Elder Technology Experts
INTERESTING STUFF: 22 September 2012

National Falls Prevention Day

category_bug_journal2.gif Here's a nice little pun for you: tomorrow, 22 September which is the first day of fall, has been declared by U.S. Senate Resolution 553 to be National Falls Prevention Awareness Day.

That's not really news. The Senate votes the Resolution every year but even though it's routine, it is a good annual reminder to be sure we have done all we can to prevent falling. Here is why this is so important to us personally and collectively:

One-third of all Americans age 65 and older fall each year.

More than 95 percent of hip fractures are caused by falls.

Men are more likely than women to die from a fall. After taking age into account, the fall death rate in 2009 was 34% higher for men than for women.

HUMAN COST
In 2010, 2.3 million nonfatal fall injuries among older adults were treated in emergency departments and more than 662,000 of these patients were hospitalized.

Falls are the leading cause of injury deaths among elders.

In 2009, about 20,400 older adults died from unintentional fall injuries.

In 2007, there were 281,000 hospital admissions for hip fractures among people age 65 and older. Twenty percent of hip fracture patients die within a year of their injury.

COST IN DOLLARS AND CENTS
In a study of people age 72 and older, the average health care cost of a fall injury totaled $19,440, which included hospital, nursing home, emergency room and home health care but not doctors’ services.

In 2010, the direct medical costs of falls, adjusted for inflation, was $30.0 billion.

Most falls can be prevented but we need to make some adjustments to our lives to keep ourselves and others safe. Here is a good general list:

  1. Exercise. It makes you stronger and improves balance.

  2. Get up slowly after you have been sitting or lying down which can sometimes make you dizzy.

  3. Have your vision checked every year. If you can't see well, you have a higher risk of falling.

  4. Ask your physician or pharmacist about the drugs you use – prescription and over-the-counter. Some can cause sleepiness and dizziness that can lead to falling.

  5. Do a safety assessment of your home.

There is a long list of measures you can take to help fall-proof your home. Among them:

Increase the lighting; no dark areas or corners

Two secure railings on all stairways

Grab bars in the tub, shower and next to the toilet

Always wear shoes with non-skid soles – even indoors

Remove all throw rugs

Immediately wipe up all spills

Install nightlights to lead you to the bathroom

Use non-skid mats in the shower and on the bathroom floor

Remove clutter from floors to prevent tripping

That list is nowhere near complete. There is a thorough section on fall prevention at the Centers for Disease Control (CDC) and here is the home page of their excellent section of elders and falls.

The National Council on Aging (NCOA) also has a good section of falls prevention.

If you think you might be at risk for falling and particularly if you live alone, don't be shy (or stupid) about subscribing to a medical alert service. There are many of them and they are becoming more sophisticated and useful all the time. Just Google “medical alert services” for a large list of links.

One important caveat: not all such services are as reliable as you would want. Before you choose one, use the internet to find reviews and recommendations from other users.

If you think I'm making too much of this (I post a similar story here at least once a year), scroll up to the top and read those statistics again.

At our ages, a couple of seconds of inattention or lack of preventive measures can lead to a fall that would leave us crippled and dependent or even kill us. Common-sense precautions can save our lives.


There is no story at The Elder Storytelling Place today. New ones will resume on Monday

Comments

I'm curious: lately I've been taking Claritin which seems to be everyone's over-the-counter anti-inflammatory anti-allergy medicine. It's not supposed to have any side effects, but I feel as if it undermines my balance. I breath better, but I wake up wobbly. Nothing serious, but enough to feel it. This is new to me.

I don't like being wobbly! Anyone else?

Thank you. The reminder about taking up small rugs is especially important here. Wobbly, Yes, but I'd rather breathe.

Hi Jan...
Many drugs can cause balance problems and especially, combinations of drugs - prescription and OTC.

Plus, I cannot remember where, but just yesterday I read somewhere that sometimes when drugs make the transition from prescription to OTC - like Claritin - side effects don't always make the trip and may be not listed on the box.

