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May 3, 2014

Do all you can to prevent falls for seniors

By Barbara J. Garcia
The Daily Star

---- — Falls are a common problem for older adults. Every year, one in three adults age 65 and older falls, but less than half of the adults who fall talk to their health-care providers about their falls.

Falls among this age group are the leading cause of injuries, some of which are fatal. 

In 2010, 2.3 million nonfatal fall injuries among older adults were treated in emergency departments and more than 662,000 of these were hospitalized. About 21,700 older adults died from unintentional fall injuries. The cost of fall care was $30 billion.

Twenty to thirty percent of people who fall suffer moderate to severe injuries such as lacerations, hip fractures or head traumas. Falls are the leading cause of traumatic brain injuries, and most fractures in that age group are related to falls.

Those injuries can result in a change in independence and may also increase the risk of early death. 

If people are uninjured in a fall, they may still develop a fear of falling. The fear may result in them limiting their activities, which then leads to a reduction in their mobility and loss of physical fitness, and in return can actually increase their risk of falling.

Our population consists of many aging adults, and it is important to understand the leading risks and to take the important measures to help keep everyone safe from falls. Most falls occur in the home and are preventable. So looking at ways for individuals to age in the comfort of their home, by adapting their living environment and improving, maintaining and preventing decline in function is important.

Environmental changes include simple home changes to improve safety:

• Make sure rooms, hallways and stairways are well-lit. Use brighter bulbs; add lighting, and night lights. 

• Remove clutter and tripping hazards, such as papers, boxes, shoes, clothes, etc.

• Arrange furniture arranged with clear pathways. Secure throw rugs with non-slip backing, or remove them. 

• Furniture (chairs, sofa and bed) should be appropriate height to make it easy to stand.

• Keep cords out of walkways.

• Handrails in stairways should be on both sides, and grab bars placed inside and outside tub/shower and next to toilet.

• Arrange clothes at a good height.

• Use non-skid mats or rugs, or textured floor strips, by tub/shower.

• Use a shower chair or bench.

• Don’t stand on chairs or boxes to reach a cabinets or shelves use a step stool with handrail to hold on to or use of a reaching device.

• Store food, dishes and cooking equipment a good height.

• Always immediately clean up spills.

Health-hip or bone weakness, osteoporosis, neurological conditions such as Parkinson’s, multiple Ssclerosis, and Alzheimer’s disease, and blood pressure changes make older adults more prone to falls

• Report falls to your health-care provider, as they may be a sign of a new medical problem.

• Have your vision tested at least once a year, or sooner if you think it has changed.

• Get an annual physical examination and have your blood pressure checked in the lying and standing positions.

• Walkers, canes and all medical equipment should be properly sized and fitted by a qualified medical professional.

• Reduce fractures by maintaining a diet with adequate amounts of vitamin D and calcium.

Many medications have side effects that can affect coordination and balance or cause confusion, dizziness or sleepiness.

• Ask your health-care provider or pharmacist to review all your medications, including both prescription and over-the-counter medicines, including herbals, vitamins and minerals.

• Always take any up-to-date medication list to health-care appointments, including over-the-counter medicines as well as those that have been prescribed. 

• Make sure medications are properly labeled and there instructions are clear.

• Take medications on schedule with full glass of water and avoid alcohol in excess.

Proper shoes and clothing are important, too.

• Wear properly-fitting, low-heeled, sturdy shoes with nonskid soles.

• Replace slippers if they are stretched out or too loose.

• Do not wear socks without shoes.

• Use a long-handed shoehorn if you have trouble putting on your shoes.

• If you’re a woman who can’t find wide enough shoes, try men’s shoes.

• Make sure clothing is properly fit including length to prevent clothing from catching or tripping on it. 

Older adults often fear exercise may lead to a fall, but regular physical activity is the first line of defense against both falls and fractures. Physical activity strengthens muscles and increases flexibility and balance.

• Mild weight-bearing exercises, such as walking, climbing stairs and water aerobics, may help slow bone loss from osteoporosis (having strong bones, especially in your lower body, can prevent fractures if you fall).

• Practicing tai chi helps with balance and control. It uses slow, flowing movements to help relax and coordinate the mind and body.

• Group and community exercise programs help increase flexibility, strength, balance and coordination. These kinds of exercises also can be done at home.

• Care providers can also refer older adults to physical therapists to help establish an exercise plan based on a limitation or disease process to help improve walking confidence.

Falls are a health problem that can be greatly decreased if we as a society are able to help our older adults adapt to the changes that accompany the aging process. By helping our aging population to adapt with these helpful tips, we will be helping to promote a healthier and more independent lifestyle.

Registered Nurse Barbara J. Garcia, BSN, is inpatient nurse manager and coordinator of Nurses Improving Care for Healthsystem Elders at Bassett Healthcare Network’s O’Connor Hospital in Delhi.