FALLS

By J. Manuel Cordova, M.D.

(part 2)

Our past comments about falls consider an elevated risk factor for aging people. That is true if we consider the reason behind falls and fall injuries. Usually a fall occurs when one’s center of gravity moves outside of his or her base of support and insufficient, ineffective, or no effort is made to restore balance.

Classification protocols have been developed to help explain how falls occur. One of the classifications used is called Extrinsic. Extrinsic refers to falls caused by environmental factors, slips, trips, in addition to the relationship with irregular balance.

Intrinsic conditions are a result of deficits in balance, mobility, cognitive or sensory functions. Non-bipedal falls, such as falling out of bed or other non-classifiable falls are considered Intrinsic.

Personal reactions and characteristics in conjunction with medicines and behavioral factors can alter resting balance and affect older people, which can also be a factor in falling.

Your body posture responses to challenges posed by the environment, or posed simply by movements such as a change from sitting to walking can cause instability and result in a fall.

Observation may suggest that one factor dominates more often in certain falls, but it is the interaction of multiple factors that cause most falls.

What can I do about Risk Factors?

Multiple studies over the past 15 years in the community and nursing homes have identified a number of factors that increase an older person`s risk of falling. Studies show that the risk of falling increases with the number of risk factors a person has (muscle weakness, age, history of falls, balance deficit, use of assistive device, visual deficit, depression, arthritis, etc.)

While most characteristics may not be modified, the most important modifiable risk factors for falls are balance, strength, and gait impairments.

We think of the five senses of sight, hearing, smell, touch and taste, but often don’t realize that the ‘sense of balance’ is a major factor in preventing falls. Prevention is the most important thing to remember.

FALL PREVENTION IN THE HOME

Most falls occur inside the home! The type of fall will determine the severity, but whether it is minor or major, ‘prevention’ is always the best remedy. Even a ‘minor’ fall can cause permanent damage and require extensive rehabilitation time.

The bathtub and shower is the #1 accident location inside the home. Have hand rails installed and always use some type of rubber pad to stand on while taking a shower. Be very careful getting in and out as well.

Steps inside and outside the home contribute to many falls. Whether it is a single step or a stairway, they both can be very dangerous. Many times a single step can do more damage than a stairway because you forget it’s there or don’t see it. Install proper hand rails and put colored tape on the floor to help prevent accidental falls.

Liquid spills undetected can quickly cause an accident. If you have any sources of leaks in your home, make sure you take care of the problem before someone is injured.

As much as we all love our pets, they often cause falls because they get under our feet.   Remember the risk if you have a pet in the house and look down first before starting to walk. Our pets want to be close to us, but avoid hurting yourself and your pet by being extra careful.

Getting in and out of our vehicles is another area that requires extra attention. Hopefully, your vehicle is ‘people friendly’ for getting in and out.