Falls can cause broken bones and head injuries

Each year, approximately 3 million older adults in the U.S. are treated in the emergency room for injuries related to falls, according to the Centers for Disease Control and Prevention (CDC). At Inova alone, falls are the leading cause of death in people 65 and older. These falls can cause everything from broken bones and fractures 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,” says Robert A. Hymes, MD, Interim Chairman, Department of Orthopedic Surgery, Inova Fairfax Medical Campus, and a member of Inova’s Orthopedic Trauma team. “Everyone’s walked all day, every day, and the vast majority have never fallen. So educating patients around their known risk factors is by far the No. 1 thing we can do and should do.”

Below, you’ll find a series of tips from physicians at Inova 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 center in Northern Virginia is located at the Inova Fairfax Medical Campus and Loudoun County’s first and only designated trauma center at Inova Loudoun Hospital. The Level 1 center at Fairfax provides the highest level of trauma care and has experts available for every aspect of injury from prevention through rehabilitation.

Stay fit and active. Dr.Hymes says it’s important for people to stay active, especially as we age. Of all trauma deaths related to falls at Inova in 2018, over 73 percent were in the geriatric population. “If you can stay mobile — in the sense of maintaining your balance and maintaining strength as you age — that’s one of the best things you can do to prevent falls,” he says. For older individuals, that can be accomplished through less intense strength and balance exercises, Dr. Hymes says, such as tai chi or yoga.  

Clear pathways. Dr.Hymes also tells us that it’s important to control your environment as best as possible in order to prevent falls. In 2018, 65 percent of falls resulting in death at Inova were at ground level or included furniture, while 23 percent involved stairs. Below are a few ideas that can help keep your environment free and clear of hazards:

  • Keep unneeded items off of the floor and keep walk areas well-lit.
  • Keep items that you need frequently in lower cabinets or drawers.
  • Use a “grabber” to get hard-to-reach items, and ask for help, rather than standing on a chair.
  • If you have to get up at night and go to the bathroom, install lights that turn on automatically and have your walking device close by if you use one. 
  • Avoid multitasking, such as texting on your phone, as you’re walking.

Pay attention to footwear and foot care. Denise Mohess, MD, a geriatric medicine physician at Inova Medical Group, says 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. Making sure that you or the person you care for has properly fitting shoes is an important step in preventing falls, Dr. Mohess reinforces.

Educate caregivers. Equally as important as educating patients is educating their caregivers. Dr. Hymes says caregivers should be cognizant of things like struggling gait or a change in one’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,” he says.

Avoid certain medications. Dr. Hymes says 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, as they can hinder one’s ability to function, and slow reflexes and reaction times.

Dr. Mohess adds that over-the-counter medications that are not recommended by a physician, especially those that aid in sleep may pose problems. “People should be aware of and talk to their doctors about all medications they use. Even relatively benign medications such as Benadryl, Tylenol PM, or allergy medications can­ create falls due to drowsiness, confusion and imbalance,” she says. “Anything that causes confusion or even momentary loss of balance can cause falls in the elderly.”

Make sure medical devices are adapted for the home. Dr. Mohess says she recently had a patient who was given a walker due to ambulatory problems. But when he got home, he couldn’t use the walker properly because his floor was carpeted, and it was difficult to move it along the floor. He made his own adaptation instead He made his own adaptation instead, which lowered the fall risk. “Adapting assistive devices and other techniques to the patient’s living environment is critical,” Dr. Mohess says.

Be extra cautious if you’ve fallen previously. Dr.Mohess says older adults who’ve fallen before have a significantly higher predisposition to falling again. “They also develop something we call a fear of falling, especially if they fell and were injured,” she says. “It’s an anticipatory anxiety that happens with walking because they’re so fearful they will fall again. It actually prevents people from participating in physical therapy or walking, and then they become deconditioned. It can really be a vicious cycle.”


If you or a loved one has fallen and needs immediate assistance, find an Inova Emergency Services location near you.

Download a PDF of a Fall Prevention Home Checklist.

Falls Prevention Classes

Inova classes aim to prevent falls in those with limited mobility.

The Inova Trauma Center – Fairfax hosts an evidence-based falls prevention program, Stay Active and Independent for Life (SAIL), which combines aerobic exercise, strength training, balance training and fall prevention education. The classes are taught by Linda Watkins, the Inova Trauma Center Injury Prevention Coordinator at Inova Fairfax Hospital. Classes are held for one hour twice a week for 12 weeks.

The Inova Trauma Center – Fairfax will soon launch an eight-week class called A Matter of Balance, which focuses more on changing one’s mindset regarding falls. This class is ideal for those who’ve had a fall previously or are struggling with mobility. A Matter of Balance will begin in Spring 2020. The classes are primarily for the 65 and older population, Watkins says, though anyone is welcome to participate.

Contact Linda Watkins at linda.watkins@inova.org or 703-776-3259 if you’re interested in participating in these programs.

1 Comment

  1. Sylvester "Sy" on February 1, 2020 at 4:15 pm

    I enjoyed reading the 7 Ways To avoid Prevent Falls and found it very informative and made me aware of a couple of changes I can make in the house, i.e. clearing a pathway in part of the garage and being aware of what I am doing as I move about. Secondly, purchasing some motion sensitive lights so that I have instant lighting when I enter a room or go down the hallway particularly at night. I am a spry 85 yr old recovering from my third corneal transplant in the right eye. Vision is improving. Thanks you enjoyed the letter and the effort you all put in to it.

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