Falls Prevention for Older Adults
Falls and their resulting injuries, disability, loss of independence, and impact on family members are among the most serious health issues affecting older adults. Falls also take a toll on the U.S. healthcare system overall. About $50 billion is spent every year on non-fatal fall injuries,1 according to the Centers for Disease Control and Prevention.
The increased risk for falls in the elderly can be attributed, in general, to aging and decreased activity, as well as a slow deterioration of the central nervous system (brain and balance system). For example, the sensory cells in the ears’ balance system gradually decrease in number and cannot be replaced. The nerves that carry important sensory information to the brain do not work as well, leading to problems in the way the brain processes complex motor operations. Plus, nerve endings themselves do not produce the chemicals needed for the transmission of information. This process worsens after age 50.
Other conditions and disorders common in older adults can also affect the central nervous system and balance. Hardening of the arteries, called atherosclerotic cardiovascular disease, decreases blood flow and can lead to stroke. Arthritis can cause permanent crippling effects on the bones and joints of the hips, knees, and ankles, and osteoporosis can lead to bone and muscle weakness. Together, these ailments can dramatically increase the probability of serious injury from a fall or cause a spontaneous fracture that might lead to a fall.
Finally, muscle strength gradually decreases with age while joint tendons and ligaments lose their flexibility, resulting in limited range of motion. Carrying out complex motions that were once routine can become more difficult from the combined effects of bone disease, joint disease, and inactivity.
Can Medications Contribute to Falls?
Absolutely! Often, older patients are prescribed multiple medications from multiple physicians and specialists that can have additive side effects on the brain and sensory function. Coordination of all medications through a single physician can help avoid interactions leading to adverse drug reactions. Maintain a complete list of all your medications and dosages, and make sure to share this list with every provider you see. Your list should include:
- Over-the-counter medications, such as antihistamines, sleep aids, analgesics, and cough suppressants
- Medications used to treat high blood pressure, heart disease, allergy, insomnia, stomach acidity, and depression
- Medications listing alcohol as an ingredient, since it affects movement and judgment and adversely interacts with many medications
- Vitamins, herbs, and other supplements
How Can I Recover from an Injury Caused by a Fall?
Make sure to seek immediate medical attention following any fall. A thorough and complete evaluation of sensory, muscle/joint, and balance functions should be performed. This includes a search for causes of dizziness, such as disorders of the inner ear, circulatory system, heart, and central nervous system. An evaluation of the inner ear balance system can be important, as well as a careful review of all medications (prescription and over the counter), eyeglasses, hearing aids, and more.
Head injuries, sometimes caused by falls, can damage the sensory organs in the inner ears, or the brain itself. Physical activity that is recommended and approved by your physician can assist in recovery; however, injuries to the knees, hips, and back often do not heal completely and can lead to a limited range of motion. Physical therapy can help achieve the greatest possible function.
Rehabilitation as directed by professional caregivers seeks to increase the body’s range of motion, physical strength, and balance and may include physical or vestibular (inner ear) therapy designed to reduce vertigo and dizziness, gaze instability, and/or imbalance. Walkers and canes can aid stability, while simple changes in the home, such as installing handrails in bathrooms or along walls, can help increase confidence and reduce the likelihood of another fall.
It’s also important to keep in mind that drastically changing a familiar environment can delay recovery. Including family members and home support groups improves the odds of rehabilitation. Returning to approved physical activity along with social interaction with family and community organizations help patients stay active, engaged, mentally aware, and responsive to their surroundings.
What Can I Do to Help Prevent Falls?
As problematic as they can be, falls are also predictable and preventable, even for older adults. In addition to aging, many changes in muscle, bone, and the central nervous system can be brought on by inactive lifestyles and self-inflicted damage from smoking, poor diet, lack of exercise, and other factors. Although hardening of the arteries is occasionally hereditary, in most cases it can be reduced by diets low in cholesterol and saturated fatty acids, as well as regular physical exercise.
In addition to healthy diets and habits, other health considerations include:
- Have regular hearing and vision check-ups—if your hearing and vision are impaired, important cues that help maintain balance can be overlooked
- Get up slowly from sitting or lying down—a momentary drop in blood pressure can cause dizziness when standing up too quickly
- Stay active by walking—walking is a good form of exercise and can improve your strength, muscle tone, and coordination
- Enhance your balance when moving—wear sturdy, low-heeled shoes with wide, nonslip soles; a cane or walker can help maintain balance on uneven ground or slippery surfaces; avoid ice
Beware of potentially hazardous situations in your home, such as:
- Keep walking surfaces smooth and even—be mindful of raised doorway thresholds; rearrange furniture to keep electrical cords and other obstacles out of walking paths; secure area rugs to the floor with approved rug tape or tacks
- Ensure appropriate lighting—put a light switch by the bedroom door and by your bed so you do not have to walk across the room to turn on a light; night lights in your bedrooms, halls, and bathrooms are very helpful
- Install grab handles—be sure stairways and bathrooms have sturdy handrails; use nonskid mats inside and outside your shower and tub
- Use approved shower chairs and bath benches
- Never stand on a chair anywhere
Related Conditions
The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.
Copyright 2024. American Academy of Otolaryngology–Head and Neck Surgery Foundation