Falls Prevention Awareness Week

September 22nd is the beginning of fall, but it's also the commencement of an event that's just as important: Fall Prevention Awareness Week! If you haven't experienced mobility issues, it might be easy to overlook how distressing the prospect of falling might be. For older adults, it's a major cause of injury and stress, one that has a significant impact on independence and quality of life. Many older adults may not be aware of the many fall prevention programs available to help reduce their risk of falling.

The Cost of Falls

• 25% of Americans 65 years and older fall each year.
• Every 11 seconds, an older adult is treated for a fall.
• Falls are the primary cause of fatal injury and nonfatal, trauma-related hospital visits among senior citizens.
• More than 3 million falls are treated annually by emergency departments, including over 850,000 hospitalizations and 29,000 deaths.
• The total cost of fall injuries was $50 billion in 2015, and is expected to rise to over $67 billion by 2020.

Perhaps the least acknowledged impact of falls is the diminished quality of life that they can cause even in those who haven't had a fall injury. Older adults, fearing the possibility of falling, may limit activities and social events. This can lead to depression, social isolation, and physical decline, and can actually be a factor increasing the chances of falling. Fall prevention programs often highlight this little-known concern and create coping strategies for older adults.

Dangers at Home

Home may feel like the safest place in the world, but reduced activity in older adults means they're more likely to be at home, which makes it the likeliest place to suffer a fall. Fortunately there are plenty of changes anyone can make to their home environment to make it safer and more supportive.

Safeguarding Your Home

• Clear a Path: Make sure stairs, halls, and floors are free of clutter by regularly clearing them and increasing storage space for loose items.
• Ensure Even Surfaces: Remove or secure rugs with a rug gripper. Be aware of uneven spaces like thresholds or gaps between flooring materials.
• Light a Path: Install light switches at both ends of stairways and ensure that light bulbs are bright. Utilize nightlights and glowing light switches. Visibly mark dangerous or uneven areas.
• Store Items for Ease: Make sure frequently-used items are stored in easy-to-reach places that don't require bending.
• Bolster Your Bathroom: Install grab bars in the shower and near the toilet, as well as safety rails or frames on the toilet. Non-skid strips and mats in the tub help prevent slips, and shower chairs or benches make bathing easier. Raised toilet seats make sitting and standing easier.
• Secure Your Stairs: Install handrails on both sides of the staircase. Make sure all handrails and rugs are securely fastened.
• Reinforce Your Home: Any room can be made safer. Wedges, rails, and mats can prevent bedside falls. Handles can be attached to any wall and even cars. Alarms on beds and wheelchairs can inform caregivers or rescue services of an unassisted fall.

Medication

Many older adults take medications for chronic health conditions, but sometimes these can have side effects that increase the risk of falling. Unfortunately, many of these medications are for conditions that may affect older adults: heart conditions, blood pressure, dementia, arthritis, bladder control, blood clots, and even colds, flus, and allergies.

Some side effects to watch out for:

• Balance impairment
• Blurred vision
• Dizziness and lightheadness
• Drop in blood pressure
• Drowsiness, loss of concentration

 Always be aware of the side effects of your prescriptions, and tell your doctor if you're experiencing any adverse effects from a medication.

Pets

We all love our pets, but having animals around can be a hazard -- about 86,000 fall injuries a year involve dogs and cats. Our pets love us, but aren't aware when they might create a danger of falling. Here are some tips to make home safe for your pets and yourself:

• Keep pet toys, and food and water bowls, out of paths and walkways. Clean up spills immediately.
• Get a collar bell for smaller animals that might not be easily spotted underfoot.
• Consider obedience training for larger dogs that may enthusiastically jump on you or guests, or startle people by barking or running nearby.

Dangers Outdoors

It's impossible to fully safeguard the world outside of your home from falling hazards. In public, remember three important factors to your safety: visibility, sturdiness, and situation.

Visibility:

• Walk at times and in places with a high level of visibility. If walking in the evening or night, stay in areas that are well-lit.
• Wear proper eyewear in order to spot hazards and sunglasses to reduce glare.
• Have your eyes examined regularly for changes in vision and proper prescription.

Sturdiness:

• Sidewalk and road conditions may lead to all sorts of hazards. Watch for holes, cracks, and changes in level!
• Trees might have fallen leaves or branches that can obstruct a pathway, or even roots that can push up sidewalks.
• Use handrails when climbing outdoor stairs.
• Parking lots and garages often have curbs, speed bumps, and changes in elevation.
• Use handrails and bars while riding on public transportation.
• Stay in well-maintained places such as school tracks when walking for exercise.
• Wear sturdy shoes that are appropriate for your activity and the current weather.

Situation:

• Be aware of nearby traffic, especially in parking areas. Sudden movements in reaction to drivers can easily prompt a fall.
• Foot traffic as well as recreational vehicles like bicycles and skateboards can present a hazard. Be careful in public places where these are common.
• Inclement weather conditions like rain, snow, and ice can inhibit visibly and make walking surfaces slippery.
• Take your time! Rushing yourself increases the chances of losing balance.

Choosing the Right Assistive Device

Assistive devices can help support someone who feels unsteady while walking. They include single point canes, quad canes (which have four feet at the base), and walkers. With so many options, and with every adult's living situation and physical condition being different, it's important to speak with a doctor, occupational therapist, or physical therapist about the right device for you. An assistive device should be specific to an individual's needs and a comfortable size for them.

Benefits of an Assistive Device:

• Increased support
• Reduced pain
• Increased balance and safety when walking
• Increased confidence about mobility
• Increased independence

Fall Management and Prevention Programs

Whether an older adult is in need of an assistive device or not, they can benefit from evidence-based falls prevention programs designed to improve balance, strengthen muscles, and address fear of falling. Programs approved by the National Council on Aging, such as A Matter of Balance, address and reduce falling through multiple approaches, including:

• Group-based and individual coping methods to address fear of falling.
• Self-assessments to determine personal falling risk.
• Realistic plans for increasing activity.
• Plans to change home environments to reduce hazards.
• Exercising to increase muscle strength and balance.

Programs such as these can be group-oriented or individual, with some specialized programs centered on visiting infirm adults at home. Some programs focus on those who have previously suffered falls or who have physical ailments such as arthritis and joint pain that may increase the odds of falling. Group-oriented programs are often participatory in nature in order to encourage socialization as a response to the isolating effects induced by a fear of falling. Exercise programs may include elements such as cardiovascular workouts, stretching, strength training, and tai chi.

If you're an older adult, regardless of your level of mobility or physical condition, you should speak to your doctor about assessing your risk of falls. And if you're nervous about the potential for falling, don't be afraid to seek support! Whether it's from friends, family, or medical professionals, discussing your fear of falling and making a plan for prevention will help ensure you stay healthy, active, and independent.