By Robin Seaton Jefferson | forbes.com
Spring forward. Fall back. It’s an amusing little mnemonic relating to Daylight Saving Time, indicating that clocks are moved forward an hour in spring and back an hour in autumn. But there’s nothing funny about falling at any age.
Many people think falls are a normal part of aging. They’re not. And there are more than a few people and organizations who have set out to debunk this common myth and educate individuals of all ages about how serious falls can be and how to avoid them.
Now in its 10th year, “National Falls Prevention Awareness Day” (FPAD) is a nation-wide effort by the National Council On Aging (NCOA) and countless others to bring attention to this growing public health issue and how to prevent fall-related injuries among older adults.
Every year on the first day of fall, they celebrate FPAD to bring attention to this growing public health issue. Today is that day.
The National Council on Aging will host a Facebook Live broadcast at 3 p.m. ET Friday. In addition to the misconception that falling is a normal part of aging, the council offers a list of 10 myths about falls and how to address them.
Forty-eight states and the District of Columbia now participate with NCOA in FPAD. And for good reason.
According to the National Centers for Disease Control and Prevention (CDC), each year, millions of older people fall. In fact, one in three Americans aged 65 and over falls each year, but less than half report it to their doctors. And statistics show that falling once doubles your chances of falling again.
In addition, an older adult is treated in the emergency room for a fall every 11 seconds. And every 19 minutes an older adult dies from a fall. According to the CDC, falls are the leading cause of fatal injury and the most common cause of nonfatal trauma-related hospital admissions among older adults.
The CDC reports:
- In 2014, the total cost of fall injuries was $31 billion.
- The financial toll for older adult falls is expected to increase as the population ages and may reach $67.7 billion by 2020.
- One in five falls causes a serious injury such as broken bones or a head injury.
- Falls are the most common cause of traumatic brain injuries (TBI).
In other words, falls are serious and costly. But serious injuries aren’t the only concern. What may seem like a minor injury can cause older adults not only a tremendous amount of pain, but inhibit their movement and thus their freedom.
For instance, falls can cause broken wrists, arms, ankles and hips. And many people who fall, even if they’re not injured, become afraid of falling. And a vicious circle ensues. The CDC reports that this “fear may cause a person to cut down on their everyday activities. When a person is less active, they become weaker and this increases their chances of falling.”
People fall for many reasons. The CDC reports research has identified many of risk factors. The good news is many of these risk factors can be changed or modified to help prevent falls, including:
- Lower body weakness.
- Vitamin D deficiency.
- Walking and balance difficulties.
- Medications such as tranquilizers, sedatives or antidepressants can affect balance, including some over-the-counter medicines.
- Vision problems.
- Foot pain or poor footwear.
- Home hazards such as broken or uneven steps and throw rugs or clutter.
A big part of Chris Seman’s business is reducing clutter. As president of Caring Transitions, a relocation, liquidation and estate sales company, Seman’s said not only is clutter a fall hazard, but it can actually affect a person’s quality of life. A study completed by UCLA’s Center of Everyday Lives and Families (CELF), indicated that clutter is directly linked to stress hormones and may affect quality of life, he said. “Other studies and publications have found correlations between clutter and overeating, sleeplessness, and financial problems,” he said.
Seman said many people believe that the safest place to be is at home, “however, 55 % of fall injuries among older adults occur within the home.”
Seman has some insights on the dangers of clutter and how decluttering can help to prevent falls:
- Place excess blankets and throw pillows in a basket in the corner as they can easily fall on the floor and become a trip hazard.
- Remove all newspapers and magazines, especially from hallways and staircases. Keep them in a container or recycle them.
- The kitchen, laundry room, and bathroom are typically the most cluttered rooms. Go through belongings and either donate/sell unused items or put them in cabinets and baskets.
- Organize and store clothing, dishes, food and other often-used items within easy reach.
- Secure loose rugs with tape or slip-resistant backing or remove them from the home.
Semans said Caring Transitions offers help with organizing clutter to reduce hazards but also with clearing it by selling or donating items. He said the process can be overwhelming for older adults and their families “as the average American home has more than 300,000 items.” He said his company helps older adults with a plan that begins with deciding what they need or want to keep, and then strategizing about how to get rid of everything else.