You should ask your physician about balance and wooziness and be sure to tell him/her what drugs (OTC too) you use.

Of course, I'm not saying that's the reason, but it happens often enough that drugs and drug combinations should be discussed with your physician.

One of the interesting things about getting older is noticing the little changes and frailties as they arrive and saying, "Ah, THAT's why granny did that."

I have been surprised by the fact that I do NOT feel sure-footed any more. When I walk, it always feels like the possibility of slipping is high. I never thought about slipping when I was young.

I can testify to the importance of your information, Ronni. Falling is not fun and can be a life changing (or ending) event.

Another one
who is not as sure footed
as in the past.
I try to be really careful.
Several falls in the last year and only bruises. A bad one with all I have to do in this country cottage will finish me.
Told the children that at 80
I will get the thing to hang around my neck. A few more years...

Jan, I take Claritin and sometimes Allegra and both make me a little sleepy for a time. I drink more coffee than I should to compensate. Like Mage, I can't breath w/o them.

Thanks Ronni,I have fallen twice this year, no broken bones but soft tissue damage that is slow and painful to heal. The last time was getting into the shower and a bathmat that had failed to stick. I've become very careful and I carry my cell phone in my pocket always, even just in the house. If nothing else so I won't trip over my feet trying to get to the phone. :-)

Just a note to the outrageousness of costs of falls and medical billings, my father fell in 2009 and broke his hip while in a full care nursing home. For that one day, Medicare and his supplement were billed in excess of $75,000 for the hospital, tests, and all the doctors and specialists that were consulted. I was still getting Medicare notices of payments for that one day made over a year after his death from the fall. He received no actual treatment for the broken hip until the next day when I arrived from out of state. Sure he was 89 and had health issues, but really?

Several things I've noticed in my own home: I have to be careful around the bed where the corners of the bedspread touch the floor and can cause tripping.

Also, pets. I have a dog and a cat, and although I'm careful, we do occasionally get in each other's way and a trip is possible. I'm also careful to keep their many toys picked up off the floor.

PiedType is absolutely correct about bedding that reaches the floor.

A few months ago while making the bed, I tripped over a bedskirt that was too long by only and inch or so and fell.

Fortunately, nothing was broken and not even a bruise. Nevertheless: End.of.bedskirt.

I've always been a bit of a klutz and still am, but the couple of minor stumbles I've had so far have been just that--minor. I don't worry much about falling yet, but that could change 5 years from now when I'm 80. We still have throw rugs, but they're either secured or have non-skid backing. Our two cats are pretty good about staying out of our way. My husband is almost 83, and he's more aware of balance issues than I am. Still, I don't take unnecessary chances anymore. I take Claritin or Zyrtec (generic version) and haven't noticed any of the side effects mentioned.

I think awareness is a good thing, but if (reasonably healthy) elders worry about falling to the extent that we're afraid to do anything, that may not be such a good thing. . .

BTW, is anyone besides me sick and tired of the CDC's ads that seem to be on TV every 5 minutes about "gynecological cancers"? We've heard it--enough already!

I'm glad someone mentioned pets -- our cats do get underfoot, especially at feeding time and I've learned to just scoot my feet at those times so as not to trip over them.

My worst fall was on the step from our back door to our deck. We have a hand-hold there, but I wasn't using it and just when I stepped up onto the step a huge spider spun down right in front of my face! I stepped backward in reaction -- into just space! I HATE SPIDERS! My husband helped me up and all I got was a small bruise, but I was sore for a week.

I watch friends who look only at the ground when they walk, and I know that's only making any balance problems worse. I do some balance exercises a couple times a week and avoid watching my feet when I walk. I'm a klutz and fall about once a month, so I'm guessing I'll have to start carrying a hammer so I can beat myself to death before the medical interventions start and make everything worse.

LOL! I meant should I fall and seriously injure myself.

I don't really relish beating myself to death unless I'm faced with a long hospital/nursing home stay. Under those circumstances it would be equivalent.

