Health Matters: Four things to know about fall prevention

lady with walker

June 9, 2021

Falls are the leading cause of fatal and nonfatal injuries for persons aged 65 and over. According to our 2018 Community Health Survey over 45% of Lewis & Clark County residents over the age of 45 fell at least once that year. At St. Peter's Emergency Department we saw over 800 patients due to a fall in the past year. Falls are a significant problem in our area and can lead to serious injury that can limit mobility or independent living.

Understandably, as we age, many of us become fearful of falling.

The good news is that there are things that we can do as we age (and really at all ages) to reduce the likelihood that we experience a fall that at best lands us with a sore back and, at worst, lands us in the hospital.

I teach a class called Stepping On at St. Peter's Health, which helps people prevent falls at home and while they're on the go.

Here are four important things to know about fall prevention:

1. Everyone, including older adults, can reverse muscle weakness. 

In the class that I teach on fall prevention, we repeatedly talk about and practice strength and balance exercises. Why? Because it is so important!

The concept of using it or losing it applies to us at any stage of life, especially as we age. And interestingly, activity avoidance can actually lead to falls.For example, avoiding uneven surfaces is important if you are injured or unable to maintain your balance. But avoidance over a long period may mean when you are re-introduced to the activity; you are more likely to fall.

That's why it is so important to do very basic strength and balance exercises. It helps you maintain muscle as you age to ensure that you can continue to do activities confidently like walking on uneven ground or going up and down stairs safely. Below, we discuss assistive devices like canes. These can be great tools and help you avoid falls.

2. Most older adults fall in living spaces like living rooms or hallways. 

Most of us think that most falls happen in the bathroom: we're getting up and down, in and out. Contrary to popular belief, most falls actually happen in other living spaces like living rooms or hallways. Why? Because it is quite easy to trip on things like rugs, cords or clutter. Plus, we may not be paying as much attention in familiar spaces. 

I recommend that everyone -- regardless of age -- complete a home audit. This means walking around your home, ideally with someone else like a family member, to identify any trip hazards or other conditions that may lead to falls.

Is the dog bed placed in the middle of a room? Do you have cords near walking paths? Is there just that one thing in your house that trips everyone up, but you've delayed taking care of it? Lighting is one thing that you may not think about when you complete your home audit. Do you have adequate lighting in areas where you may walk in the middle of the night (i.e., bedroom, bathroom, and hallway)? Sometimes a small flashlight or a night light can help.

3. Assistive devices can be helpful. 

We talk a lot about assistive devices in our Stepping On class, and not just the ones that jump into our minds like walkers or canes!While walkers and canes can help prevent falls, and many people in our community of all ages rely on the devices to remain stable or get around, there are also other helpful devices for everyday life.

Things like a car cane can be helpful. A car cane is a portable handle to help enter or exit the car with ease and stability. People often hesitate to use assistive devices as they age or begin to experience mobility concerns. It can be hard to realize that we aren't as stable or physically able as we may have once been. However, many people can maintain their independence and favorite activities with the help of an assistive device.

Remember, it is essential to know how to use assistive devices safely. It's also important to make sure that devices are installed correctly (e.g., grab bars in bathrooms). If misused or poorly installed, a device can contribute to a fall! 

4. Your fall potential may change throughout the day. 

We've all done it - stood up too fast and gotten lightheaded. I encourage everyone to adopt this simple habit early: stand up slowly. Many people fall, including people who are usually quite stable, getting up from bed because they get up too quickly and become lightheaded or dizzy.

Medications may be another consideration since dizziness is a side effect of many. Be aware of this, especially if you start a new medication!

The National Institute on Aging has some great information on fall prevention:

Falling is not a normal part of growing older. You can take several simple steps today to increase your awareness of hazards and decrease your risk of falling.

Marisa Hardy, RN is a Population Health & Wellness Nurse at St. Peter's Health. She is a certified health coach and teaches Stepping On, Freedom from Tobacco and Health Coaches for Hypertension Control classes for the organization.