The Importance of Preventing Falls

Falls happen in a moment, but their impact can range from minor discomfort to deadly. In the U.S., falls cause more than 95 percent of hip fractures and up to 40 percent of traumatic brain injuries. Bone fractures account for about 70 percent of reported fall-related injuries. People often break wrists and arms as they try to break their fall. They may also fracture legs, ankles, ribs, and other bones, and suffer soft tissue injuries such as bruises, lacerated skin, and torn muscles and ligaments.

Young children are exploring their world, learning to use their bodies, and playing sports. They fall the most, but because of their small size they tend to avoid serious injury and usually recover quickly. The number of falls starts to increase at age 18 and continues to rise until age 75 and above, when falls peak at 115 per year per 1,000 people.

According to the federal Centers for Disease Control, falls cause 55 percent of traumatic brain injuries (TBIs) in children from birth to age 14. Falls are the leading cause of TBIs in adults aged 45 and up, and cause 85 percent of TBIs in people age 65 and older. TBIs are responsible for 30 percent of all deaths due to injury.

Even among young people, a fall-related injury can have serious consequences. A broken wrist, for example, may leave someone temporarily unable to work or drive. Cooking, eating, grooming, and personal hygiene may become difficult. For the elderly, who may have fragile bones and generally poor health, a fall may lead to loss of independence, moving to a nursing facility, and even death.

Falls are the leading cause of death due to injury among seniors, according to the federal Centers for Disease Control. An estimated one in four adults aged 65 and older falls every year. In 2014, there were an estimated 29 million falls among seniors, causing 7 million injuries and more than 27,000 deaths. The cost of treating these falls was $31 billion. Seniors who have fallen once have more than double the risk of another fall than seniors who haven’t fallen. They may become so afraid of falling that they limit their activities and seldom leave their homes. This isolates and weakens them, putting them at even greater risk. About half of seniors who have fallen don’t tell anyone, for fear of losing their independence.

Among the elderly, hip fractures are the most dreaded result of a fall, with good reason. About 25 percent of seniors who suffer a broken hip die within the first year. Men are more likely to die than women. Survivors are left weakened by prolonged immobility. Only about half recover the function they had before the fall. Many will need assistance, either at home or in a nursing home, for the rest of their lives.

Fortunately, falls are preventable, and fall prevention benefits everyone. Preventing falls has two prongs: keeping people healthy so they don’t fall and injure themselves, and removing or reducing fall hazards in their surroundings.

People who are worried about falling should discuss their concerns with their doctors. It’s important to be honest about whether they’ve fallen already. Doctors can assess the risk of falls. They can look for underlying conditions that may be affecting strength, balance, and coordination, prescribe treatment, and order bone density tests.

Some medications can interfere with balance and alertness, such as opioid pain relievers, some blood pressure drugs, sedatives, and antihistamines. A pharmacist can look for harmful drug interactions. Alcohol abuse increases fall risk and should be addressed.

Eyes should be examined yearly. Cataracts, macular degeneration, and outdated lenses can make it difficult to see hazards and judge distances. Bifocals can make objects look farther away than they really are.

Exercising regularly builds strength, balance, and coordination. Yoga, Tai Chi, and Pilates are especially recommended. Look for a class aimed at people of your age and fitness level. Weight-bearing or resistance training increases bone density. A personal trainer can recommend safe exercises and guide you through them. If you’re out of shape, check with your doctor before starting an exercise program. Exercise also enhances alertness. Good nutrition promotes overall health and protects bones and muscles.

Shoes should have low heels, soles with good traction, and offer good support. If the outdoors is slippery or balance is a problem, use a cane, trekking pole, or walker for stability.

In the home, good lighting is essential. Don’t scrimp on light bulbs! Lights should be shielded or aimed so they don’t create glare. Light switches should be easy to see and reach. Night lights can help people orient themselves and avoid obstacles if they have to get up in the dark.

Throw rugs are a prime tripping hazard. Clear the floors of trash, clutter, electrical cords, toys, pet supplies, newspapers, and magazines. Wipe up spills promptly and forgo the slippery floor wax. People can and do trip over small pets who haven’t learned to stay out from underfoot. If a family member is at risk of falling, either keep the pet away or have a serious discussion about rehoming.

Stairs should have handrails on both sides. Don’t use stairs as storage shelves. If possible, have the washing machine and dryer on the living level so people aren’t lugging laundry hampers up and down poorly designed basement stairs.

Many falls happen in the bathroom. Install grab bars near the tub, shower, and toilet and apply non-skid surfaces in the tub or shower. Keep outside walkways free of ice, snow, wet leaves, and clutter. Avoid smooth stone paving that becomes slick when wet. Use non-skid strips or paint on stairways, porches, and decks. Turn on exterior lights if people are coming and going at night.

As long as gravity endures, falls will be a part of life. Prevention can reduce the risk and, if a fall does happen, limit the impact.