By Cory Hewitt, RN, BSN, TCRN – Ocala Health VP of Trauma Services
May is national Trauma Awareness month. Over 10,000 baby boomers are turning 65 every day. As this expanding demographic grows, healthcare is forced to redefine commonly held concepts. A commonly held myth is it is “normal” for elderly patients to fall. Falls are all too common in the geriatric population and they can have devastating consequences. Falls are the leading cause of accidental death for adults over the age of 65. According to a recent study, only 15-20% of patients who are hospitalized due to a fall will live more than one year after the injury. Falls are estimated to cost the United States health care system almost $55 billion by the year 2020. Despite the serious nature of these injuries, there are many practical steps we can take to decrease the risk and consequences of a fall.
The first step in making improvements in our lifestyles is to identify what type of conditions can put us at a greater risk. The more risk factors that apply, the greater chance you have of falling. Some of the factors not in our control are our age and sex. Symptoms from illnesses or even side effects of medications for treating high blood pressure can commonly affect balance. While this list can help us identify our risk of a serious fall, we need to look a little deeper into each of them. We will find there are many changes in our lifestyles that can decrease the impact on our overall risk.
As we age, we notice a distinct and increasing change to our vision, hearing, muscle tone and reflexes. Mixing alcohol and medications greatly increase risks leading to a dangerous fall. It is extremely important that everyone speaks with their primary doctor and pharmacist about the side effects of medications they may be taking. Not only can your medications cause sedation or dizziness but also can increase your need to urinate which can increase the risk of falling when you need to go urgently in the middle of the night. Your physicians may be able to adjust the type of medications, the frequency, or timing of when you take the medication.
Bone frailty is an increasingly important area in preventative medicine. Starting at age 35, all adults will start to lose bone density (osteoporosis). Men can lose 20-30% while women can lose up to 50% of the strength of their bones. These weaknesses can usually be seen with increasing number of fractures to the upper femur (hip), wrist, and lower back. The most effective way of combating this is through dietary changes. Staying well hydrated and having a diet rich in calcium and vitamin D can slow down bone loss. The National Institutes of Health (NIH) recommends 1500 mg of calcium daily. The average intake for elderly Americans is less than 800mg. Increasing intake of dairy products, fortified orange juice, low-fat yogurt, grains and cereals can help bridge this gap. Many people take calcium supplements to help but this should only be done after speaking with your primary physician or pharmacist.
Another way to mitigate the risk of falling is to look at the environment where we live. The majority of serious falls happen in the bathroom and kitchen. A common side effect of blood pressure medicine is postural hypotension, which causes us to get lightheaded or even pass out if we sit up or stand too quickly. To help increase the safety for those middle of the night trips, make sure that the floor is clear of objects and remove throw rugs. Have night lights positioned so that you can clearly see all obstacles. Add non-slip surfaces to all stairs and try to make them light colored. Install hand railings to both sides of all stairs. Use a cane or walker if your doctor recommends them.
Finally, one of the most effective ways to keep healthy is to stay active. The best forms of exercise will include increasing balance, core strengthening and improved coordination. A good example would be water aerobics or Tai Chi. The most important thing is that you involve yourself in an activity you enjoy! Not only will you have fun, but you will continue to be active and healthy for much longer. An active lifestyle will improve flexibility, increase muscle tone, help control your weight and blood sugar and decrease stress. While exercising, make sure you wear supportive shoes with good rubber soles, hydrate well, warm up and cool down, and stop if you have chest pain, shortness of breath or discomfort in the chest or jaw area. Speak with your physician about what kind of exercise and activity is right for you.
With a few changes in your lifestyle and home, you can greatly decrease your risk of falling. Key points to remember are to stay actively engaged in physical exercise and social interactions. Make sure you are speaking with your physician and pharmacist often. Stay involved, stay active, stay aware and help us fight the epidemic of elderly falls!
RISK FACTORS FOR FALLS
• AGE ABOVE 50
• PREVIOUS FALL
• MULTIPLE MEDS
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