Ask the Expert: Falls Prevention
Dr. Lisa Mandl, Rheumatologist, answers questions on how to prevent falls. This is a second part to our first post on falls prevention in September from our social work department.
Q1. Why are elderly more prone to falls?
A. The elderly are more prone to falling for a variety of reasons. They can have muscle weakness, poor balance, impaired vision and hearing. They may have other medical conditions that might make them vulnerable or may be on multiple medications that interact with each other.
Q2. How can medications affect balance?
Multiple medications can interact with each other to cause problems. Medicines can reduce your mental alertness, make you more confused, weaken your balance, impair your gait, and create a drop in blood pressure. It can be hard to compensate for these changes. It is important to see your primary care doctor regularly to go over the medications you are taking. Make sure you are only on the ones you really need.
Q3. What can be done around the home to prevent falls? (this is also in the post from September…)
There are many things you can do around the house to help prevent falls. Some examples are below:
- In the bathroom (where many falls occur):
- Install grab bars around the tub
- Make sure you have a non-skid mat
- Utilize a liquid soap dispenser instead of bar soap in the tub (a bar can fall easily so you will have to reach down for it)
- Use a padded shower seat
- Use a raised toilet seat
- In the living room:
- Secure all rugs carefully with non-skid tape
- Get rid of throw rugs
- Install a phone on every floor or even in every room, so you are not running to the phone when it rings
- Tape electric cords by the wall to keep them out of the way
- Make sure you have good lighting – have automatic lights or nightlights in case you get up in the middle of the night
Q4. What are some recommendations for preventing falls outside of the home?
While you are outside your home, make sure all cracks in sidewalks and driveways are fixed. Install a handrail on any outdoor stairs. Keep the outside clutter-free (no tools lying around, etc.). Hire someone to shovel your driveway to get rid of snow and ice in the winter. Have adequate lighting for when you are outside after dark. Once you leave your home, it is hard to control your environment but use an assisted walker or cane if necessary. And always, walk slowly!
Q5. How can one prevent injury during a fall?
When someone falls, they can suffer a serious injury such as a hip fracture. It is important to be able to prevent an injury if you do fall. Be sure you have adequate calcium and Vitamin D levels and treat osteoporosis if you have it. It is helpful to do weight-bearing exercises as you age to combat weakness.
There is also a cycle of “fear of falling”. For some people, even if they don’t hurt themselves, they are afraid they are going to fall, so they start to restrict their activities and become less active. This can be combated with activities such as Tai Chi – which is a great way to improve muscle strength, mobility and balance, and keep older people confident in their ability to be active.
Dr. Lisa A Mandl is a rheumatologist and clinical researcher at Hospital for Special Surgery with a focus on osteoarthritis, inflammatory arthritis, and total joint replacement.