Someone else to check with about OTC meds is the pharmacist. Good topic, Ronni with solid info. Thanks. Dee

Excellent advice Ronni. Apparently I've entered the falling stage of life and hate it. Around the house and outside, I wear a flat little cotton bag across my shoulder and chest which holds a small high power flashlight and my cell phone. Began this after falling from a step stool and smashing the back of my head to the tune of 30 stitches and staples in the ER. The ambulance ride was $2,000 and the ER, $9800. Luckily Anthem sliced the ER bill down to $980. But still. Does anyone have a site with balance exercises that don't strain the knees? I'd love to know about it.

A couple of years ago I started standing on one leg while I clean my teeth. A few very wobbly seconds at first with my foot a couple of inches off the floor but now I I can now stay on the same leg in a half lotus position for the whole flossing, brushing, tongue cleaning and mouth-washing process, which takes over five minutes and involves a fair bit of arm movement. I'm 'only' 60, but I do think it's amazing what a body that age can learn to do. And I'm a big fan of taking a gentle approach to all aspects of health and well-being; a couple of minutes a day doesn't sound much but it can make a huge difference over time to how you feel and, in this case, how much less likely you are to fall.

Cats! You have to really watch out for your cats who seem to enjoy trying to trip you up.

I took a tumble earlier this week when I missed the bottom step of going down to the front row of a theatre. You might say I made a memorable entrance. I have only minor bruises so I called it a "tumble" and not a fall. I am usually especially careful on steps an especially in dimly lighted places. Usually I hold a rail even if I think I don't need it. In that case there was no rail and my mind was on the person I was meeting more than the step. Awareness is always important.

Excellent suggestions. Also consider, if anyone is falling, feeling insecure, I would suggest they report this to their doctor with an inquiry about the appropriateness of being given an order (prescription) for Physical Therapy. P.T. at my local hospital inpatient and outpatient settings has special equipment for balance training. P.T. would be able to devise a program specifically for each individual's needs based on that person's functional level, then adapt it so the person can continue independently at home once their hospital therapy has ended.

Another reason for making physician aware of any falls is so can be assessed as to whether or not there's an association with slight stroke.

I am aware of several possible causes for balance issues as Janinsanfran described, other than due to medications, including: eustachian tube may not be functioning as should due to several possible reasons. Allergy/sinus with infection, swelling, other can cause -- a problem I had which was misdiagnosed for years as migraine due to additional symptoms that developed when this simple problem was not figured out. Also, if infection is an issue, initially it may be viral, maybe later becoming bacterial -- or not.

For some people, there can be problems associated with those three little bones in the middle ear, but this all takes further diagnosis, too, likely through referral to Otolaryngologist who may also refer to Audiologist.

Family member wanted me to get a medical alert system after my husband died, but I declined -- especially once I had a cell phone. I kept our land line which we had to have for my husband's pacemaker, so I have several portable phones, also. So, I have either the cell or portable phone with me wherever I am in the house or yard -- sometimes carry car key which has a security button for car alarm I can set off if need be.

Climbing on a ladder for me has been discontinued above a certain height when I started to feel uncomfortable doing so last year to replace burned out kitchen ceiling light bulbs. I'm saving up little odd jobs and will eventually have a handyman or someone come in to take care of them.

I also have flashlights of various types,(always take one if I visit somewhere overnight) easily accessible in all rooms with a couple small handhelds if I get up at night, along with automatic nightlights.

A very active 50 to 60 yr old acquaintance (not one of my patients) prided herself in doing all her inside and outside work. She fell backwards off a ladder when she was climbing up to roof eaves, bumped the back of her head on the ground and ended up with closed head trauma (no external cuts, breaks, or bleeding.) But, her brain had bounced around inside her skull damaging a frontal lobe area that caused her to cease to use appropriate judgment for her own safety, her actions were impulsive (acted before thinking, would also speak inappropriately,) other cognitive problems -- she ultimately was educated to recognize she had these problems and tried to self-correct sometimes, but was no longer safe to live alone. So, there are other reasons we do not want to fall, besides not wanting to break bones.

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