The household goods liquidation resource also helps families evaluate the value and volume of the possessions they hope to sell or discard before settling on a solution of what to do with them and provides information on estate sales, online auctions, private sales to the company’s network of collectors, or a combination of donations, cleanouts and buy outs.
Anytime Fitness Certified Personal Training Director Josh Cox said a consistent exercise program can ward off falls. He offered some tips on how older adults can implement exercise programs to improve balance and prevent falls.
“The world is a crazy place and accidents happen and all that, but that doesn’t mean you can’t upgrade your preventative measures to ensure you stay upright at all times,” Cox said. “Advanced age can bring with it a cornucopia of issues that most have never had to deal with prior to qualifying for an AARP membership.”
Cox said mild dehydration, too much sitting or lying down for prolonged periods of time and then standing, heart issues, thyroid issues and overeating can all contribute to a drop in blood pressure. To combat the issue, he recommends drinking plenty of water, avoiding overeating and walking as frequently as possible to keep your blood flow optimal and your heart health strong.
Lack of exercise and neurological issues and sensory problems such as numbness in the feet can cause balance problems that can lead to falls. Cox recommends building and sticking to a consistent exercise routine to help with balance issues as well as sensory problems.
Muscle weakness can result from lack of exercise, variance in movement and functional motion. Cox suggests spending as much time outside as possible to offer your body varied distances and surfaces and mimicing real life movements such as going from sitting to standing until your tired.
According to Kathleen Pace Murphy, PhD, of the University of Texas Health Science Center at Houston (UTHealth) and the Consortium on Aging, reducing falls and fall-associated deaths and serious injuries is one of the major goals of Healthy People 2020.
As part of the Geriatrics Guide on the university’s website, Murphy has compiled a fact sheet about falls.
She lists falls as the leading cause of death due to injury in the older adult and the most important risk factor for falling as a history of falls. According to Murphy, exercise is the best way to prevent falls with increasing core and leg strength and improving balance as musts for fall prevention.
Murphy stresses that doctors and patients should pay attention to overlapping medications, regular eye exams to assess diminishing vision including cataracts, whether the senior is getting adequate nutrition including calcium and vitamin D, osteoporosis screenings, physical therapy consults to assess gait and balance dysfunction and interprofessional team home visits to conduct home safety evaluations.
“Falls often go unrecognized by health care professionals because they are not routinely evaluated while taking a patient’s history or during a physical exam” unless there is an obvious injury, Murphy states. She recommends these histories be taken whenever an older adult is admitted to any facility, transferred from one unit to another within the facility, following any change of health status and at every outpatient primary care visit.
“Many patients do not admit to falling for fear of losing their independence,” she states. And yet it is critical they do so in order to prevent them in the future.
Murphy lists two broad categories of risk for falls, including intrinsic and extrinsic risk factors.
Intrinsic risk factors include:
- history of falls
- medical conditions
- impaired mobility and gait
- sedentary behavior
- psychological status
- nutritional deficiencies
- impaired cognition
- visual impairments
- foot problems.
However, she cautions that many older adults have multiple conditions that increase their fall risk including neurological, cardiovascular, metabolic, urinary, musculoskeletal and psychological disorders. And medications that treat these conditions may produce side effects that further impair their physical or psychological status and make them even more prone to falling.
Extrinsic risk factors for falls include environmental hazards such as:
- uneven surfaces
- poor lighting
- unstable or inappropriately placed furnishings
- inappropriate assistive devices
- ill- fitting clothing and footwear
“Health care providers should always ask patients, aged 65 and older if they have fallen recently or have a history of falling,” Murphy states.
Murphy encourages patients and families to suggest a simple mnemonic to their doctors for obtaining a complete functional histories on themselves or their loved ones. It’s called CATASTROPHE:
C Caregiver and housing
A Alcohol (including withdrawal)
T Treatment (i.e. medications)
A Affect (depression or lack of initiative)
S Syncope (any episodes of fainting)
T Teetering (dizziness)
R Recent illness
O Ocular problems
P Pain with mobility
H Hearing (necessary to avoid hazards)
E Environmental hazards
For more information on all the best tips for preventing falls, visit ncoa.org.