Are You Headed for a Fall?
Falls are a major health concern among older adults, becoming one of the most
serious health issues among the elderly. One of every three people over the
age of 65 fall each year - often resulting in serious injuries that can sometimes
be fatal. Hip fractures are among the worst consequences of a fall. A quarter
of hip fracture patients die within one year; 40 percent require a nursing home
and 50 percent who undergo rehabilitation need an assistive device (e.g., walker,
wheel chair, etc.).
Why do we fall?
Balance is a complex process that depends on three major sensory systems:
(1) vision (2) musculoskeletal (strength, joint integrity, sensation); and
(3) the inner ear. Movement results in information from all these systems. Thus,
a synchronicity, or harmony, from the three sensory inputs must exist to send
accurate information to the brain. It is particularly common in older adults to
have one or more of these systems impaired. For example, accuracy of the visual
system can be diminished - both in visual acuity and in the peripheral visual
system. The eyes also have a more difficult time adjusting to lighting changes.
Second, the musculoskeletal system may be impaired due to decreased strength
and range of motion. Additional factors may include arthritis/osteoporosis,
decreased sensation in the feet or burning, and decreased endurance. Third, the
inner ear may also be involved. Many common inner ear disorders (e.g., viral,
positional vertigo) contribute to an increased fall risk as well as the inner ear
has a natural aging process that may contibute to hearing and balance problems.
Additionally, any neurological disorder such as Parkinson's Disease, stroke or
dementia will greatly increase the risk of falling.
Who Falls?
Anyone call fall but as we age the risk becomes much greater. The following are
a list of common risk factors:
- Age
- Taking 4 or more medications
- Inability to stand on one leg for at least 5 seconds
- Multiple health problems
- Loss of strength, flexibility and/or sensation in the legs
- Poor posture
- Fluctuations in blood pressure
- History of dizziness and/or vertigo (spinning sensation)
Where Do We Fall?
Falls can occur anytime, anywhere. The majority of falls, however, occur in the
home. Research shows 60% of falls occur in the home; 30% occur in the
community; and 10% occur within institutions (assisted living facilities, hopsital,
etc.).
What Can I Do?
Prevention is key! Studies suggest taht 50% of falls are preventable. The
following guidelines are recommended:
- Get a physical annually. Talk to your doctor about any health concerns, including side effects of medications.
- Have your vision and hearing checked regularly, especially if there is any change. If your vision and hearing are impaired, you may have issues that need to be addressed medically. As discussed earlier, vision and hearing are important components of balance.
- Exercise regularly. Inactivity accelerates the deterioration process with aging. Exercising is important for improving strength, bone density and endurance.
- Take care of your feet. Talk to your doctor about any pain or burning in your feet as well as mention any corns or thickening of your nails. As for shoes, it is best to wear low-heeled shoes with a non-skid, non-friction sole.
Home modifications may be necessary. Since most falls occur in the
home (at least 60%), follow these tips to make your home a safer environment:
- Have good lighting. Put lights in hallways, bedrooms, and bathrooms. The majority of falls occur between the bedroom and the bathroom.
- Remove throw rugs and tack down any loose carpet. Electrical cords should not be in walking areas and remove raised doorway thresholds.
- Use hand rails. Grab bars shuold be used for bath/shower and toilet use. Have sturdy rails for steps/stairs.
- Avoid stepladders and never stand on a chair. Place items within easy reach - not too high or too low.
- Use non-skid wax on floors and wear non-skid, non-friction shoes (avoid slippers). Also, use non-skid mats in the bath/shower.
Physical Therapy may be needed for a more thorough evaluation of balance
and specialized rehabilitation, especially after a fall. We at 360° Balance
specialize in balance and dizziness disorders, including comprehensive testing and
customized treatment programs. The examination includes the following evaluation
components:
- Vital signs (heart rate, blood pressure, respiration rate)
- Mental function, including assessment of the fear of falling
- Cranial nerve and oculomotor (eye movement function), including computerized testing with electronystagmography (ENG*) when indicated
- Sensory (sensation) and motor (strength, range of motion) function as well as postural assessment
- Reflexes, coordination and other neurological tests
- Balance testing, including clinical and computerized testing* to assess the various sensory systems (e.g., vision, inner ear, etc.)
- Gait (walking) analysis
- Review of medications (prescription and over-the-counter) as well as other medical factors that could be contributing to unsteadiness and/or dizziness
- Establish a plan of care that is sent to the primary care physician and/or referring physician. Recommendations for additional referrals may also be made if deemed appropriate.
*Note: computerized testing mentioned above is performed by our audiologist who
can also evaluate hearing loss and assess need for hearing aid(s).
If you or someone you know has a balance problem, the best time to act is
now ... before a fall occurs. Do not wait to find out from a fall.
Be proactive and take charge of your physical condition and your surroundings.
Talk to your doctor or a physical therapist to find out how you can improve
your strength and mobility. And, remember: falling is NOT a fact of life as
we age, but only you can take the first steps to prevention.
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