Growing Old Isn't For Sissies: Understanding Fall Risks, Prevention and Recovery

Each year, millions of older people—those 65 and older—fall. In fact, one out of three older people falls each year, but less than half tell their doctor. Falling once doubles the chances of falling again. Falls account for 25% of all hospital admissions, and 40% of all nursing home admissions, and 40% of those admitted do not return to independent living; 25% die within a year.

An Aging Population

The increasing number of falls correlates, ironically enough, with our general improvement in health and extended life expectancy. The average life expectancy of someone in the United States has increased from approximately 50 years at the beginning of the 19th century to 74 years in 1980 and 78 years in 2010.

Key balance & fall concerns in the geriatric patient:	Common risk factors for falling include:
Medications Vision Appropriate footwear Non-essentials on the floor Poor lighting Muscle weakness and coordination	Use of medication (sedatives) Stroke, balance and gait disturbances Loss of joint mobility and strength Dementia, decreased cognition Parkinson’s Disease, neuropathy Dizziness, postural hypotension, Poor circulation, foot disorders, acute illness Visual Impairments

I’ve Fallen, Now What?

So what can you teach your client to do if they’ve fallen? It’s critical that they be made to understand how important what they do next is. Teaching them these steps can speed up how quickly help can reach them to prevent a tragedy.

• Relax, take a few deep breaths
• No one should pick them up off the floor unless they are a medical professional
• Self-Assess for injuries:
  • Ankle pumps, circles to assess for possible ankle injury
  • Heel slides to assess for possible knee, hip, or pelvic injury
  • Wrist pumps, rotate, open and close hand to assess for possible wrist or hand injury
  • Ceiling reaches to assess for possible elbow, shoulder, or scapular injury

Everything Moves?

Good news, chances are your client hasn't suffered an immobilizing injury and can crawl to a stable object and get off the floor. It is still recommended they seek medical attention as they could have sustained a head injury and been on the floor longer than perceived. There could be a compression fracture in the spine, or internal bleeding that requires immediate medical attention.

Cannot Heel Slide?

If they cannot do a heel slide, it's possible they have a knee, hip or pelvis injury. The only option is to scoot backwards to a phone REACHABLE from the floor to call 911. When calling from a cell phone it’s important for your client to know that they MUST provide specific address and location. If they are the least bit confused, they will not be located. When calling from a land line the 911 operate knows exactly where they are without question and can help immediately.

Cannot Heel Slide OR Reach for the Ceiling?

With this scenario, we are looking at a possible double injury to the upper and lower body, making mobility nearly impossible. The ONLY survival for this is “lifeline”, or medical alert monitoring system. Medical alert systems usually carry a monthly fee, starting as low $27 per month. These are the steps your client can take to get themselves help after an incident, but certain preventative measures can help reduce or eliminate the chances of subsequent falls. Understanding risk factors, balance assessments, and balance exercises not only reduce the chance for falls, but also gives your clients the skills to deal with any future incidents. For a full plan of attack in helping reduce the risk for falls and safe methods to recover, check out the course the information provided here came from, “I’ve Fallen, Now What? Helping Educate Your Patient Following a Fall” by Shari Kalkstein, PTA, NSCA/CSCS, ACSM/HFI, ACE/CPT. Shari's courses and several others are on sale this month with promo code SAFE16.