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Fear of Falling

By Frances Maguire Paist

Today's Caregiver Magazine: Fear of Falling

Until it personally touches you, falling seems pretty innocuous. But itís touched me, and life hasnít been the same since. He was a man I respected. In fact, he was a man everyone respected. Such an example of leadership and moral value, he embraced everyone he met, never putting himself first. He was ageless, really, and when he made the decision to climb a ladder one day while his wife was out, he never thought about the danger. He was simply doing what he had to do. But he fell. And then he died.

According to the Home Safety Council, falling causes more than 4,700 deaths and over one million medical visits annually for adults 65 years and older who have initially fallen at home. Widening the net, about 38 percent of all unintentional injury deaths among older adults were caused by falls in 2002, and an astounding 1.64 million seniors were treated in emergency rooms nationwide for non-fatal falls the same year. The National Center for Health Statistics and the Centers for Disease Control & Prevention state that by 2020, the national cost for falls by adults aged 65 and older is expected to reach a staggering $32.4 billion annually.

Itís a very big problem and yet, until now, falls prevention has been largely ignored except in specific settings, treated instead as an inevitable fact of aging. But through the combined efforts of the Home Safety Council, the National Council on Aging (NCOA), the International Council on Active Aging (ICAA) and the Archstone Foundation, the nationís first falls prevention action plan has been developed and released. Falls Free: Promoting a National Falls Prevention Action Plan sets forth ideas and strategies to help reduce falling dangers for older adults. Says Home Safety Council President Meredith K. (Meri-K) Appy, ďThe National Action Plan will help consumers, health care and service providers, policy makers and the housing and remodeling industry become more aware of, and promote, home safety measures that can lower the risk of falls. Through this important initiative, we hope that all older adults and caregivers will have knowledge and access to critical resources that can help reduce fall dangers and increase the safety of their homes.Ē

Senior adults face four major risk areas for falling: physical mobility, medications management, home safety and environmental safety in the community. Beginning an exercise program that increases strength, balance and flexibility will help older adults enhance their physical mobility. Additionally, by making them aware that falling is a common side effect of certain prescription and non-prescription medications, elders will learn to request medication reviews with their physicians who will in turn educate them about the risks of certain drugs. Since the home is the place where most falls occur, it is imperative to implement home safety measures to reduce risks. Examples include installation of grab bars near commodes and in showers and tubs. Finally, older citizens need to be made aware of falling risks in the community and educated about ways to prevent this from happening. At the same time, communities must accept the challenge of improving their environments to better accommodate elders.

Caregivers can help their loved ones avoid falling by ensuring that, in addition to those noted above, the following important matters are accomplished:

  • Make certain that alcohol intake is limited by seniors. Even a small amount can negatively affect balance and coordination.
  •  Avoid having older adults rise too quickly from a sitting or reclining position.
  • Get vision and hearing check-ups on a regular basis for the older person in your life.
  • Ensure that the senior in your care uses a cane or walker to help maintain balance on uneven surfaces.
  • Outfit elders in sturdy, non-skid, low-heeled shoes.

Fall proofing the home is another excellent way to support this important initiative on a personal level. Following are some ideas that are sure to help. Starting at the entrance to the home, install sturdy handrails adjacent to steps. Make sure that the inevitable level change from doorjamb to floor is clearly delineated. This can be done with a color or texture change showing height changes and level differences. In the living area of the home, get rid of shag carpets and other rugs as they can easily trip anyone, including our older friends and relatives. Remove glass tables.

 Instead, use sturdy wooden tables with rounded corners. Arrange furniture so that there are open pathways and keep electrical, telephone and computer cords out of the pathways. Remove objects like toys, crayons or magazines that could cause slips and stumbles, and be careful that children and pets donít unwittingly get in the way and cause falls. In their exuberance and affection, pets often jump up onto a person, and children will run and hug a grandparent or older friend around his or her legs. This can easily offset oneís balance. In the kitchen, clean up grease and liquid spills immediately and never wax floors. Avoid climbing or reaching high cabinets or shelves. If you must do this, use a sturdy stepstool and try to make sure another person is nearby. In the bathroom, use a nightlight and bathroom rugs that have non-skid backings. Install grab bars by commodes and in the tub/shower area. Vary wall and fixture colors so older adults can more easily see the edges of things. Make sure shower stalls have shatterproof glass. Always make sure the older adults in your life avoid icy surfaces as a slip or fall on the ice could be devastating.

No matter the risk involved, it is important not to let fear get an upper hand. In an almost vicious cycle, some seniors limit their activities unnecessarily so as to avoid falling. Itís even been said that 80 percent of seniors avoid going outside in the winter. But this tendency towards over-protectiveness means less physical activity and results in reduced strength and flexibility. And in a never-ending cycle, reduced strength and flexibility means an increased chance of falling. It is incumbent upon the caregiver to help the older ones they love stay active and involved. Research shows active individuals are more alert and better able to withstand the risks associated with falls. And, besides, at the end of the day, two is better than one anyway. Noah knew that.

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