From 2021-2022, in the WakeMed Trauma units at Raleigh Campus and Cary Hospital, the upward trend in falls has also been evidenced — with a 8% increase in falls-related trauma among patients 65+.
Fall prevention is critically important as people age — since falls account for a significant number of injury-related deaths in adults 65 and older. Despite this reality, the number of impacted adults is steadily on the rise.
What’s Age Got to Do with It?
As we age, we may experience numerous changes in our health that increase the likelihood of a fall.
- We may be less active or fit than when we were younger which may lead to poorer balance and weaker muscles. As such, a slip or trip can more easily turn into a fall.
- Dehydration and poor nutrition may also contribute to an increased risk of falling since these issues cause dizziness and a drop in blood pressure.
- Previous falls also make an individual more susceptible to falls because the person likely has risk factors that led to the first fall.
- With age, some people experience limitations in mobility and range of motion with daily activities of living. This can result in impaired gait and balance and poorer reaction times. There are several reasons why older adults have more mobility and range of motion issues. These include depression, dizziness, incontinence, cognitive difficulties, arthritis, diabetes, pain, biological female sex, osteoporosis, living alone (falling without someone available to assist with getting up) and foot issues (calluses and nail deformities can affect balance).
- Low vision may happen with age, making it more difficult for older adults to see trip hazards in their path.
- Accumulating medical problems often occur with age and this along with polypharmacy (taking more and more medications due to having more medical problems) increase chances of falling.
Why Falling Really Hurts with Age
We experience a decline in our strength as well as the ability to recover quickly when suffering injuries to our muscles, bones and other tissues as we age. This is noted by the fact that older persons have an increased risk of injury compared with a younger person who may experience the same impact.
Preventative Measures
There are actionable steps we can take to prevent falls and strengthen our bodies as we age.
- Exercise: Consider endurance, Tai chi, resistance and flexibility training. Partake in exercises that strengthen balance, such as walking heel to toe and standing on one foot.
- Review medications: Psychiatric medications, such as antidepressants, sedatives, hypnotics and benzodiazepines as well as taking more than four regular medications per day are all linked to an increased risk of falling. Discuss risks and benefits of medications with your provider, and discontinue unnecessary medications, if possible.
- Supplement vitamin D: This vitamin helps to improve muscle strength and balance. I recommend 1000 IU daily as it can help prevent falls by 19%.
- Access a home risk assessment from an occupational therapist: This evaluation can help shore up methods in the home to help prevent falls, especially for those at risk for falls who are recently discharged from the hospital or rehab.
Fall Dangers in the Home
Many older adults fall in the place they feel safest — at home. Despite the home being a major danger zone for falls, there are actions we can take to eliminate several slip, trip and fall hazards.
- Improve lighting: Add night lights for better night vision and brighter bulbs for all day.
- Clean up clutter: Remove boxes, newspaper, electrical cords and phone cords from walk paths. Rearrange furniture, so it is not in the way when walking. Make sure the sofa and chairs are the right height, so it is easy to get out of them.
- Repair/remove tripping hazards: Remove area rugs and house plants. Replace slippery floors or add an anti-slip coating.
- Install grab bars where needed: A few helpful spots where falls are more likely include the bathtub, toilets, hallways and stairways. Raised toilet seats can also be helpful.
- Wear shoes with good traction.
- Add non-slip mats: These can be useful in bathtubs, showers, floors in the kitchen, bathrooms and porches.
- Live on one level in your home: Stairs greatly increase the risk of a fall.
- Move slowly: Pause when moving to check your surroundings.
- Watch for your pet: Know where your pet is lying when you stand up or walk around. A bell on your pet’s collar can help you hear your pet to prevent a fall.
- Follow up with your primary care provider for a possible referral to occupational therapy if ever you have a concern of falling: An occupational therapist can help brainstorm fall prevention strategies after a home assessment.
When to See a Provider after a Mild Fall
When it comes to advanced age, it is always a good idea to see a provider after any fall, not just the ones that result in sprains and strains. This fall could be a sign of a new medical problem.
Visiting a provider can help identify risk factors for future falls. It can open a conversation to review medications, especially if taking blood thinners. It can also lead to referrals for physical therapy/ inpatient rehab for balance issues, vision/sensory evaluations, home safety referrals as well as psychological referrals (sometimes patients develop a fear of falling which can reduce their ability to do activities of daily living).
How to Know if a Fall is Serious
It isn’t always clear where to go after a fall if you “recover” and are able to resume your life. However, if you become confused or disoriented after falling, visit a medical provider immediately.
Go to the emergency department if you have a broken bone coming out of skin, a body part pointed in the wrong direction and possible broken bones in the face, ribs, skull or pelvis. For less severe broken bones, Wake Ortho also offers urgent care.
Emergency care is needed if a fall is followed by loss of consciousness, trouble breathing, fainting or other severe symptoms.
What if You’re Not Sure Where to Go?
You are always welcome at MyCare 365 where our providers offer primary and urgent care for falls, including sprains, strains and simple fractures. WakeMed MyCare 365 offers a unique blend of primary and urgent care services, all in one location. Available 365 days a year, our physician-led team of clinicians offer convenient access for routine and non-life-threatening illness. Access and availability on a walk-in basis, weekends and from home or in person, means you and your family have the care you need when you need it.
About Lucy Phung, PA
Lucy Phung, PA, is a board-certified physician assistant with clinical interests in metabolic diseases such as diabetes, obesity, hypertension, and hyperlipidemia. She received her master’s degree in physician assistant studies from Methodist University in Fayetteville, North Carolina, and bachelor’s degree from the University of North Carolina. Lucy joins WakeMed with experience in primary care and urgent care specialties.
Lucy advocates for her patients through health education so they can achieve their health goals. Outside of work, Lucy enjoys cooking, traveling, spending time with her family and volunteering.
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