Falls: Why Do We Do This?
Our body relies on many functions to keep us upright and balanced. Our muscles, vision, eyes, lungs, nervous system and inner ear work together to keep us from falling. But sometimes, things go awry. Everyone has a story about the time they had aterrible fall. There are even nursery rhymes about it — Humpty Dumpty and London Bridge! So, why is it that we fall? In the case of the precious patient on this page who came to us for rehabilitation after her severe fall, it happened in a place she knew well around a beloved pet. If it happened to her, it can happen to you. She made an amazing recovery after severe injuries. If she can do that, so can you. So, here’s the big question one more time. Why do we fall?
There are many reasons we fall, from a misstep that causes loss of balance to having a clinical condition such as osteoporosis, that weakens the bone and can sometimes cause the bone to fracture (usually the hip bone) on its own even before the fall occurs. Many times we fall, and we do not report the fall to our physician, we chalk it up to clumsiness, or being accident prone. It is important to report falls to your physician as it could be an indicator that something may be wrong. Many medications have side effects such as lightheadedness and dizziness; Medical conditions such as Heart disease or Heart failure can cause dizziness, balance problems, muscle weakness and fatigue, even with only slight exertion. Heart disease is also frequently associated with respiratory difficulties, which can result in many of the same falls-related conditions. A decrease in vision, whether caused by glaucoma and cataracts, or just aging eyes, makes it far more difficult to judge distance and avoid obstacles that could trip you up. This is naturally a particular concern at night or when in the dark. These are just some of the many reasons we may experience a fall.
Fall Prevention: Know the Facts
According to the CDC (Centers for Disease Control), the statements below are facts:
- Women are twice as likely to fall then men.
- Women over the age of 75 who fall are 4-5 times more likely to be admitted to a long term care facility for a year or longer than those age 65-74.
- Among older adults, falls are the leading cause of both fatal and nonfatal injuries.
- Over 95% of hip fractures are caused by falls.
- Falls are the most common cause of Traumatic Brain Injuries.
- Most fractures among older adults are caused by falls. The most common are fractures of the spine, hip, forearm, leg, ankle, pelvis, upper arm, and hand.
- The results of falls may range from no injury, lacerations, fractures, traumatic brain injuries to even death.
- The death rates from falls among older men and women have risen sharply over the past decade.
- A fear of falling may occur which often limits activities, quality of life, reduces exercise and movement, which increases the risk of falls.
“I’ve Fallen, and I Can’t Get up”
The bad acting and over dramatization of the 1980’s commercial showing an elderly person who had fallen made this slogan popular and is still often used as a punch line, quoted in movies, and even today, can be seen used in YouTube videos. The reality is that this is a very common and serious problem for many seniors who live alone. Many elderly people who live alone can sustain a serious injury related to a fall and will be unable to get to a phone and call for help. If you live alone, be sure you have a system in place where someone checks on you regularly. There are also many services, such as “Life Alert” that can provide immediate assistance if you fall. It is important that you make your home as safe as possible to avoid accidental falls. Safety check your home for hazards:
- Reduce tripping hazards such as removing throw rugs and mats, or securing them with floor tacks or non-skid pads or double-sided tape.
- Install grab bars in bathrooms for tubs/showers as well as toilets.
- Add railings to stairways. Check these regularly to be sure they are not broken and are securely fastened.
- Repair holes and uneven joints in walkways.
- Ensure lighting inside and outside of your house is bright. Add nightlights in hallways, bedrooms, bathrooms and stairways.
- Keep your home free of clutter; keep items you use frequently such as dishes and food items in easy reach.
What Else Can I Do To Prevent Falls?
Schedule and see an eye doctor at least yearly. Eye glass prescriptions need to be kept up to date to ensure the best vision. After consulting with your physician, exercise regularly with focus on increasing balance and leg strength. Consult with your physician and/or pharmacist for a medication review. Some medications may have side effects that cause dizziness and balance issues. Tell your physician if you have fallen, or if you are experiencing dizziness, lightheadedness, or a decrease in strength. Get adequate calcium and vitamin D-from food and or from supplements Wear appropriate footwear, look for flat, nonskid shoes; strapless, slip-on or high-heeled shoes increase your chances of becoming unbalanced and cause you to fall. Use canes and walkers if recommended by your physician or therapist.
Caring for Yourself or Your Loved One After a Traumatic Fall
The road to recovery after a hip fracture can be long and difficult. In my experience working with patients recovering from a fall, those who keep up their morale and think positively seem to recover the fastest. Stay consistent in your efforts and work hard to regain the quality of life you had before the fall. Don’t accept the idea that partial recovery is enoug or that it’s okay to live with less mobility.
Push for Complete Rehabilitation
Usually, patients with hip fractures get four to six days of post-surgery care in the hospital—followed by two to six weeks at a rehabilitation facility and another three to four of home or outpatient rehabilitation. The amount of time needed for your recovery is determined by your motivation, general health status prior to the fall and whether or not you have other complications during or after your surgery.
Start your rehabilitation right away. Whether you are at a rehabilitation facility, or at home, lying in bed resting, or not wanting to do the exercises because of pain will prolong your rehabilitation time. Staying active will decrease your chances of medical complications and increase your healing time.
Eating a healthy diet promotes good health and will improve your strength. In addition, eating protein will help you build muscle.
Choosing the Right Place for Your Rehabilitation
Tour area rehabilitation facilities to see if they can provide you with the care and services you need in order for a speedy recovery. Things to consider during your visit include the following:
- Does the facility specialize in rehabilitation?
- Does the therapy equipment/space available meet the needs of your rehabilitation?
- How much therapy will you receive?
- Are board certified medical staff available at all times?
- What is the ratio of qualified nursing staff to patients?
- Who develops the treatment plan?
- Do they provide outpatient rehabilitation?
- What other medical services is the facility able to provide?
- Is the facility clean and appealing? Are staff friendly and smile?
I hope this information helps you avoid falls. All of our patients will share with you that avoiding falls is way more fun than recovering from them. Stay safe and well!