When I started taking care of Dad (he was 93 1/2) I was aware that falls in elderly are the main reason for accidents for those age 65 and over. And it became my primary concern when he moved in with me. Especially since he was almost deaf and blind with macular generation.
Dad was proud too, as many seniors are. He exercised twice a day (only appropriate exercises for the elderly) was fully ambulatory, not even needing a cane. And wanted to keep it that way. So did I — yet we had to be careful. I did not want a literal outplaying of “pride goeth before the fall”!
Then one day when Dad was almost 97, it happened. Out of the blue. He fell. By this time he was using a cane. He was in his bedroom, and I was in the next room. It was afternoon and he was going to lay down for his nap. I heard a big “boom” and went running in. He was sitting on the floor by the wall and said he was fine.
I checked him and he seemed OK, no apparent signs of concussion. When I asked, he said he didn’t know what happened — he “just fell.” But being rather limber, he got right up and had no hurts or injuries whatsoever. We thought. I take my caregiver duties very seriously and was alarmed out of my wits. I called the doctor and we went right in. I also wanted to talk about stroke symptoms.
The doctor did not think he had a concussion. She wanted to do a brain scan anyway, common with falls in elderly. She said if I heard a big boom, chances are he had banged his head. And may have bleeding in the brain. If so, I would have to make an immediate decision.
Either take him to the hospital that very afternoon to have a hole drilled into his skull and the blood drained out (which he may not survive); or if we did not choose that, to let her know right away. Because he would die. And we’d have to prepare ourselves fast.
I was in shock. Because of Dad’s deafness, he was not fully comprehending this. She told me not to feel responsible, that such falls in elderly can happen anywhere not just at home, even in a facility with full nursing staff all around. (The doctor later believed he may have had a mini-stroke that can cause elderly falls).
And if everything was OK, the doctor said Dad was still better off living with me at home. And I’d dealt with the important safety issues that could affect him. Thankfully, the scan showed everything was OK. But it was a very sobering few hours.
Especially since the next day I was going to the funeral of my very good friend’s mother. Who had just died. From bleeding in the brain. From tripping and falling off the step on her shuttle bus. She had seemed perfectly fine, they took her to ER, she went unconscious, and died within three days. There was nothing the doctors could do.
We know that falls in elderly can abruptly change one’s quality of life. Sometimes it can be a matter or life — or not.
We’re all familiar with a medical alert system for getting help, and basic prevention methods for falls. But falls in the elderly has still continued to be one of the most persistent problems. And expensive. It’s been estimated that one in three American seniors over age 65 falls. Of those, at least 30% require treatment.
Statistics to verify this are there, says the Centers for Disease Control (CDC) and National Council on Aging, but not exactly accurate, since many falls in the elderly are not reported. Nor do our older loved ones always go to the doctor or hospital.
A common and serious result of falls is hip fracture. An estimated 25% percentage of hip fractures result in death. (My own doctor advised me that elderly usually don’t fall and break a hip; the frail hip breaks and then they fall. Especially in women.)
More than half are sent to nursing homes, sometimes permanently. Several professionals at local nursing homes that we interviewed did agree that one of the biggest reasons for admission is due to falls in elderly. Falling happens more frequently to women.
The CDC has estimated that deaths caused by falls in elderly in the U.S. have increased by 39% from 1999 to 2005. It also estimates about $19 billion are spent annually for treatment of these incidents and resulting elderly problems. Since most of this is paid by Medicare, it has become a major issue for the system. If falls in elderly continue at the same rate, it is projected that by 2020 costs will be over $43 billion.
These are sobering findings. There is good news, though. Much has been done to discover the cause of, and therefore prevent falls in elderly. Studies by the CDC and various medical researchers indicate the main causes of falling. And I had had many discussions with Dad’s doctor and my medical friends. Let’s take a look at some of these causes.
Causes of Falling
As we know, normal aging causes many physical elderly issues that contribute to falling. Many of these, however, can be controlled. Dad’s doctor went over some of the most common physical issues causing falls in elderly with us:
- Vision and hearing impairment, as with Dad
- Dementia (which I think Dad was developing at the time)
- Problems with feet
- Imbalance, dizziness, irregular gait (Dad’s gait had changed)
- Problems transferring (to and from bed, chair, toilet, etc.)
- Not using a cane or walker when needed (Dad now does)
- Epilepsy and other disorders of central nervous system
- Osteoporosis; weak bone mass
- Muscle weakness
- Chronic health conditions (incontinence, heart problems, high blood pressure)
- Medications, including over-the-counter
The environment is a huge factor in causing falls in elderly, yet most of them could have be eliminated ahead of time; or at least later. So it is very important to check your home or that of your loved one. We had thoroughly prepared our home for Dad, yet it did happen anyway. Here are some of the most common problems in one’s surroundings:
- Poor lighting (both indoor and outdoor), especially if the person has vision issues like the common macular degeneration
- Pets getting in the way
- Uneven floors, patios, sidewalks (had to repair our sidewalk and driveway)
- Rugs and carpet (low nap is best); smooth slippery floors, such as some vinyl and wooden floors
- Things out of place; clutter around
- Extension cords in the way
- Broken or unstable furniture
- Lack of railings and/or grip bars (we installed several)
- Weather conditions such as snow, ice, even rain – best to remain at home inside
Falls in elderly can be decreased and controlled a great deal just by dealing with the possible issues above. (See our page on Care For Elderly In Home – Tips and Ideas). But it won’t be totally perfect, as we certainly found out. When you read our page, I’m sure you’ll have your own ideas to add too.
The bottom line is, the more cleared out, simplified and clearly marked the environment is, the better. And couple that with plenty of sturdy and supportive areas to grab and hold on to — around furniture, stairs, and transfer areas particularly.
If basic measures are taken, plus awareness about changing physical health and needs, then a great deal of the risk factors for falls in elderly will be eliminated.
Most falls in elderly, although they may require treatment, do not necessarily result in death. Severity of injury varies. But those who have had a fall are frequently afraid of it happening again in the future.
And statistically, it does happen again.
But sometimes elderly become, then, overly cautious and dependent out of fear, with lessened quality of life. If we use common sense, awareness, and moderation, many of these elderly problems can be prevented. But perhaps never perfect.
Also make sure to read:
Care of Elderly – Don’t Be Overwhelmed — Care of elderly can seem overwhelming sometimes, as well as rewarding. Learn the specifics on what to do.