Frequently Asked Questions About Falls

Some medicines can actually increase a person's risk for falling. The reason is that many of them have side effects such as drowsiness, fainting, or extreme weakness.

If an older adult is taking any of the drugs that may have these side effects, make sure they do not stop taking them until they talk to their doctor. With all medicines, the risk must be weighed against the good it will do. This is a decision that the older adult and his or her doctor should make.  Remind seniors that they should:

Always ask the doctor:

• What does the medicine do?
• When should I take it?
• How should I take it (with meals, not with dairy products, etc.)?
• What are the possible side effects (how your body might react to the medicine)?
• Will the medicine react to any other medicines, foods, drink or herbal supplements I take?
• Should I avoid doing anything while I am taking it (e.g. driving)?
• How will I know if the medicine is working?

Know about the medicine(s) that are being taken:

• Name of the medication(s)
• Reason for taking it
• How long to continue to take it
• Any special instructions (example: take only at bedtime).
• When to call the doctor

Falls threaten the health, well-being and independence of older people. Here are some ways to help reduce the risk of falling that can be shared with older adults. 

General Safety

• When moving from lying down to standing, sit up first and stay sitting a moment or two. Then stand up slowly and stand a few seconds before trying to walk.
• When you first wake up, sit on the edge of the bed and make sure you are not dizzy before you get out of bed.
• Use a cane or walker if you are unsteady. Promptly replace worn rubber tips of these devices.
• Be careful around pets. They can get in front of your feet or jump on you.
• Eat breakfast every morning. Skipping a meal could make you dizzy.
• Wear clothes that fit properly. You can trip on a coat, pair of pants or bathrobe that is too long.
• Don't leave clothes or newspapers on the floor.
• Close cabinet drawers so you won't stumble over them.If you are not close to the telephone when it rings, don't rush to it. Fast, sudden moves could throw you off balance.
• Make sure you have access to a telephone that you can reach to call for help if you fall. Consider carrying a portable phone.

Bath/Bedroom

• Never grab a towel rack, shampoo holder or soap tray for support in the shower. These will not hold a person's weight.
• Let the soap suds go down the drain before you move around in the shower. Do not turn suddenly.
• If you are prone to falling, use a shower chair and a handheld shower attachment.
• Clean up puddles of water immediately.
• Do not lock the bathroom door. That will delay help in reaching you.
• Arrange clothes in your closet so they are easy to reach.
• Replace satiny sheets and comforters with products made of nonslippery material, i.e., cotton, wool.

Stairs

• Never carry any package that will obstruct your view of the next step.
• Keep at least one hand on the handrail.
• Concentrate on what you are doing. Don't be distracted by sounds.

Vision/Lighting

• Wear glasses if you need them, but remove reading glasses before you walk.
• Have your eyes checked regularly. Do not put off getting new glasses.
• Use 100-watt bulbs, as light takes longer to reach the back of your eye where you sense color motion. Note: Only use higher watt bulbs if they do not exceed the warning on your lamps or fixtures to avoid a fire hazard.
• Keep flashlights handy in event of a power outage.

Medication Side Effects

• Feeling weak or dizzy can be a possible side effect of many medications and can increase the risk of falls. Talk to your doctor or pharmacist about side effects caused by your medications, and read the information about side effects that comes with each of your prescriptions.

Sensible Shoes

• Have your feet measured each time you buy shoes since your size can change.
• Buy properly fitting, sturdy shoes with nonskid soles.
• Avoid shoes with extra-thick soles.
• Choose lace-up shoes instead of slip-ons, and keep the laces tied
• Select footwear with fabric fasteners if you have trouble tying laces.
• Use a long-handled shoehorn if you have trouble putting on shoes.
• Shop in the men's department if you're a woman who can't find wide enough shoes.
• Always keep your toenails well trimmed.

Everyone gets older but there are some things that can be done to help reduce the risk of falling. Just by following these several things, older adults increase their chances for avoiding falls and remaining independent.

• Keep moving. Seniors should ask their doctors for a general exercise program that may include walking or other group exercises such as water workouts in a pool, Tai Chi, a gentle exercise, have been proven very effective in reducing risk for falls.
• Follow your doctor's recommendation. Exercises a doctor recommends can improve balance, strength, coordination and flexibility. A doctor may also have referred the physical therapist to the home to provide an individual exercise program to improve balance, muscle strength and gait (how you take steps).
• Use medical equipment when appropriate. The doctor may also recommend a cane or walker to ensure a degree of balance when the individua is moving. The secret to reducing the risk for falls is moving more and moving safely. As a person gets older, he or she is not helping themself by moving less.
• Make the home safer. There should be a periodic check for hazards. The older person may need help with making some compromises to make it safer but it's worth it.
• Stay in touch. If an older adult lives alone,  someone should be checking in on them once daily, or the family should consider paying for an emergency monitoring device. These systems usually have three components: a small radio transmitter (a help button carried or worn by the user); a console connected to the user's telephone; and an emergency response center that monitors calls. When emergency help (medical, fire, or police) is needed, the user presses the transmitter's help button. It sends a radio signal to the console. The console automatically dials one or more pre-selected emergency telephone numbers. Most systems can dial out even if the phone is in use or off the hook. Most systems are programmed to telephone an emergency response center where the caller is identified. The center will try to determine the nature of the emergency. Center staff also may review the person's medical history and check to see who should be notified.

After a senior falls, panic is often the first reaction. However, it's important for family members or family caregivers to remain calm. How some reacts after a fall can sometimes cause more injuries than the fall itself. If an older adult tries to get up too quickly or in the wrong position he or she may make an injury worse. Here are the steps to follow:

• Have the person take several deep breaths, assess the situation and determine if he or she is hurt.
• If you believe the person is injured, do not attempt to get them up. Instead, call 911 or get help from a family member.
• If the person feels strong enough to get up, follow the steps provided by the American Academy of Orthopaedic Surgeons

Although anyone can fall, as a perons ages, falls become more common and more serious. The good news is that older adults do not need to let the fear of falling rule their lives. With some medical management, physical activity, and common sense seniors can help avoid falls and stay independent longer.

Normal aging and risk for falls

A person is more likely to fall as he or she ages because of normal age-related physical changes and medical conditions - and the drugs that are taken for those medical conditions. As someone ages, time takes its toll on the body and the person may find themselves taking more medications or experiencing some limitations in mobility. While the changes are unique to each individual, many aging changes are common and put older indivudals at higher risk.

• Poor eyesight. Seniors may not see as well which affects their coordination and balance.
• Reduced reaction time. The nerves that carry information from an older adult's brain to his or her muscles can deteriorate slowing reaction time and the ability to move away from obstacles quickly enough. (I.E. Avoid an ice patch on the sidewalk.)
• Decline in muscle strength. Normal decline in muscle strength and joint flexibility can change how easily a senior stands up, walks, or gets out of a chair.
• Limited movement. If an older adult does not regularly exercise, changes occurring with the aging process can be worse.