Staying Safe: Avoiding A Fall Is Way More Fun Than Recovering From One

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?

Reasons

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.

Stay active

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.

Eat right

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!

Staying Safe: Apps and Driving

I’m in my mid-twenties and I’m pretty sure I don’t know what I’d do without my smartphone. It’s how I make plans, take photos; it wakes me up in the morning, and may even be the first thing I would reach for in case of an emergency.

It’s not just texting and phone conversations anymore. It’s the wonderful world of social apps – Facebook, Twitter, Snapchat, Instagram, the list goes on. The thing about most social apps is that they are constantly updated with new content.

Campaigns like AT&T’s “It Can Wait” and state laws that ban texting and driving, drivers may think twice about checking text messages. However, I rarely hear anything about using apps while behind the wheel.

Familiar with a lock screen that looks similar to this? This is usually when temptation kicks in.

Staying Safe: The Terrible Truth About Falls

Our thanks to Alachua County Fire & Rescue for all of the support they have provided for this month’s Spotlight Series on Unintentional Injuries — the third leading cause of death in Alachua County and for much of North Central Florida. This article is written by Toya Bauer. In her work with Alachua County Fire & Rescue, she has seen plenty of real life examples of falls that went beyond injury and caused loss of life. In our area, the number of fatal falls has continued to increase. That’s the terrible truth about falls, and it is a trend we need to change.

This is How it Begins

It was finally quiet at Station 16. The crews rested peacefully. Today had been a long one, two vehicle accidents with multiple patients, one almost house fire and a multitude of medical calls and fire alarms. The station tones broke the silence, beepbeepbeep, “Squad 16, Rescue 16 respond fall patient.” The medic looks at his watch and sighs, 2:30 in the morning.

“Probably fell on the way to the bathroom,” he mumbles to his partner as they make their way out to the truck. The dispatcher confirms his suspicions, “A 70 year old female who has fallen in the bathroom; she’s bleeding from her head and can’t get herself up from the floor.”

On scene, Mr. Allen leads them where his wife lay on the cold bathroom floor, a towel pressed to her forehead. “She lost her balance and fell. I heard her crying. When I came in she was like this.” Mr. Allen goes on to say “she must have struck her head on the counter and her right leg hurts when she tries to move it.” A quick evaluation reveals she didn’t pass out and is not having any neck or back pain. After a full evaluation for any other injuries, she’s moved to the stretcher and taken to the hospital. This is an all too familiar occurrence in the daily shift of a paramedic.

How many of these calls can be avoided?

As we age, our risk of falling increases. Falls are the leading cause of injury over the age of sixty-five. The Centers for Disease Control report that one in three adults over sixty-five fall each year. Of those, two million end up in the emergency room. Fortunately, the majority of these falls can be avoided. All it takes is a little preparation, mindfulness and a realization that we aren’t as young as we used to be.

What can we do around the house?

Install hand rails:

Because Mrs. Allen lived in a nice retirement community, hand rails had already been installed in the bathroom. A quick glance around showed hand rails in the shower and around the toilet. Both she and Mr. Allen used them to get into and out of the shower. They came in handy when they need a little extra help getting up from the toilet or floor.

Trip proof:

When you had children you kid proofed your home. Now it’s time to trip proof it for yourself. The Allen’s small apartment was neat and clean. Their furniture was sparse but adequate, allowing for plenty of open space to walk between. There was no clutter to accidentally stumble or slide on. The small area rugs in the foyer and kitchen were skid resistant and the area rug in the living room was installed with double sided tape to keep it in place and the edges from rolling up. The shower had a skid mat on the floor and the bathroom mats were held firmly in place by grip mats.

Add lighting:

Mrs. Allen’s apartment was well lit with both overhead lighting and lamps. By increasing the amount of lighting in the home you decrease your chances of a missed step or trip. As we age our eyes don’t work as well as they used to and more light means you can see more.
Steps and stairs: Mrs. Allen didn’t have any steps or stairs to contend with, however, this is not the case for everyone. Steps and stairs are a special hazard and should be treated with special attention. Hand rails are a necessity and should be strong and well anchored. Nothing should be stored or placed on the steps. The lighting for stairs or steps should be extra bright and the switches easy to access.

What should we look out for?

Know the effects of your medication:

Mrs. Allen had long ago made it a practice to discuss all new medications with her physician before she started taking them. Being a retired nurse she was more than aware of the effects some meds could have. Medications, such as muscle relaxers, sleep aids, blood pressure medications, etc. can cause dizziness or drowsiness. These medications should be taken with care and an honest awareness of their effects. The more you know the safer you can be.

Be aware of your surroundings/watch where you walk:

When we were young girls we were told to walk with our heads high and our eyes straight ahead. Now we need to take that book off the top of our heads and look at our feet from time to time. There are any number of things that can trip us up; Fluffy or Fido racing for the food dish, a rug that wrinkled, a small knick-knack that has fallen to the floor or even a toy or ball that has been left unattended. The dangers of falling are not isolated to the home. When we’re out, parking curbs, pot holes, uneven sidewalks and tree roots are all falls waiting to happen. Always look where you put your feet.

