Preventing falls is about balance – physical, medical, and nutritional
Anyone can fall. But according to Health Canada, seniors fall more often, and the consequences are more serious. More than one in three Canadians over 65 will fall each year. Half will have an injury that reduces their mobility and independence.
Physical changes that occur with aging increase the risk of falling. Muscles lose strength and flexibility. Balance reflexes slow down. Vision is poorer. Health conditions like arthritis, stroke, and Parkinson’s disease increase the risk of falling. What’s more, some prescription medications, such as drugs to control blood pressure, interfere with balance.
These risk factors are cumulative — the more risk factors you have, the greater the risk of falling. Recognizing these factors is the first step in preventing falls. The next step is adjusting home and lifestyle to reduce as many risk factors as possible, and stay safe.
Keeping a healthy balance of physical, medical, and nutritional factors in your life will help you to live an active life and prevent falls.
Exercise is one of the keys to preventing falls. It maintains your strength, endurance, and bone health. It also contributes to balance. There are many ways to exercise – from dancing or walking to armchair fitness. You can go to a gym, but you can also get your exercise at a shopping mall, a senior centre or just at home. Talk to your health care provider about the best program of exercise for you.
Many seniors enjoy walking their pet as a form of exercise. One caution: be careful around dog leashes, which can cause falls.
Safety aids and supports
Have your vision and hearing checked regularly. Wear your glasses or hearing aid(s). Wear good supportive footwear with closed heels and toes, and of proper size.
Use an aid for walking if you need it. The new Nordic-style walking poles are becoming very popular.
Keep your home well-lit. Make sure stairways have good lighting. Install a night light at the top of the stairs. Keep a flashlight near the bed in case the power goes out.
Don’t stand on furniture to reach a shelf. Instead, use a sturdy stepladder. If you have been having balance problems, ask for help. Put items that you use a lot on the lower shelves. It is easy to ‘overbalance’ and fall if you are lifting something heavy over your head.
Install handrails and grab-bars in bathrooms and stairways. When you carry things up and down the stairs, always keep one hand free so that you can hold on to the handrail.
View all of your safety aids and supports as sources of strength to help you do things independently, not signs of weakness.
Maintaining your balance
Talk to a doctor or pharmacist about the possible side effects of any medicine you take, especially drowsiness or dizziness. Be sure to ask about its effect when combined with other medicine, food or health supplements you take. If you take medicine for blood pressure, ask your doctor or nurse to measure your blood pressure both while sitting and standing. Some people find that their blood pressure may drop when they stand, which can make them dizzy. An adjustment to the dosage of medication may be required.
You can help to prevent morning dizziness by sitting on the edge of the bed for 10 seconds before you get up.
Take good care of your feet. Make sure that any corns, calluses, or long nails are trimmed. Get your feet checked regularly, especially if you have diabetes.
A healthy diet maintains strength, balance, and resistance to disease. Some people find it helps to eat smaller meals throughout the day rather than the traditional ‘three squares’. If you drink alcohol, watch out for its effect on your balance and walking. This goes double if you are also taking medications.
Tips for controlling hazards at home
- In winter, keep steps and walkways clear. Use salt or sand on ice.
- When walking outdoors in winter, put tips on canes and other walking aids that help prevent slipping.
- Wipe up any spills as soon as they happen, especially on ceramic floors.
- Don’t leave clutter on the stairs.
- Remember to slow down, even if you are late. In a rush, it is easy to overlook hazards.
About the Author
Compiled by the Seniors’ Health Division, Canadian Physiotherapy Association
Preventing Falls in Older Adults
By Mark Speechley, PhD
First, the good news: everybody falls – it’s normal – ask any toddler or hockey player! And fortunately, most falls do not cause serious injury.
Now, the not so good news: as we age, about one third of us start to fall in situations where we would not have fallen when we were younger. Suddenly, we slip on a floor or trip over a doorsill that we’ve used safely for decades. This is a warning sign. When older adults fall, they are about two and a half times more likely to fall again in the next year.
