By Carol A. Cates, MSN, MBA, RN, NEA-BC
Chief Nursing Officer
Odessa Regional Medical Center
In the last few years of her life, my stepmom fell far too many times. Most of the time she was uninjured or had something minor, like a bruise of a scrape, but a few times, the injuries were more serious. Towards the end of her life, with all of her health issues, she was so weak, and her judgement was so poor because of her dementia, that we had to have a 24/7 caregiver just to keep her from falling. My stepsister, who is also a nurse, and I were terrified that if we didn’t take those precautions, it was a matter of time before she had a fall that killed her.
That concern about falls in older adults is a very real one. According to the Centers for Disease Control and Prevention (CDC), falls are the leading cause of injury for adults aged 65 and over. Over 14 million older adults fall every year. 37% of those falls caused an injury that required some sort of medical treatment. 3 million emergency room visits occur each year in older adults, and 1/3 of those end up in the hospital. The scariest fall fact for me though, is that in the most recently published statistics, 78 out of every 100,000 older adults in the U.S. die from a fall each year. The falls I am talking about are not falls from heights, the falls I am talking about are referred to as “same level falls”. They are the falls related to slips, trips, and/or loss of balance.
According to the CDC, 319,000 people are hospitalized for hip fractures. Of those, 83% of hip fracture deaths and 88% of emergency room visits and hospitalizations for hip fracture were caused by falls. I think most people think traumatic brain injuries happen most commonly because of things like car wrecks, sports injuries, or in our combat veterans. But the most common cause of traumatic brain injury is actually falls.
Recently, a meta study was published about how dizziness and falls often go hand in hand. The way I think of a meta study, is those studies are the “king” of studies. Meta Studies look at all the research on a subject and by evaluating those studies as a group together, they can give very strong conclusions about that body of research. In this study, dizziness was defined as sensations such as vertigo, imbalance, light-headedness, and disorientation. What this research found is not just that dizziness causes falls, but dizziness is a very strong predictor of future falls. People who experience dizziness are 60% more likely to fall in the future than those who have not had dizziness symptoms. Dizziness is common, affecting 1 in 3 older adults, but it is not normal. Dizziness has distinct causes with treatments and even cures. If you are experiencing dizziness, you need to speak to your primary health care provider so your dizziness can be evaluated and you don’t become a fall statistic!
Other risk factors for falls are lower body weakness, Vitamin D deficiency, difficulty with walking or balance, medications such as tranquilizers, sedatives, antidepressants. Some over the counter medications can affect balance. Vision problems, poor lighting, foot pain or poor footwear, and hazards such as broken or uneven steps, throw rugs, or clutter on floors.
Most falls don’t cause injuries, but people who fall, tend to fall again. Statistically, every time a person falls, their chances of falling again doubles. An ironic problem with falling is people who fall, tend to fear falling again and because of that fear they become less active. Rather than decreasing the risk of falls, lack of activity actually increases fall risk because they become weaker.
The best thing you can do when it comes to falls is fall prevention. The National Council on Aging has a free falls check-up on their website at https://www.ncoa.org/tools/falls-free-checkup/ by answering their short questionnaire, you can find out your risk for falls and get resources to help you prevent falling. Your best resource, however, when it comes to fall prevention is your primary health care provider. Speak to them about your fall risk and, If you do fall, always let your primary health care provider know, even if you weren’t injured.