Leave the slippers in the closet:

I’m not saying we should go without shoes. Actually the opposite is true. But we are safer wearing closed toed shoes with rubber, non-skid soles, like tennis shoes. I know how we all love our heels and dress shoes but these should be limited to special occasions and short periods of time. Also, sling backs and flip flops can easily get caught and cause a fall. As I mentioned before, we aren’t as young as we used to be.

Exercise:

Daily exercise improves the strength of our muscles, bones and mind. It improves our balance and mental acuity. All of these decrease our chances of falling and improves our ability to heal after an injury. This isn’t about being a certain size or shape; it’s about being strong and healthy. Mrs. Allen took a yoga class every week and walked daily. There are many options in the community for exercise.

Get your vision checked:

Mrs. Allen had a standing appointment with her eye doctor every year. She had gotten cataract surgery and her glaucoma was caught in the early stages. Yearly eye exams are highly recommended. Decreased vision acuity or vision field increases our chances of not seeing an obstacle or misjudging a step; these initial changes can be hard to notice until it’s too late.

Use walkers and canes:

Mrs. Allen’s fall was caused because she didn’t use her walker when she got up to go to the bathroom. She lost her balance. “But the bathroom is just right there,” was her reasoning. It only takes one moment for our feet to slip, our minds to whirl or our legs to give out. Without something to steady us or hold onto, we can fall.

Final Thoughts on Falls

Use the tools available to you to keep you healthy, uninjured and moving.
Falls are a scary possibility for us as we age. They can cause serious injury and debilitation. Thankfully, they are preventable with just a little planning and help. As we begin the New Year, we hope that 2015 will be fall free!

Just One Thing: Staying Safe

Happy New Year to all the women who are already part of Women and Wellness and to those who will join us this year. Here’s this week’s ‘Just One Thing’ for you to consider.
Our Spotlight Series as we begin 2015 is about Staying Safe. Some of the information you will learn this month will probably surprise you.

Did you know that Unintentional Injury is the Number 3 cause of death in Alachua County? It’s not just a problem here. Throughout the 16-county region that makes up North Central Florida, Unintentional Injury is either the Number 3 or Number 4 cause of death. It’s right behind Cancer, Heart Disease – and in a few counties, Lung Disease.

While there are a number of different types of unintended injuries that lead to death, most are in two categories. So, it’s those two kinds of accidents we will work on in January. We’ll give you as much information as possible to help you and those you love avoid these injuries and Stay Safe.

What are those two big categories? Here’s a hint. Think Cars. Think Falls.

News Flash! Staying Safe is just as big a part of your health as nutrition and exercise. Just One Thing to think about…

If you want to know more about the biggest causes of Unintentional Injuries and what you can do about them, we’ll keep adding information throughout the month. So, be sure and check back.

Staying Safe: Just the Facts

Who Knew? Unintentional Injury is a Leading Cause of Death

Surprised to read that Staying Safe would truly be as important to your your health as nutrition and exercise? It’s a fact. Consider our research.

Unintentional Injury is the third leading cause of death in Alachua County. Throughout the 16-county region of North Central Florida, unintentional injury is either the third or fourth leading cause of death, depending on the county. While there are a variety of unintentional injuries that cause death, the greatest majority are automobile accidents and falls. Data from Well Florida Council and Alachua County Fire & Rescue shows that most of the automobile accident fatalities happen to people who are younger – between the ages of 20 and 50. The majority of fatalities from falls are for people who are between the ages of 60 and 90.

car-wrecks

Trends for Fatal Car Wrecks

Well Florida Council provides data that helps us understand trends for these two major causes of injury and death. In the 5-year period from 2004 to 2008 – Alachua County’s age adjusted death rate for car wrecks per 100,000 population was 15.8. That is below the statewide average of 18. In the 5-year period from 2009 to 2013 – Alachua County’s age adjusted death rate for car wrecks per 100,000 population was 10.4. That is below the statewide average of 12.5.

While it is positive that this trend has gone down slightly and positive that we are below the statewide average, our loss of life from car wrecks in North Central Florida is still too high and needs to be improved. Additionally, in some counties in North Central Florida, the situation is more serious. In Columbia County, for example, auto accident deaths are double the statewide average, and that needs to be addressed.

fatal-falls

Trends for Fatal Falls

In the 5-year period from 2004 to 2008 – Alachua County’s age adjusted death rate for falls per 100,000 population was 17.0. That is more than double the statewide average of 6.7. In the 5-year period from 2009 to 2013 – Alachua County’s age adjusted death rate for falls per 100,000 population was 18.0. That continues to be more than double the statewide average of 8.5. Obviously, these numbers are of grave concern. It’s important to remember that these numbers are not about all falls – they show the falls that actually lead to deaths. There are even more falls that cause injury.

The Bigger Picture for Unintentional Injury

Data from additional sources provides further validation that unintentional injury is a leading cause of death nationwide – not just in our community. The Centers for Disease Control reports that Injury is #5 in the list of leading preventable death nationwide with 36,836 preventable; it’s also #5 in the list of leading preventable deaths in Florida with 3,252 preventable.

The Bottom Line?

Preventing unintentional injuries is something we can all work on. That is what this month’s Spotlight Series on Women and Wellness is all about. More to come!