At a recent book club meeting, I asked the assembled women about their experiences with falls. For one person, each had either a personal story of a fall or one from a close friend or family member. A member related how an elderly friend had refused to use the tools she had been given, against advice, resulting in two broken hips on several occasions.
“You know what they say,” the book club member quipped, “Pride comes before a fall.”
This well-known quote from Proverbs refers metaphorically to the comeuppance that comes from hubris, but in a literal sense; it fits in this case. Falls are a major hazard at any age, but they can be particularly devastating for seniors and are often the result of disregarding fall prevention advice from experts.
Like everyone else I’ve interviewed, I’ve had a few falls over a number of years, all fortunately minor, but most illustrating something preventable. I fell off my bike foolishly riding through a deep puddle, not realizing it was covering a muddy crevice. I slipped like a banana peel on a tennis ball our dog was playing with. Once I stumbled with a pair of ill-fitting shoes. Last but not least, ironically, I fell off the BOSU, a balance machine, at my gym. A few scratches, but nothing serious.
The Centers for Disease Control and Prevention collects data on falls, and the data shows that falls are serious and costly. Falls are the leading cause of fatal and nonfatal injuries in older adults. Nearly one million people are hospitalized each year for a fall, most often resulting in head injuries or hip fractures. In 2015, the total medical cost of falls exceeded $50 billion; Medicare and Medicaid covered 75 percent of those costs.
The most common causes of falls will be familiar to you, but there are some causes that may surprise you. First up are frailty or decreased muscle strength, difficulty walking or balance, certain medications, vision problems, poor footwear, and domestic hazards such as uneven steps or carpets. In a moment I’ll talk about one that doesn’t get much attention but is a common cause.
Recently, an acquaintance shared her experience of four falls over a two-month period. Known for his sense of humor, this person said she’s found a “new respect for gravity.” Each fall had a different cause, and each was potentially preventable.
The first fall occurred when the floor in a retail store was slippery. Embarrassed but not badly hurt, she welcomed help from strangers. The second fall occurred when, instead of picking something up, she kicked it and lost her balance. The third happened on the front steps of her house on a cold day. Unaware that the steps were icy, she fell and walked down the steps, each one “like someone was hitting me with a baseball bat.” The most recent, the worst, was when her dog ran away on the leash and dragged her down two steps.
As with many unexpected and traumatic events, she felt she learned a lot about herself as a result. She has nothing but praise for the physical therapists she has worked with who have helped her with stretching, strengthening, warmth and “lots of advice”. The most important thing she learned was to stay active.
“The better shape your body is in, the more confidence you have in how your body moves through the world.”
There are two important takeaways I want to expand on from this person’s story because they are relevant to all of us. Remember her final fall was caused by a leaking dog. Each year there is a surprising number of falls involving a pet, mostly dogs but occasionally cats. She said someone told her that “nobody over 70 should have a dog.” This is extreme advice; We all know the tremendous emotional benefits we derive from pets, but there are precautions older pet owners can take. Most injuries are sustained by dogs, either inside or near the home, often walking or tripping over them. Cats are injured when the owner steps over a cat and loses balance.
The second point that is often misunderstood is the psychological consequences of falls. My friend commented, “You are losing confidence in your ability to travel the world. It makes it more likely that I’ll stay close to home.”
Although it is impossible to prevent all falls, there are things that can be done:
- Regular physical activity, including walking and strength training, can make seniors more resilient.
- Specific exercises – standing on one leg and then the other while holding onto a counter or taking a few steps back and forth can help. This link to the Mayo Clinic Health Letter has a slideshow of helpful exercises at mayocl.in/3E3XEsG.
- Tai Chi is a proven balance improver. A search for “Tai Chi near me” turned up several studios in our area with Tai Chi classes.
- Make your home fall-proof by removing carpeting and making sure there are no power cords to trip over.
- Have your dog train not to jump up or jump up. If necessary, hire someone to walk your dog. Make sure pet toys and food bowls are out of traffic areas. Don’t step over your pet.
- Be careful with medications that make you drowsy or unsteady. These may include anxiety medications, sleeping pills, Benadryl, bladder medications, and some older antidepressants. Talk to your doctor about stopping them or making substitutions.
- Avoid ill-fitting or slipping shoes.
- If you’ve fallen, resist the temptation to snuggle up at home. Take wise precautions, but engage in positive self-talk about your ability to successfully navigate the outside world.
- If you feel your balance is poor, ask your doctor for a physical therapy referral. They are experts in balance training.