Falls and How To Prevent Them

By Brian O'Neil PT, OCS, CSCS

One out of three adults age 65 and older will fall each year.  Falls are the leading cause of injury death in the US, with 20,000 deaths among older adults each year.  Fifty percent of those hospitilized due to a fall-related injury are discharged to long term nursing care and will never return to independent living.  Direct medical costs from falls amount to almost 30 billion per year.  There are several risk factors that will increase an older adult's chance of suffering a fall.  They include gait and balance problems, poor vision, muscle weakness, chronic health problems, diabetes and/or peripheral neuropathy, taking 4 or more medications, and environmental factors such as poor lighting and lack of hand rails and grab bars.  Although advanced age is a risk factor, falls are not a normal part of aging and should not be tread as such.

Fall prevention must begin in the home.  Grab bars should be installed in the shower and beside the toilet.  All stairs should have hand rails on both sides, and any scatter rugs should be securely taped down or removed.  Re-arrange closets and kitchen so that the things used most often are between waist and shoulder height.  Review medications with your physician to see if dosages can be reduced, and see your optometrist yearly to have your vision checked.  Increase your vitamin D intake to help improve muscle strength.  You may also consider beginning a community-based exercise program, such as Tai Chi or the Otago Exercise Program.  Both programs have been thoroughly researched and proven to reduce falls from 35-60%.

Tai Chi is an ancient Chinese martial art that has been adapted over the past century into a popular exercise form.  It involves gentle motion exercises that improve body awareness, balance, and strength.  It is offered by many communities, including here in Scituate, as a proven, effective fall prevention strategy for seniors.  It has many other health benefits as well, including stress relief, cardiovascular health, and joint health.

The Otago Exercise Program is another evidenced-based exercise program designed to improve strength and balance.  Initially instructed by a physical therapist, it can be performed at home at a person's own convenience.  This program involves low-impact, standing weight training and balance exercises, and is supplemented by a walking program. 

If you have fallen in the past or feel like you may be at risk, please visit your doctor or physical therapist in order to be properly assessed and referred to an appropriate fall prevention program.

Brian O'Neil is a physical therapist with Magill and Gardner Physical Therapy in Scituate, Massachusetts.  He can be reached at mgpt@comcast.net.