Most Falls In The Elderly Can Be Prevented

DANBURY — Falling down from balance problems, osteoporosis, or dizziness, along with low vision issues, comprise some of the most common causes of injury in the elderly. More than 75 percent of falls today occur right at home.

But truth be told, most falls can be prevented.

A panel of orthopedic, physical, and occupational therapists, trauma and home-care experts discussed protecting the elderly from falls at a recent Medical Town Meeting sponsored by Danbury Hospital, “Injury Prevention in the Elderly.”

The panel included Thomas Nipper, MD, orthopedic surgeon at Danbury Hospital; Lisa Dransfield, a physical therapist and director of the Balance and Vestibular Center at Associated Neurologists in Danbury; Mary Ann Faraguna, executive director of the Danbury Visiting Nurse Association, an affiliate of Danbury Hospital; Carolyn Lucey, an occupational therapist from the Danbury Hospital Main Street Physical Rehabilitation Center and the Physical Medicine Center of Southbury; and Kathy Lewis, Danbury Hospital trauma coordinator.

The panel discussed the reasons people fall, how to make the home safe and risk-proof, and ways to compensate for physical problems with adaptive devices, like canes, walkers, magnifying glasses, large-print items etc.

It is wise to prevent falls because more than half of all the elderly who fracture a hip need long-term care, according to Dr Nipper. It is estimated that 1,000 people fracture their hip every day in the United States. Many of these falls are the result of osteoporosis, the thinning of bone mass that occurs with age and affects more than 90 percent of women over age 75.

Risk factors for osteoporosis include increasing age, being a woman, being Caucasian, having a thin frame, being in menopause, having an unhealthy lifestyle, taking certain medications, and a family history.

Preventing osteoporosis in the first place can prevent falls later, Dr Nipper said. Steps to prevention include taking calcium and vitamin D; exercising, especially weight-bearing programs; making lifestyle changes to stop smoking and limiting alcohol; and taking bone-building drugs, if indicated.

Having trouble with balance and dizziness is another reason people fall, according to Ms Dransfield. Balance is a complex issue, she said, since it involves coordinating three sensory systems — the feet, the eyes, and the ears. Taking four or more medications, and low or uncontrolled blood pressure can also put one at risk for a balance-related fall. Ms Dransfield recommended talking to a doctor if balance problems are experienced, as there are exercises and skills to increase balance.

Low vision from macular degeneration, glaucoma, and cataracts can also cause falls, according to Carolyn Lucey. Since most cases of low vision usually cannot be corrected, Ms Lucey recommends adding illumination to the home and opting for assistive devices, like magnifying lenses, etc. She also suggests marking medication bottles with large letters that are easily recognizable.

The bottom line in any fall prevention program, according to Ms Faraguna, is to make the home safe and risk-free. She suggests picking up throw rugs and securing electrical cords, which can cause someone to trip, and decluttering doorways, hallways, and rooms, especially the bedroom. Adding grab-bars in the bathroom, ramps instead of steps, and extra railings can also help.