Seven ways to prevent falls

Falls can cause broken bones and head injuries

More than 30% of people older than 65 – and 50% of those living in long-term care facilities – fall each year. These falls can cause everything from broken bones to severe head injuries and even death. In many cases, these falls could have been prevented through more education.

“No one wakes up and says, ‘Today is the day I’m going to fall,’ and then suddenly falls,” said Robert A. Hymes, MD, Chairman, Department of Orthopedic Surgery, Inova Fairfax Hospital, who is also a member of Inova’s orthopedic trauma team. “We all take walking for granted, and the vast majority of people have never fallen. So, educating patients around their known risk factors is by far the number one thing we can and should do. It’s about helping individuals maintain their independence.”

Below, you’ll find a series of tips from physicians from Inova’s trauma centers on the best ways to prevent falls for you, your friends and loved ones. Inova has two designated trauma centers. The region’s only Level 1 Trauma Center in Northern Virginia is located at Inova Fairfax Hospital, and Loudoun County’s first and only designated trauma center is located at Inova Loudoun Hospital. The Level 1 Trauma Center at Fairfax provides the highest level of trauma care and has experts available for every aspect of traumatic injury, from prevention through rehabilitation.

Seven top tips for fall prevention

Stay fit and active

Dr. Hymes said it’s important for all of us to stay active, especially as we age.“If you can stay mobile –  in the sense of maintaining your balance and strength as you age – that’s one of the best things you can do to prevent falls,” he noted. For older individuals, he said, that can be accomplished through less intense strength and balance exercises such as tai chi or yoga.  

Clear pathways

Dr. Hymes also explained that, according to the Centers for Disease Control and Prevention (CDC), many fall-related deaths and injuries are considered preventable through interventions like fall risk assessment, medication management and physical therapy. Below are a few ideas that can help keep your environment free and clear of hazards:

• Keep unneeded items off the floor
• Keep walking areas well lit
• Keep items that you need frequently in lower cabinets or drawers
• Use a “grabber” to get hard-to-reach items
• Ask for help to get an item in a high place, rather than standing on a chair or ladder
• If you must get up at night and go to the bathroom, install lights that turn on automatically
• Have your walking aids (if you use them) close by your bed at night 
• Avoid multitasking such as texting on your phone as you’re walking

Pay attention to footwear and foot care

Cara Mitchell, DO, a geriatric medicine physician at Inova, said balance issues and falls are often due to problems with the feet such as hammer toes, foot deformities, neuropathy, chronic edema or improperly fitting footwear. Walking barefoot or in socks is particularly risky. Making sure that you or the person you care for has properly fitting shoes is an important step in preventing falls. Shoes with thin, hard soles may be most helpful for balance.

Educate caregivers

Equally as important as educating patients is educating their caregivers. Caregivers should be cognizant of things like a struggling gait or a change in the patient’s gait, slowing down, dizziness, and decreasing vision. “It’s hard to detect if you’re with someone every day, because the changes can be really, really subtle,” said Dr. Hymes.

Avoid certain medications

Dr. Hymes said it’s important to avoid narcotics, opiates and sedatives – anything that alters a patient’s level of consciousness – in those who are susceptible to falling. Those medications can hinder a person’s ability to function and slow their reflexes and reaction times.

“Certain medications and supplements can interact in ways that increase the risk of falls. It’s important to regularly review your entire medication list (including over-the-counter vitamins and supplements) with your healthcare provider to eliminate any medications that may no longer be necessary and review medications that may interact with each other,” Dr. Mitchell said. “Frequent alcohol use can also heighten fall risk and interfere with important medications.”

Over-the-counter medications that are not recommended by a physician, especially those that aid in sleep, may pose problems as well.

Ensure medical devices are suitable for use in the home environment

Assistive devices, such as walkers, may work well in clinical settings but can present challenges at home – when used on carpeted floors or uneven surfaces, for example. If a device is difficult to maneuver in the home, it may increase the risk of falls rather than prevent them. Adapting devices and techniques to fit the patient’s living environment is essential for safety and effectiveness. It’s also important to address any sensory issues, particularly vision impairments, as untreated eyesight problems can further increase the risk of tripping and falling.

Be extra cautious if you’ve fallen previously

Older adults who’ve fallen before have a significantly higher predisposition to falling again. They can develop “anticipatory anxiety,” which can prevent a person from walking because of a fear of falling, ultimately causing them to get weaker over time.

“If you or someone you care for has recently experienced a fall, it’s vital to inform your healthcare provider, even if you weren’t hurt. A thorough falls risk evaluation can help prevent future falls and potential injuries or hospitalizations,” Dr. Mitchell noted.