Don’t let a fall put you in a downward spiral

Falls are sometimes used in movies for comic effect, but falls in real life are no laughing matter. Falls are the leading cause of injury or death for people 65 and older, according to the CDC.

For a closer look at the hazards of falls and how to prevent them, we spoke with two experts from the Visiting Nurse Association of Cape Cod.

“Anyone is at risk for falls, but as we age, have visual changes, and our overall strength decreases, we are at a higher risk for falls,” said Erin Fay-Azzato, OT Rehab Practice and Training Specialist.

There are many factors that go into someone’s fall risk, said Eileen Spall, PT, Rehab Practice and Training Senior Specialist. She said some of the things that can put you at risk of a fall, regardless of your age, include:

• A recent illness or a surgery
• A medication change
• Dehydration
• Urinary tract infection

Potential injuries from falls, according to Spall, include:

• Hip fractures
• Wrist fractures
• Spinal fractures
• Rotator cuff tears
• Concussions

The biggest risk indicator for having a new fall is having had a prior fall, she said. Falls are sometimes under-reported, because people may brush them off if they have no injuries.

“We ask patients if they have had any close calls. Have they ever ended up on the floor when they didn’t intend to do that? Anytime you find yourself on the floor and that wasn’t your intended destination, then that is a fall. Often it's a loss of balance that a family member or a caregiver will notice. Maybe they’re reaching out and holding onto furniture or walls.”

Fall Prevention Tips

Here are some fall prevention tips from Fay-Azzato and Spall:

Have a relative look around your house –“Over time, we get used to our own environment and may not even realize the hazards that may contribute to a fall, said Fay-Azzato. “Someone coming in with a fresh set of eyes can spot some risks.

Make sure there’s plenty of lighting – “Your eyesight is one of the most important tools we have to prevent falls,” said Spall. “There should be good lighting, not only in the rooms you use, but in the hallways. This is especially true in the winter, when it gets dark so early. Use night lights or string lights along the hallway from the bedroom to the bathroom.”

Clear out the clutter – “Make sure you have all of your pathways clear of obstacles,” said Spall. “That includes any electrical cords or oxygen lines. You never want those crossing a walkway. Shoes are a common thing that people can trip over. A lot of times people have their pet bowls in an area where they can easily fill them, but that's another thing for people to trip over.”

Rearrange the furniture – “We do this a lot when we go into a home to create a clearer path,” said Spall. “Maybe it’s moving a trash can or a coffee table out of the way to make sure you have a clear path.”

Check the rugs – “I’ll put my foot on an area rug and see if I can move it with my foot, because if I can move it, it’s going to move when people step on it,” said Spall. “It should have a non-skid backing, especially in the bathroom.” Also, frayed edges can be a tripping risk.

Use the safest chairs – “I always ask people where they sit during the day,” said Spall. “Most people have a favorite place to sit while watching TV or reading a book. You want to make sure that that chair is very sturdy and secure, that when you go to sit down, it doesn’t move under you. If the chair is too low, it’s quite hard to get up and you have to use a lot of momentum, which can throw you off balance. I love the university chairs with the full arms. They’re a nice height and easy to get in and out of.”

Be sure access to your bed is safe – If you use a walker, make sure you can get all the way to the bed with it, and not leave it by the door, said Spall. “Sometimes we can change the orientation of the bed to create easier access to the bathroom,” she said. “Your bed should be at a height where you can easily get off and on, without plopping down or climbing up. Grab bars are an easy addition that can attach to a bed frame or slide between the mattress and box-spring.

“Be sure that any bedding at the bottom of the bed is tucked in. If you’re often up at night, sleep in non-skid socks, so you don’t have to reach down for your slippers.”

Don’t create stretching or bending risks – “Keep clothing or items that you use regularly within reach, not on the top shelf or too low in a closet,” said Fay-Azzato. “The same thing with drawers, especially if a bottom drawer is hard to pull out. Keep a stable chair in your bedroom for getting dressed, so you don’t have to worry about your balance while pulling clothes over your head or putting on your socks.”

Pick the right footwear – “Ideally your shoes will have some sort of rubber or non-slippery sole,” said Spall. “No open-heeled slippers or flip flops and no bare feet. Walking in stocking feet, if you don't have the non-skid kind, is very unsafe.”

Move thoughtfully – “Don’t get up in a rush to grab the phone or answer the door, or even to use the bathroom,” said Spall. “Stand up slowly and make sure you’re not light-headed or dizzy. Be aware of any pets and be sure they aren’t in your way. Get up every hour or so and walk around, so you don’t get stiff.”

Don’t be afraid to ask for help – “If you’ve had a fall or near fall, notify your physician because they need to get to the root of it, if there’s a medical reason,” said Spall. “Your physicians may make a referral to physical therapy or occupational therapy for a home safety and fall prevention assessment.

In addition to environmental recommendations, your physical therapist or occupational therapist may also instruct you in an individualized balance and/or strengthening program to minimize your fall risk.”