As a healthcare provider, I am aware that falls are a serious threat to the health and
well-being of my older patients. More than one out of four people 65 and older fall each year,
and over 3 million are treated in emergency departments annually for fall injuries. More than
95% of hip fractures are caused by older adult falls. Falls are preventable. The fall prevention
course that I attended in California, presented by the La Jolla Eldercare Planning Council, was
very informative.
Who is at risk for a fall? People who have fallen once are likely to fall again. People who have
been advised to use a cane or walker may be more likely to fall. Unsteadiness, grabbing onto
furniture or needing support while walking are signs of poor balance; making a fall likely. Those
worried about falling are more likely to fall. Trouble standing from the seated position and
negotiating a curb indicate that leg muscles are weak which is a major reason for falls. Also,
rushing to the bathroom, especially at night along with incontinence increase one’s chance of
falling. Those with numbness in their feet and those who are light headed are also at risk for a
fall.
So, how can a caregiver prevent their patient or family member from falling?
-Talk openly with your loved one and their healthcare provider about fall risks and prevention.
-Tell a healthcare provider right away if your loved one has fallen, or if they are worried about
falling, or seem unsteady or confused. Poor judgment can lead to falls as well.
-Keep an updated list of your loved one’s medications. Show a healthcare provider or
pharmacist all of their medications, including over-the-counter medications, and supplements.
Discuss any side effects, like feeling dizzy or sleepy.
-Ask their healthcare provider about taking vitamin D supplements to improve bone, muscle,
and nerve health.
-Keep the patient moving. Activities that improve balance and strengthen legs (like Tai Chi) can
prevent falls. Speak to the patient’s doctor about starting a formal PT program.
-Have eyes and feet checked. Being able to see and walk comfortably can prevent falls.
-Replace eyeglasses and shoes as needed.
-Make the home safe. Most falls (80%) happen in the bathroom. Be sure to make use of shower
chairs, benches, and raised toilet seats. The Bathtub edge can be carved out to make getting
into the shower easier. Add grab bars in the bathroom—next to and inside the shower, and next
to the toilet.
-To make the bedroom safer, be sure there is a night light in the hallways between the bedroom
and bathroom. Use of lifts, ceiling to floor poles, bedside commodes, bed rails and electric beds
(that move up and down) can improve safety.
-Keep floors clutter-free.
-Remove small throw rugs, or use double-sided tape to keep the rugs from slipping.
-Have handrails and lights installed on all staircases.
-Make sure the home has lots of light. Be certain pets are not getting in the way when the
patient is walking.
-Insure the patient is eating/drinking sufficiently to maintain blood sugar levels and muscle
development.
As a physical therapist and nutritional counselor, the course reinforced the importance of doing
balance testing and gait analysis during my evaluations to determine which muscles are weak
so that they can strengthened during the PT treatments. Monitoring blood pressure to identify
orthostatic hypotension ( excessive lowering of blood pressure), and a home safety evaluation
are important as well. Asking patients about their diet and assessing their mentation can
identify fall risk factors as well.