As we get older, our minds sometimes outpace our bodies. We tend to lose muscle strength as we get older. We may have a little deficit in our balance. Our vision may not be what it used to be. And while we all want to stay active and should stay active, sometimes it puts us at risk for falling.
The worst injuries are brain injuries. We all fall and bump our head now and then. But if you’re on any blood-thinning medication, such as aspirin or other anti-platelet agents for coronary stents, medications that might be given for atrial fibrillation to reduce the risk of stroke or medication to prevent formation of blood clots if you’ve had a previous DVT or pulmonary embolism, all of these put you at risk for a severe brain injury after hitting your head.
Other injuries that the older population suffer include rib fractures. Those can be of significant consequence. If patients get fractures, they have more pain, and aren’t breathing as deeply, and are at risk of pneumonia. As we age, our bones lose strength and fractures of any sort are possible after a fall.
There are a number of things that we should do. First, risk assessment is important to discuss with the primary care provider. If you’ve had a fall in the last year or if you’re afraid of falling, these are things you should discuss with the primary care provider. There are certain questions that they can ask to evaluate your risk and potentially do some interventions.
We should stay active. We should exercise. Exercises that focus on strength and balance are the two keys to preventing a fall from the exercise standpoint.
There are interventions around the house as well. It’s important to have a clear path where you normally walk. You don’t want light cords on the floor. Anything loose on the floor could be a hazard. A rug that gets bunched up, slippery floors can be a problem too.
Adhesives can be helpful in certain parts of the house. It’s important to have handrails, in some cases on both sides of the stairway and handrails in the bathroom.We see a lot of people who fall in the bathroom. Handrails to help get up off the toilet or to help in the shower or around the bathtub, those can be very good for prevention.
You have to remember that not wearing them can alter your perception and a misstep is pretty easy to happen then.
Medications that prevent hypertension can sometimes lower the blood pressure too much. So, if you stand up and feel a little bit lightheaded, that may be a sign that your medication dose ought to be adjusted or that you need to drink more water or take in more salt. There are a lot of side effects of medications that can lead to falls.
It’s important to do it at the annual physical because people of all ages are susceptible to falls. The older population is where we see the increase in the fall incidents, but it’s always helpful to talk about it with the primary care provider.
Yes, we make it very safe in the hospital and at the doctor’s offices. Everybody’s wearing masks. There’s a lot of attention paid to cleaning all the surfaces and making it safe. The patients are physically separated. The COVID patients are kept separate. So, please do not put off visiting the doctor or visiting the hospital for fear of contracting COVID in the healthcare environment.
If you can handle it every day, I would say every day. Walking is a great exercise. It’s the best one you can do on a daily basis. It gets you up. It gets your legs stronger. If you can handle 20 to 30 minutes every day, I think that’s a good target.
There are a variety of exercises for balance. I would suggest going on YouTube and looking for videos of things to follow. There are apps that you can get that show exercises for balance and different body areas that you want to focus on. Tai Chi is a good technique that many people use.
Any significant pain after a fall, a bony deformity, swelling, that should trigger an evaluation because there may be a broken bone. Major cuts ought to be evaluated, especially if the bleeding is not stopping right away. If you hit your head and you take any kind of blood-thinning medications, I’d recommend getting evaluated immediately.
Lightly edited for clarity
Watch the San Diego Health video with host Susan Taylor and Dr. Biffl discussing fall prevention tips.