The consequences of falls can be major – a broken wrist, leg, hip, even a head injury. And, it usually takes older adults longer to recover. Injuries to bones, muscles, and joints can restrict your movements and keep you from living as independently as you would like.
But, back to the good news: an unexplained fall can be a great opportunity for you to start taking back control. Excellent research on thousands of people has shown clearly that many falls can be prevented.
Why do we fall?
Most falls happen for more than one reason. Normal, age-related changes in our body combine with things in our environment to cause a fall. For example, cataracts in our eyes reduce our ability to see in dim light, and it is normal for our legs to become weaker with age. These factors can come together and make us trip over something because we didn’t see it, or couldn’t recover our balance in time.
The best approach to fall prevention is to use strategies that adapt your body to your environment, and adapt the environment to your body.
Adapting your body to the environment
Your balance system is an amazingly complex machine that usually works automatically. With proper maintenance, it can be kept in good operating condition. The research evidence is overwhelming that regular physical activity is good for you in many ways, including preventing falls. The most helpful exercise programs involve walking, lifting weights, yoga, swimming, or Tai chi.
Leg strength is very important to our balance system, and it can be maintained through regular walking. You can increase grip strength in your hands by squeezing a small rubber ball, even while you watch television. Get regular eye checkups to keep your eyeglass prescription up to date. Take care of your feet, because corns and calluses can impair balance.
Dizziness is a common complaint in older adults. Certain medications can impair balance. Be sure to mention any problems with dizziness to your doctor, especially after starting a new medication. Keep an up-to-date list of all your prescription and over-the-counter medications. Show it to the doctor, nurse practitioner, or pharmacist before starting any new medication.
Some falls occur when people are in a rush and not paying full attention. Perhaps everyone would be a bit healthier if we could just slow down a bit!
Adapting your environment to your body
Here are some tips on fall-proofing your environment:
- Install brighter lights in dimly lit areas, especially staircases.
- Install handrails on stairs that are of the right size for you to grip.
- Put non-slip strips on the bottom of rugs beside your bed or the bathtub to prevent them from slipping across the floor. Or, replacing them with mats with a rubberized bottom.
- Have grab bars installed in your bathtubs. (Get help from an occupational therapist on installing these properly.)
- Wear shoes that fit properly and do not have slippery soles or heels. Slip treads over your winter boots to improve your grip on ice during winter.
Have you considered using hip protectors? These plastic shields fit in pockets in your underwear, right over your hipbones. Several excellent studies have shown that they can reduce your risk of hip fracture when you fall. Like seat belts, they can be a little uncomfortable in the beginning. Also, like seat belts, you have to wear them for them to do any good!
Maintaining bone health
Research has shown that physical activity, sunlight, and social activity are good for us in many ways, including our bone health. Combine them with a healthy diet, supplemented with Vitamin D and Calcium.
Weight-bearing physical activity helps keep your bones strong to reduce the risk of fracture if you do fall. Tai Chi and strength training are two weight-bearing exercises that have been proven very helpful in preventing falls. They increase the strength of your legs, ankles, and feet. They can also improve your walking stride and to help you keep a good sense of balance.
Before you start any physical activity program, discuss your plans with a health care professional. Make sure that the program emphasizes safety and can be tailored to suit your needs. This is especially important if the activity is new to you. Get guidance from a qualified leader.
Your local seniors club or public health unit can probably help you find physical activity programs for older adults. If there aren’t any programs for older adults in your community, see if you can get one started at the local seniors club, recreation department, college or university.
Professionals who can help with preventing falls
Your family doctor or nurse practitioner can address overall health, dizziness, eyesight, and medications. Physical therapists and kinesiologists are experts on muscle strength, range of motion, and exercise programs. Occupational therapists are experts on helping you make your home environment safe. Nutritionists are experts on healthy eating.
About the Author
Mark Speechley, PhD, Western University, London Ontario