one's habits and home for falling safety.

I write about fall prevention so frequently that you must know the U.S. statistics related to people 65 and older by now. The two most important are:

  • An elder is treated for a fall in an emergency room every 13 seconds
  • In 2016, 29,668 people in that age group died as the result of a fall

If that doesn't get your attention, in May, the Los Angeles Times, working with data from the Centers for Disease Control, reported an alarming increase in death from falls among elders:

”...falls ended the lives of 61.6 out of every 100,000 senior citizens [in 2016]. Back in 2007, there were 47 fall-related deaths for every 100,000 senior citizens. That means the mortality rate due to falls increased by 31% over the course of a decade...”

The Times attributes the increase to growing numbers of people living longer, and Kaiser Health News reports that one's 80th birthday is a warning sign of increased susceptibility to falling:

”Fear of falling — and the emotional and physical blowback from a fall — are part of turning 80.

“If you are in your 80s and living at home, the chance that you might fall in a given year grows more likely, said Kritchevsky...The study notes that the risk increases with age, making people in their 80s even more vulnerable.”

So this is a good time to do a home and personal inventory to reduce the possibility of falling. The biggest change I made this year is to give up ladders. I'm just not as sure-footed getting up and down on them, so time to stop.

This video, even with its brevity, covers almost everything you need to know about preventing falls.

This infographic from the NCOA covers similar ground:

Ncoa-falls-free-infographic-680pixels-2

And this is a list of websites about most of the hazards and preventions we should check for and correct once a year:

National Institute on Aging

AARP – Preventing Falls in the Elderly

Mayo Clinic

WebMD

National Institute on Aging

Just this week, Apple announced the release of its Series 4 Apple Watch that includes a fall detection algorithm. (It is also a blood pressure and heart rate monitor). Here is a photo:

Apple-Watch-ECG-heart-handout-712

Reports MobiHealth News,

”Apple's addition of fall detection is likely to be overshadowed by the ECG news, but it's also an impressive achievement...

"When the Watch detects the fall, it will give the user an opportunity to call an emergency contact. But if it detects that the user is immobile for one minute after the fall, it will automatically reach out to authorities using Apple's emergency alert system. It also sends a message to emergency contacts in that situation.”

Of course I have no idea how well this works – just letting you know it exists, among many other kinds of wearable falls detection devices. You will find one comparison list here.

On the other hand, if you're thinking this is too much ado about only one kind of elder danger (it isn't, but go with me on this for a moment), there is always this solution to taking a fall:

Cantgetup

My apologies to the TGB reader who sent this cartoon – I forgot to make note of your name.



Comments

Good reminders, Ronni.

My TaiChi instructor drills doing squats as one of the most important exercises for balance and not falling. I also got rid of all throw rugs and consciously get out of the shower tub holding onto somethings attached to a wall.

I've seen friends' lives changed from one mistake. One didn't want to break the teacup she was carrying, so had a bad fall instead, from which she will never fully recover. Solve that by whenever carrying anything, except a baby or child, that whatever's in your hands will first get tossed if a problem occurs. Do this enough times mentally and it's in your mind and body parts to stay aware and away from questionable actions.

It goes without saying to wear suitable shoes whenever possible (when is it not?), use a walking stick, give the roller blades away.

And accept new limits. At 75, I recently realized that I can't run, though if in a panic, who knows. But on a secure foam track, it doesn't happen. Also cannot lift heavier home small appliances, etc., that are on shelf adjacent to the floor or needing a footstool. I can get TO them, but chancy to lifting them or myself securely.

And now I no longer find the "I can do this" motto of any use or pride without safety evaluations included.

Thank you Ronni, for this timely and comprehensive 'state of the art' reminder list. Good ideas from Simone, too !

Since breaking both bones in my right wrist in May 2016 I have been highly motivated to get serious about most of the ideas you included. Hyper-vigilant is likely closer to my truth, and the reward is no more falls so far. :-)

I would like to add one more idea. At 81 fatigue is a real issue in the afternoons when I'm in the kitchen alone coming up with a meal. Taking shortcuts like using a footstool to reach the top shelf is nearly automatic and I left the pickup tool somewhere???

