I hope everyone had a wonderful holiday season and happy new year! Your Geaux 2 PT was having a jolly good time in Great Britain and is refreshed and ready to write about some very important subjects. I’m starting 2010’s blog with a topic that is near and dear to me: preventing falls in the elderly. With winter now in full swing (8-10 inches of snow here yesterday) and icy, slick conditions around, it’s important now more than ever to talk about falling. Falls and resulting complications are serious health issues facing older adults. Falls are the leading cause of injury deaths, the most common cause of non-fatal injuries, and the most common reason for hospital admission due to trauma in older adults. Read that sentence again. It’s staggering. Brain injuries and fractures incurred from a fall can be devastating and potentially life threatening. In 2001, I lost someone very close to me because he fell and broke his hip at the age of 76. He suffered a brain injury from the fall, causing trauma-induced dementia, to the point that he could not take care of himself (previously living in his own home independently). He never left the hospital and complications eventually caused his death.
One of the reasons that our risk of falling increases as we age is that our balance declines. This decline is partly due to age-related changes within the body and partly due to changes in lifestyle. The best way to avoid the complications associated with falls is prevention. The good news is you can improve your balance and decrease your risk of falling by performing a few simple exercises. In physical therapy I use a variety of activities to reduce someone’s falls risk including stretching, aerobic conditioning, strengthening, and balance tasks. The company I work for, HealthReach Rehab, offers specialized programs including falls evaluations and safe home evaluations.
Our balance and ability to stay upright is generally controlled by three things: vision, the inner ear, and the musculoskeletal system. If there are problems with any of these systems, our balance can decline. Some people rely heavily on their vision to maintain their balance and as vision becomes impaired, balance can be significantly affected. You can try a simple test (if safely able): try to stand on one foot then close your eyes. The task gets harder. For those who really rely on their vision for balance, staying upright when their eyes are closed is not possible. How does this relate to everyday life? Ever get up in the middle of the night for the bathroom? Had to walk in a dimly lit movie theatre? Walk outside at night? Our inner ear and musculoskeletal system need to be strong to compensate in these conditions.
Risk Factors for Balance Impairments and Falls
• Impaired vision
• Muscle weakness
• Inflexibility
• Decreased endurance
• Inner ear dysfunction or history of inner ear dysfunction
• Dizziness or lightheadedness
• Certain medications
Tips to prevent falls
1. Stay physically active and include balance exercises in your routine.
2. Have your vision checked yearly and update your prescription as needed.
3. Discuss your medication list with your doctor or pharmacist for interactions that may cause balance impairments.
4. Make your home safer by clearing clutter, loose wires, and ensuring adequate lighting throughout your living spaces.
A good website to check out is the Fall Prevention Center of Excellence’s. There are lots of resources on identifying whether you or a loved one is at risk for falling and information on options for lowering that risk including fall-proofing the home.
Even if you feel like you have relatively good balance and your vision and inner ear are functioning normally, you can still be at risk for losing your balance if your muscles are weak, tire easily, or have lost flexibility. If you are experiencing a feeling of unsteadiness, loss of balance, or have fallen recently, talk to your doctor and ask about treatment options including physical therapy.
Resources
Fall Prevention Center of Excellence http://www.stopfalls.org/
January 8, 2010
General Information, Geriatric, Vestibular