Here are the facts
One in three adults over the age of 65 fall every year.
2/3 will fall again within 6 months.
95% of hip fractures are causes by falls.
Falls are the leading cause of death in the 65+ age group and the most common cause of hospital admission.
Over 70% of emergency room visits of people 65+ years old, were related to falls.
Falls often and quickly lead to the loss of independence.
Who’s at risk of falling?
- women more than men
- people who are older
- people who live alone
- people who lack physical activity
- people who have fallen before
- people with disabilities, gait and/or balance problems, ambulatory or walking device or wheelchairs
- people who take multiple medications
- those with urinary incontinence
- reduced vision is a hazard and prescription drugs can cause vision problems.
- hearing loss, even mild hearing loss is a factor.
There’s no debate. HSPers fall more than average so it’s important that we do what we can to minimize our falls – not just because of the embarrassment of falling, but because we can get very seriously hurt (hospital emergency room visits!) and that can very negatively impact our lives (loss of independence!) and the lives of our loved ones.
Another factor to consider is that those who understand their increased risk of falling often experience fear of falling. Unfortunately this can further reduce physical activity, making falls more likely and leading to increased isolation. Understanding the negative impact of this might help motivate people to set realistic goals for increasing activity.
Research shows that educational materials alone are not enough. More needs to be done! What you can do?
- Get moving – exercise and increase your activity. There is proof! Exercise programs containing balance and strength training, and specifically Tai Chi are helpful. While we’ve always recommended sessions with a trained physiotherapist, there are simple exercises below (under Evidence Based Programs) designed to reduce falls in elderly. A very serious issue HSPers should think about is the risk of falling backwards. Physiotherapists have recommended HSPers spend time safely and slowly walking backwards (along a wall with one hand on the wall or on a treadmill) and elderly are being encouraged to do the same. (see Otago website below.)
- Wear the right shoes.
- Talk with your physiotherapist or occupational therapist about falls, how to fall and how to get up again.
- Discuss your medications with your pharmacist and falling issues with your doctor.
- Get your vision and hearing checked
- Check your home for risks – and eliminate rugs, power cords and other obstacles. Add grab bars in the bathroom and lighting on stairs. You’ll get more ideas of ways to make your home safer in this Home Fall Prevention Checklist for Older Adults.
For Wheelchair and Scooter Users:
- Consider the way you transfer, and share that info with others
- Lock when you transfer
- Turn off power when not in use
- Don’t remove features (like anti-tip gear)
- Don’t add things that throw the weight off (like backpacks)
- Don’t take risks.
Evidence Based Programs
Matter of Balance
One of those programs is called Matter of Balance and there is interesting and motivating information in two short videos here: http://www.mainehealth.org/mh_body.cfm?id=432
Otago is a muscle strengthening and balance retraining program that can reduce falls. It is delivered at home by a physiotherapist through seven home visits over one year. The New Zealand Falls Prevention Research Group developed and tested the program. The rationale behind Otago is that while muscle strength, flexibility, balance, and reaction time are risk factors for falls, they can easily be modified. Always check with your primary care provider and physiotherapist prior to beginning any of the Otago strength, balance, and walking exercises.
Here you can find videos of or printed illustrations for the exercise program. http://www.med.unc.edu/aging/cgec/exercise-program/patient-resources
The US’s National Center on Health, Physical Activity and Disability (NCHPAD) is positioned to effect change in health promotion/obesity management among people with disabilities through its existing 13-year history of providing advocacy, services and programs to numerous organizations and people. For free, web-based personalized fitness programs for all sorts of debility levels, they have a ton of good information on their website, including 14 week fitness programs here:
And an intro to strengthening exercises here: http://ncpad.org/374/2096/Strengthening~Exercises
Falls Prevention Programs
Various fall prevention programs are offered throughout Australia. A few are listed below. Please verify qualification first, as some programs have age and physical restrictions. You can also inquire with your local hospitals and community centers for courses.
Stepping-On was developed in NSW and is considered to be one of the most effective falls prevention programs available, giving people the confidence to undertake their everyday activities safely. http://www.activeandhealthy.nsw.gov.au/program_types
A Stepping-On program for North Coast communities http://healthynorthcoast.org.au/activities/stepping-on/
A free program from Hawkesbury District Health Service in NSW http://www.hdhs.com.au/uploads/PDF/stepping-on.pdf
Exercise Medicine Australia (EMA) offers Tai Chi courses for health and falls prevention including standing and chair based modules. http://www.exercisemedicine.com.au/fallPrevent.asp
Otago options for Queenslanders http://www.health.qld.gov.au/stayonyourfeet/for-professionals/otago.asp
North Eastern Rehabilitation Centre (in Ivanhoe near Melbourne) http://www.northeasternrehabilitationcentre.com.au/index.php/our-services/falls-prevention-and-balance-program/
Data for this article comes from the Webinar Preventing Falls in Adults with Disabilities and Chronic Health Conditions 09/17/13 http://www.spinalcord.org/webinar-archive/