I solved it by simply emptying all of the upper shelves totally, removing the temptation for a tired lady. Helps one pass on the rarely used items and gave the seldom used dishwasher a new sense of importance! A secondary gain was a lower electric bill, by the way.

From what I have been able to read online, the newest Apple watch would not have recognized either of the two worst falls I've had as falls, because they happened in slow-motion. One was my foot failing to lift high enough to clear a very low step in someone else's house, resulting in a loss of balance and a slow, semi-controlled collapse onto, unfortunately, some scattered toys. The other was a multi-tasking failure on a moving treadmill in our condo's exercise room, which slowly but inexorably dumped me off onto the floor.

Neither fall resulted in what a doctor would call serious injuries, but the bruises still took months to recover from each time, and each one delivered a permanent hit to my stamina.

My daughter uses an Apple Watch for business reasons, and she has been trying to convince me to get one, but from what I have been able to discover, in its current iteration it would not make me safer, and might even create new dangers.

I don't actually need one right now, so I think I will let other people discover the bugs first.

Ronni

Just of note....Your "CONTACT" link does not appear to be working, at least from my geriatric laptop. When I try the "submit" button. It tells me "This site cannot be reached".

Okay, another tech toy for elders.......but could it not be bad ju ju? Wearing a constant, tangible testament to the power of falling, heart failure, and oh, I dunno, other bad things that happen to elders. Whooo, maybe that's too negative for me. "An ounce of prevention..."
There are so many ounces, they add up to pounds and pounds. Hey, what about.......enjoy your body!?! What about, dance in any way you are able to your favorite music? SING!? Or oh, buy a new vibrator!? Maybe tomorrow I fall out in the field, lie there til I die, and my little loved animals starve to death. I've thought about that. But in the meantime, oh in the meantime........let me not spend more time trying to stave off sickness and death than in living.

When I rise up
let me rise up joyful
like a bird

When I fall
let me fall without regret
like a leaf

Wendell Berry

I'd read about the ECG feature in the new Apple watches, but not the fall detector. Not ready to buy one yet, but am certainly keeping an eye on them. They get better every year.

My oncologist's office has made me almost paranoid about falls. Every time I check in (only twice a year now) I'm asked "Have you been out of the country?" and "Have you fallen?" Almost as though they expect it in someone my age. Happy I can still tell them "No." They have made me very nervous about stepping in and out of my shower/tub. I keep dreaming of a luxurious walk-in shower in the same space, but I'm sure the cost would be prohibitive.

Enjoy Fall, everyone. In my book it's always been the very best time of year.

Thank you Salinda for the comment on living. Nobody teaches us how to get old, so we just all do the best we can and make up our own ways. I'm not going to take lessons from the techies who are selling us yet another product that takes my finite attention away from doing the next right thing with as much openness and zest as I can manage. At 78 I don't always feel like dancing, but I can manage to love something (a bird, a geiko, my cat, a flower, a friend ) everyday without checking my watch.

I'd like to second/reinforce this comment by Simone...

"I've seen friends' lives changed from one mistake. One didn't want to break the teacup she was carrying, so had a bad fall instead, from which she will never fully recover. Solve that by whenever carrying anything, except a baby or child, that whatever's in your hands will first get tossed if a problem occurs. Do this enough times mentally and it's in your mind and body parts to stay aware and away from questionable actions."

*******
Several years ago, I was living on the top floor of a three-story walk-up apartment in Vancouver. My sister lived in the same building. One day as I was leaving my suite to take my large and strong-willed Golden Retriever for a walk, I ran into the apartment manager chatting with my sister by the top of the stairs. I stopped to chat with them. I had the dog leash in my left hand and was poised with my back to the stairs while I chatted, ready to continue on my walk. Suddenly without warning, my Golden decided there had been enough chatting and in one leap, sailed down the entire flight of stairs, to the landing below. I sailed with him, backwards and airborne, down the whole flight of stairs, landing on my back with my head crashing into the wall. There was dead silence for a minute, while all of us tried to determine if I was still alive, heh. As it turned out, I was completely unhurt, except for a few bruises. But here's the thing: I was still hanging on to the leash...even after I'd landed.

