Falls are a serious problem, one that many people are concerned about either for themselves or for a loved one. Rightfully so, as one in five falls leads to a serious injury and each year, 2.5 million older people are treated in the emergency room for fall injuries. At least 250,000 older people are hospitalized yearly for hip fractures and more than 95% of hip fractures are caused by falling. Falls are also the most common cause of traumatic brain injury. Every 13 seconds, an older adult is treated in the emergency room for a fall. Every 20 minutes, an older adult dies from a fall. Falls are the leading cause of fatal injury and the most common cause of trauma-related hospital admissions among older adults.
One of the largest misconceptions about falling is that it is a normal and unavoidable part of aging. This is simply not true! Yes, falling becomes much more common as we age, but it is not normal. If you or a loved one experience falls or decreased balance, please do not brush it off as a normal part of aging. There is a lot that can be done to help with this problem, and there is hope that the problem will get better. Another misconception is that if a person is falling, they should become less active to avoid falls. This is exactly what you should not do! Physical activity keeps our muscles strong and our joints more flexible, both of which help with balance. Balance is just like a muscle, in that the less you use it, the more you lose it.
Balance is complex, and many things affect it. Some major factors that are associated with decreased balance and falls are:
o Lower body weakness
o Vitamin D deficiency
o Medication side effects
o Vision problems
o Problems with walking or with the balance system itself
o Foot pain/poor footwear
o Neuropathy- such as nerve pain or numbness in feet from diabetes
*Lack of hand rails
So, you may be asking yourself, “What can I do to help prevent falls?” The answer is a lot! Wear appropriate footwear that is closed all the way around the heel, such as a tennis shoe. Be careful of laces that have a tendency to come untied. Sandals, flip flops, open back and high heeled shoes are all poor options when trying to prevent falls.
Seeing your physician for regular appointments can also help prevent falls. They will help you identify problems such as vitamin D deficiency, low blood pressure, or dehydration than can affect balance. They will also help manage other health conditions that may affect your balance, such as foot numbness or burning associated with diabetes. A physician, along with your pharmacist, can also help you identify if any of your medications may be causing side effects of decreased balance.
Regular eye exams assist with balance and fall prevention, as our vision is an important part of our balance system. Don’t assume that you will automatically know if your vision is getting worse. If our vision is changing sometimes we may not even notice it until it is severe. That’s why it is important to see a professional who will make sure that if you have any vision problems, you can get the help you need. The better we see, the better our balance.
Making your home environment safer is something you can easily do to assist with balance and fall prevention. First, remove all clutter that does not need to be there. Clutter creates obstacles that can trip you and cause a fall. Get rid of throw rugs and mats, as these are tripping hazards. Do not place electrical cords across areas that people walk. Add hand rails in places where your balance is challenged, such as near the toilet, near or in the shower or bathtub, and along staircases or entryways. If you have a ledge of some sort in your home, such as a step from one room to the next, brightly colored tape placed on that ledge can help you be more aware of it. Make sure to fix any broken steps or fraying carpet, as these can also be tripping hazards. Often times, people fall trying to rush from their bedroom to the bathroom at night. Use night lights in the bedroom, hallways, and bathroom to assist with vision at night. You may try using an assistive device, such as a cane or walker, to help you get to the bathroom at night, even if you don’t normally need one during the day.
Another way to help prevent falls is to stay active. There is much research to support that regular strengthening exercises, especially of the leg muscles, can help improve balance and reduce fall risk. Also, balance specific exercises can assist with fall risk reduction. Many local gyms will have personal trainers or specific group exercises classes designed to help with balance. For example, Tai Chi is one type of group exercise that has been shown to reduce fall risk. If you do not feel safe or comfortable starting an exercise program, then that brings me to my final point: see your physical therapist!
Physical therapists are uniquely trained to evaluate you and determine what may be contributing to your balance issues. They will discuss your own goals for your rehabilitation, and then they can provide treatment targeted specifically to the problem areas to help you reach your goals. While physical therapy for balance retraining does include exercise, it also includes helping you decide if you need to use an assistive device and if so, what kind. A physical therapist will also go over the above mentioned points with you to identify other ways to reduce fall risk, improve safety, and improve independence.
Almost all insurances cover physical therapy for balance retraining, and the cost of physical therapy for this problem is far less, both financially and physically, than the cost of a fall.
There is so much that one can do to decrease fall risk and improve balance. Don’t let yourself or a loved one go another day being afraid of falling. Get the help you need!
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