How to prevent falls and maintain your health and independence

Posted on: 01/27/2016

January 25, 2016 1:30 pm • Dr. Herb Kunkle | Special to The Citizen

Each year, one out of every three Americans over age 65 falls, the leading cause of injury to seniors in the United States. This is compounded in the elderly by osteoporosis, where the structure of the bone weakens, causing increased risk for fragility fractures. In the winter, with icy conditions, these falls become more prevalent. Most commonly, these include fractures of the hip, wrist, spine, shoulder and ankle. In 2000, falls among older adults cost the U.S. health care system more than $19 billion, according to the CDC. That equals more than $30 billion in 2015 dollars. Three quarters of hip fractures occur in women.

The statistics of hip fractures are sobering. An elderly person who fractures their hip has a 20-25 percent chance of fracturing the contralateral hip in the next 18 months. Similarly, a humerus (shoulder) fracture in the same person carries a 15-20 percent chance of a hip fracture in the next 18 months. Additionally, while 25 percent of hip fracture patients will make a full recovery, 40 percent will require a nursing home admission, 50 percent will be dependent on as cane or walker, and a hip fracture in the elderly with comorbid medical problems carries a 20-25 percent mortality in the next year. While these statistics give all cause to worry, they also offer opportunities for patient and family education, and prevention. Fortunately, there are many things seniors can do to prevent falls in order to maintain their health and independence.

Understanding risk factors and preventing fractures is critical for senior home safety. A few common-sense precautions can make homes safe and extend senior’s health, functionality and independence.

Medical risk factors include:

• Impaired musculoskeletal function, gait abnormality and osteoporosis

• Cardiac arrhythmias (irregular heartbeat), blood pressure fluctuation

• Depression, Alzheimer's disease and senility

• Arthritis, hip weakness and imbalance

• Neurologic conditions, stroke, Parkinson's disease, multiple sclerosis

• Urinary and bladder dysfunction

• Vision or hearing loss

• Cancer that affects the bones

• Side effects of medications

Personal risk factors include:

• Age. The risk for a fall increases with age. Normal aging affects our eyesight, balance, strength and ability to quickly react to our environments.

• Activity. Lack of exercise leads to decreased balance, coordination and bone and muscle strength.

• Habits. Excessive alcohol intake and smoking decrease bone strength. Alcohol use can also cause unsteadiness and slow reaction times.

• Diet. A poor diet and not getting enough water will deplete strength and energy, and can make it hard to move and do everyday activities.

Risk factors in the home:

• Many falls are the result of hazards like slippery or wet surfaces, poor lighting, inadequate footwear, and cluttered pathways in the home.

• Most fractures are the result of a fall in the home, usually related to everyday activities such as walking on stairs, going to the bathroom, or working in the kitchen.

Home modifications to prevent falls

Research shows that even simple safety modifications, such as those at home where most senior falls occur, can substantially cut the risk of falls and related injuries.

Bedroom

• Place a lamp, telephone, or flashlight near your bed.

• Sleep on a bed that is easy to get into and out of.

• Arrange clothes in your closet so that they are easy to reach.

• Install a nightlight along the route between your bedroom and the bathroom.

• Keep clutter off the bedroom floor.

Living Areas

• Arrange furniture so you have a clear pathway between rooms.

• Keep low-rise coffee tables, magazine racks, footrests, and plants out of the path of traffic.

• Install easy-access light switches at room entrances so you will not have to walk into a dark room in order to turn on the light. Glow-in-the-dark switches also may be helpful.

• Remove newspapers and all clutter from pathways.

• Secure loose area rugs with double-faced tape, tacks or slip-resistant backing.

• Do not sit in a chair or on a sofa that is so low that it is difficult to stand up.

• Remove door sills higher than a half-inch.

Kitchen

• Remove throw rugs.

• Clean up immediately any liquids, grease, or food spilled on the floor.

• Store food, dishes, and cooking equipment within easy reach.

• Do not stand on chairs or boxes to reach upper cabinets.

• Keep stairs clear of packages, boxes, or clutter

• Light switches should be at the top and bottom of the stairs.

• Remove loose area rugs from the bottom or top of the stairs.

• Put non-slip treads on each bare-wood step.

• Install handrails on both sides of the stairway. Each should be 30 inches above the stairs and extend the full length of the stairs.

Bathroom

• Place a slip-resistant rug adjacent to the bathtub for safe exit and entry.

• Install grab bars on the bathroom walls.

• Use a rubber mat or place nonskid adhesive textured strips inside the tub.

• Stabilize yourself on the toilet by using either raised seat or a special toilet seat with armrests.

• Use a sturdy, plastic seat in the bathtub if you cannot lower yourself to the floor of the tub or if you are unsteady.

Dr. K’s Cliff notes to prevent falls

• Get an annual eye examination, and a physical that includes an evaluation for cardiac and blood pressure problems.

• Maintain a diet with adequate dietary calcium and vitamin D.

• Talk to your doctor about starting an exercise program that aids agility, strength, balance and coordination. Climbing stairs, jogging, hiking, dancing, weight training and other activities can help build bone strength and slow progression of osteoporosis.

• Wear properly fitting shoes with nonskid soles. Avoid high heels.

• Tie your shoelaces.

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

• Never walk in your stocking feet. Replace slippers that have stretched out of shape and are too loose.

• Fall-proof your home. Secure rugs. Remove extension cords, small objects, and beware of small animals that one can trip over. Place a second hand rail on stairs. Place hand bars in showers and bathrooms.

Dr. Herb Kunkle is a board-certified orthopaedic surgeon with Auburn Orthopaedic Specialists. For more information, call (315) 255-7011 or visit auburnhospital.org.

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