When my sister and I discussed it later, my first and only thought was "Why on earth didn't I just let go of the leash and grab for the banister railing, which was on my left?" At the very least it would have slowed the fall somewhat.

But then I knew why I hadn't. Over the years of living with my dogs in the city, with heavy traffic, raccoons, skunks, coyotes and a thousand other dogs, I had drilled into my mind the instruction: "Whatever happens, never ever let go of that leash. If you do, your dog could be in danger".

So I didn't. Not even when the dog was in no danger, but I was :-)

I've now amended that mantra. And I have a new respect for the power of the subconscious mind to dictate our actions, even when we would prefer that it not do so.

Your timing is perfect. Ten days ago I fell at Vancouver BC airport while walking to catch the shuttle bus prior to my luxury cruise! I landed on my face on rough pavement. Spent 10 hours at ER Richmond Hospital; caught flight home to DFW next morning.

Upshot: 5 broken, crooked front teeth (not fixed, yet); jaw broken in 2 places (jaws are wired shut for next 4 weeks; cannot talk; eating liquids thru' a straw); metal plate in chin; badly cut lips; bruises all over. Surprisingly pain is not too bad. Have lost 9 pounds (I was only 118 lbs.)

Was enrolled and participating 3 times/week in balance/exercise class. Not taking any prescription meds. Wearing my glasses (they broke).

Yes, I had cruise insurance. Will get 100% refund eventually.
Going to have to re-learn not to fall.

Always a good reminder Ronni. I fall I took while I was still in my sixties permanently wrecked my back. When I stepped into my tub the rubber mat slipped and I twisted my back trying not to fall. The villian here was my less than attentive house keeping. I did't keep the bottom of the mat as clean as I should have and just enough hair conditioner stuck to the bottom to loosen it under pressure. I usually stick them to the wall to dry but I hadn't for awhile. Now I have a walk in shower with permanent treads in it and I've quit using conditioner, it makes everything slick.

Lots of good info and links to follow. If we fall, try to protect head from hitting surface (ground, floor, object) as can result in what’s called closed head trauma as can result in subtle but serious brain injury — could include bleeds, short term memory loss just for examples. I still chuckle at cartoon as was sent to me, too, by a friend who noted having days she felt like that.

Late to the party, as usual. Has anyone noted something weird about the video? It talks about making the home safer while at the same time, it shows a small dog which will likely trip its owner someday, but nothing is said about the dangers of animals and children to old people. I've heard several stories and witnessed a child/elder encounter which could have been very serious.

My husband has fallen several times and has survived with stitches and bruises. He's on oxygen with trailing hose that entangles and he has weak legs and bad balance. I've threatened to make him wear a helmet. Your comparison list of fall detectors is most timely and welcome.

I like the idea of the Apple Watch, too.

Move SLOW! Especially when out walking.

Important information, Ronni.

Thank you.

Thanks for the reminders. I can't see the apple watch without stopping to put on my reading glasses which, of course, makes it kind of useless.

Another REALLY USEFUL post Ronni thank you. Good mention is made of keeping our muscles working so we are strong in our legs too. A friend of mine in Australia says that with all the bungalows there they envy us in the UK our two storey houses, meaning we have a built in exercise machine, running up and downstairs all day.

That humans can stand, walk, run, dance, etc on two, sometimes skinny (like mine) legs is really amazing. All of this made possible by a transparent but elaborate muscle, bone and balance coordinated system. It is not surprising to me that this system begins to falter as we age. Yes, care, exercise and slow and steady becomes increasingly necessary as we age to avoid calamity or desintagration of this capability. Sometimes I am amazed when I stand effortlessly at 71--try lifting and supporting upright a 240 pound man! Dead weight is the term that may apply. Why else are so many pallbearers required. So, what to do? Follow this post's advice, weight control, exercise, keep moving and BE CAREFUL. I just moved into a second floor apartment which may add years to my ambulatory phase from walking up the stairs multiple times daily, until I get beyond the capability to do so--when it flips, time to move downstairs, then get a cane, then a walker, then a wheelchair, and finally bed rest only. I hope to be on the second floor for a long time, however.

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