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Dangers of Falling and Fall Prevention



Danger of Falling and Fall Prevention - Health Hazards Safety Checklist - Prevent accidents and falling at home - Avoid Nursing Home Placement

The death rate from falling has risen about 55 percent for people 65 and older in the United States since the 1990s, federal health officials said Thursday, speculating that it is because people are living longer with chronic conditions like cancer and heart disease.

“Since people are not dying as much from chronic diseases, they’re more likely to die from a fall,” said Judy Stevens, an epidemiologist with the Centers for Disease Control and Prevention here and the lead author of the study reported Thursday in the centers’ Morbidity and Mortality Weekly Report.

Falling is the 14th leading cause of death among those older than 65. The research gives federal data on the deaths from falls since 1996.

The National Osteoporosis Foundation reports that there are approximately 35,700 deaths each year from complications from hip fractures. Surprisingly, 24 percent of all people suffering from a hip fracture die within a year of the fall. Another 50 percent never return to their prior level of mobility or independence.

Both Katherine Graham and David Brinkley died due to complications from broken hips. The diet doctor Robert Atkins took a spill on a patch of ice a couple of winters ago in front of his office and died from brain injury.

Consider the following facts:

  • Falls are the most common cause of injury visits to the emergency room for young children and older adults.

  • Falls are responsible for more open wounds, fractures, and brain injuries than any other cause of injury.

  • In the United States, one out of every three adults over age 65 falls each year, and falls are the leading cause of injury deaths among persons in this age group. Because most persons also lose bone density as they age, the risk of suffering broken bones from fall-induced injuries becomes an even greater concern.

Most of the older people who require hospitalization were discharged from the hospital to some other institution following hip replacement surgery for physical therapy and continuation of care.

Often the psychological consequences of falling can be more severe than the physical trauma itself:

  • Loss of Confidence – Fear of Falling

  • Social Isolation

  • Depression

  • Dependency

  • Confusion

  • Institutionalization – Nursing Home Placement.

Women and those living alone fall most often. Of falls occurring at home, 85% occur during the day. Most falls occur indoors, usually in the living room or bedroom, and on the stairs. One tends to think of the kitchen and bathroom as particularly hazardous, but it is the main living areas that are most risky. Outdoors, most falls occur on the sidewalk or on the front or back step of the patient's own home.

Falls in older people may be caused by any acute or chronic illness that causes general weakness. A fall may be considered as a possible sign of an impending major illness. Illnesses, such as heart attacks, strokes and mini-strokes, pneumonia, or gastrointestinal hemorrhage may present as falls during the early phase of the illness.

Falls are associated with depression and with dementia because of misperception of the environment. "Accident-prone" persons, the impatient, intolerant, or irritable type, are predisposed to all kinds of accidents. The tired, anxious, and hurrying person may fall because of inattention. The mental status and mood of fallers, especially recurrent fallers, needs to be assessed. A change of environment increases the accident rate as do major life crises such as bereavement or retirement.

Drugs and alcohol contribute to falls. Many prescription drugs and even over the counter drugs will cause mental confusion or a tranquilizing effect or blur vision and thus predispose to falling. Many medicines used to treat diseases can cause problems with balance and dizziness. Check with your doctor or pharmacist if you feel that any of your medications are making you unsteady or dizzy.

Taking four or more medications regularly can increase your risk of falling, you may need more than four to keep you in good health, but it is important to have medications checked regularly by a doctor or pharmacist.

Alcohol can dull your senses, affect the quality of your sleep, alter your balance and impair your judgement, all of which might increase your risk of falling. Use alcohol in moderation and avoid mixing alcohol with medications.

A poor diet, without sufficient vitamins and minerals can affect energy levels, muscle strength and bone health. A healthy and varied diet can do much to prevent problems.
Ensure that your diet contains ample calcium and vitamin D to reduce the risk of bone fracture. Taking supplements is a good idea.

Vitamin D deficiency is nearly universal in cases of hip fractures, researchers in Scotland reported online in Current Medical Research and Opinion.

A review of 548 patients older than 60 years of age who were admitted at South Glasgow University Hospital in the previous 4 years, showed that 97.8 percent of the patients had vitamin D levels below normal.

In 25 percent of the cases, levels were so low as to be described as "effectively unrecordable" by the researchers. There were no significant differences in patient age, sex or season of presentation.

Dr. Stephen Gallacher, lead researcher and consultant endocrinologist at the hospital said: " vitamin D inadequacy represents a significant correctable risk factor for fragility fracture and perhaps specifically for the hip."

Doctors, he added in a statement, "should do all they can to encourage their patients with osteoporosis to adhere to their vitamin D supplementation."

Older men and women with vitamin D deficiency are more likely to fall multiple times in the course of a year than their peers with adequate vitamin D levels, according to Dutch researchers.

Osteoporosis/pathological fractures, osteoporosis or bone metastases may cause a pathological fracture that causes the patient to fall, reversing the expected cause and effect.

Hypothyroidism and Parkinson’s Disease are associated with falling. A joint (knee, elbow, hip, ankle) that locks or gives way may cause a fall. Sometimes an undiagnosed leg/hip fracture, or a painful joint caused by a chronic infection or degenerative joint disease may cause instability and falls.

Slipping and Tripping


At least half the falls in and about the home can be avoided by using caution and common sense.

Checklist:

  • Do a safety check around your home.
    * Poor lighting in areas such as stairways and kitchens can increase the risk of falling. Try to use 100-watt light bulbs here. Always remember to turn the light on at night if you are walking around the house or going to the toilet. Changing burnt out bulbs can be very risky. Try to get someone else to change them. The use of low energy bulbs can also help because they do not need to be changed so often.


  • Get rid of clutter, rugs or electrical cords that might trip you. Have someone install sturdy handrails on all stairways and grab bars in bathrooms. Buy a shower chair if there is enough room in your shower or tub. Consider a raised toilet seat if your toilet is too low.

  • Cover stairs with lightly woven carpet or nonskid treads. Do not wax floors and always clean up spills as soon as they happen. Avoid climbing and reaching up to high shelves. Use a step stool with handrails.

  • Take an exercise class that will increase your strength and improve your balance.

Researchers at Emory University found that the Chinese martial art of Tai Chi improved balance in older people after just a few weeks and cut the risk of falling nearly in half. Contact your community center, city hall, or YMCA to find out about the availability of Tai Chi classes.

  • Sensible Shoes Only! Platform shoes, high heels, unstructured, or ill-fitting shoes can lead to falling. An unsupported foot will not provide the solid foundation needed to prevent a fall. If you have a foot problem, you may need to see a podiatrist several times a year. Some podiatrists make home visits.


  • Always wear anti-slip soled shoes. Many leather-soled shoes may not provide needed traction on certain floor surfaces (i.e. tile). Don't wear socks or hosiery, as these do not provide floor-foot traction. Consider wearing slippers with non-slip soles.

  • Outdoors walking tip - if the sidewalk is slippery, try walking on the grass. Kitty litter or salt sprinkled on a slippery icy or wet sidewalk may help to provide foot traction.


  • Install several cordless phones around your home and/or carry a cell phone on your person during waking hours.




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