Preventing Falls

As people age, the chance of having a negative outcome from a fall increases. This is especially true after the age of 70. Falls can result in soft tissue injuries, fractures, increased dependence on others, and serious complications post-injury. Psychological trauma can also result in a fear of falling, and a loss of confidence. This can lead to a decreased activity level, resulting in a loss of strength and balance, and lead to an increased risk of falling in the future.

Causes: There are many reasons that elderly people fall. These reasons can be divided into two main categories of internal and external factors.

Internal causes include aging related factors such as changes in vision, gait, the center of gravity, body sway and a position sense. Internal factors also include cognitive impairment such as dementia, including memory loss, and poor judgment. Medications can cause drowsiness, dizziness as well as increased confusion. Agitation and anxiety are strongly associated with many falls in the elderly population.

External factors include environmental hazards such as an unfamiliar setting, and a poor sensory environment. Inadequate lighting, a lack of visual contrast between floors and walls, glare from direct sunlight, or a highly polished floor can affect an elderly person's perception and ability to see. A very cluttered environment and changes in the floor surface can lead to falls, along with shoes that have little support or a slick sole.

A common factor in many falls is the need for elimination and hurrying to get to the bathroom. This is especially problematic at night.

Prevention Strategies: older adults need three times more light than younger people, and night lighting is especially important. Furniture should be placed to prevent obstruction of walkways. Decreasing clutter and securing or eliminating throw rugs also make the environment safer. Tubs and showers should be equipped with grab-bars and nonskid surfaces.

The best way to prevent falls is to build strength through exercise. Encourage strengthening and balance exercises on a regular basis. Also, the elderly person needs to be reminded to focus on their walking and to lift their feet when walking. Provide sturdy shoes with nonskid soles to increase stability and to decrease the chance of slipping.

According to a study done at Yale University, many falls in elderly could be prevented by targeting muscle weakness, poor balance, vision loss, proper footwear, and monitoring medications.

Many elderly need frequent verbal cues when changing positions, especially when using a walker. it helps to keep the instructions short, specific and simple, giving one step at a time.

Here is a list of some specific cues that the caregiver can use:

Sitting to Standing to Walking

1. Place feet in correct alignment before attempting to stand.
   


2. Push up to standing position using the chair arms, not the walker or assistive device.
   


3. Encourage strengthening thigh muscles to improve stability when changing positions through exercise and weight training for seniors.
   


4. If dizzy or wobbly, stand still before beginning to walk.
   


5. Check posture before walking. Remind to stand straight.
   


6. If using assistive device, grip correctly.
   


7. Walk.

Standing to Sitting

1. Back up to chair.
   


2. Make sure back of legs are touching chair.
   


3. Reach around to grasp arm of chair before sitting.
   


4. Lower trunk slowly into chair to sit.

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Peninsula Volunteers, Inc.
800 Middle Avenue
Menlo Park, CA 94025
Telephone: 650-326-0665
Fax: 650-326-9547