Interim HealthCare of Omaha: Sure Step: Fall Prevention Program

The odds of falling are about one in three after age 65. You are more likely to fall as you age because of normal, age-related physical changes, certain medical conditions and medications. A fall often damages more than your dignity and many people know others who have been injured or disabled after a fall. But, you do not need to let the fear of falling rule your life; with some medical management, physical activity and common sense you can help yourself and others avoid falls and stay independent longer.

Sure Step: Fall Prevention Program
Age-related physical changes affect many of your body systems and can put you more at risk for falling. Changes with your vision or hearing can have an effect on both coordination and balance. Nerves become less able to carry information from your brain to your muscles, which can slow your reaction time and ability to move away from obstacles quickly enough. Normal weakening of muscle strength and joint flexibility can make getting out of chairs, standing up and walking more difficult. The good news is that regular exercise can help to slow this process and help to keep you safe.

In order to avoid falls it is important to keep your body moving. Ask your doctor for a general exercise program that includes walking or group exercises. Exercises such as water workouts in a pool or tai chi are gentle on the body and are proven effective in reducing the risk of falls. Your doctor may also recommend using a cane or walker to make certain that you are balanced when you are moving. If you are using either of these it is also important to be sure that you are using them correctly. The secret to reducing your risk for falls is moving more and safely, not moving less. You doctor may also advise you to work with a physical therapist to create an individual exercise program for your unique needs. The exercises that your doctor or physical therapist recommend can help to improve balance, strength, coordination and flexibility.

Certain medical conditions can also increase your risk for falls. As you get older, you are more likely to have diseases that affect internal organs, your nervous system and brain. Conditions that can affect the flow of blood, such as diabetes and atherosclerosis can affect eyesight as well as contribute to dizziness and confusion that can lead to falls. Diseases such as Parkinson’s or ALS (Lou Gehrig’s disease), which affect the nervous system, are more common in the older adult and can lead to problems in judging distance or walking without dragging your feet that can lead to falls. Joint diseases such as arthritis can reduce how easily you move around including walking on uneven surfaces or going up and down stairs or getting in and out of cars or getting off buses.

The prescription medication that you take can actually increase your risk of falling. Most often this is related to changes in the way your body reacts to medication, including those that you may have taken for years. Many drugs have side effects that have an impact on your brain function and can cause you to become dizzy or lightheaded affecting your balance

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Some high-risk medications that can cause these problems are for: high blood pressure, heart disease, allergies, colds, coughs, sleeping problems, excess stomach acid, depression and diabetes.

Drugs that affect the cardiovascular system (your heart and blood vessels), including those for high blood pressure and heart disease can lower your heart rate and blood pressure, which reduces blood flow to the brain. This means it is important to rise slowly from a lying or sitting position, this will allow your body to adjust.Medications –those the doctor prescribes or you buy in the store, for allergies or colds or to sleep can contain antihistamines and can cause drowsiness or sleepiness. Sleepiness can interfere with your thinking as well as your balance and coordination.Be careful to plan activities accordingly if you are taking one of these medications; driving, exercising, cooking and bathing –especially taking hot baths, should be avoided while you are feeling the effects of such drugs.

Many prescriptions, including antidepressants and pain pills, also affect your central nervous system or brain. They can cause side effects including dizziness or feeling “drugged”. Again, it is important to safely plan your activities with enough time afterward that you feel alert. Talk to your doctor about taking some of these prescriptions at night so that the strongest side effects occur while you are sleeping and won’t interrupt your plans during the day and to be aware of any symptoms you experience.

Insulin shots and the pills you take to control your blood sugar can actually make your blood sugar lower. This condition, known as hypoglycemia can make you confused, weak or even experience a seizure. Be sure to closely monitor your blood sugar and that you know how to treat the symptoms-ask your doctor if you are not sure what to do immediately.

Combining alcohol with some medications can make you dizzy. Read the labels on the side of your prescription bottles to be sure that you can drink when you take this prescription.

If you are taking four or more medications, especially those that are high-risk medications such as those that we just talked about, it is important to let your doctor know and ask his or her help to reduce your chances of falling. In order to prevent complications it is important for your doctor to know each and every medication you are taking, including vitamins and herbal supplements. The next time that you see your doctor, take in all your medicine or a list.

It is also a good idea to always get your prescriptions at the same drug store or from the same mail order pharmacy (remember most new Plan D’s are mail order and so is AARP the largest pharmacy in the world!). The pharmacist can review ALL the drugs you take for side effects that occur only when taking some drugs together. These can be serious and cause dizziness, sleepiness, and imbalance. Also, be sure your pharmacist reviews the side effects of any new medication with you, including when to take it and what to avoid. If you don’t have a way to talk with your pharmacist, be sure to read the paper that comes with your prescription and look at the side effects. Can the prescription cause dizziness? Does it say not to drive your car?

There are many ways you can reduce your risk of falling and continue to live a healthy and independent life. When you first wake-up, sit on the edge of the bed for a few minutes and make sure you are not dizzy before trying to stand. Eat breakfast every morning as skipping a meal can make you weak and more likely to fall. It is also important to be careful around pets who get under your feet and make you trip or jump on you and could cause you to fall.. Also wear clothes and shoes that fit properly so you don’t trip. Make sure you do not leave items on the floor and that you close drawers and cabinets so you won’t stumble over them. Getting regular eye exams and updating your eyeglasses will also help you prevent falls.

Household safety is of utmost importance when trying to avoid falls. Hazards in each room should be identified and eliminated or modified in order for you to remain safe in your home or apartment. The bathroom is notorious for slips and falls, however, by using simple devices such as non-skid mats, raised toilet seats, shower chairs and grab-bars you will be able to reduce your risk of falling. Many of these items may be eligible for payment under Medicare. Talk to your doctor, physical therapist, nurse or medical equipment company.

Stairs are a constant danger for falls. Remember to never carry any package that obstructs your view of the next step and to keep at least one hand on a handrail. Make sure your living area (where you spend the most time) and bedroom have clear paths and that you have easy access to light switches, preferably switches that turn the lights on before you enter the room.

Have someone help you “tour” your house and find hazards such as cords, wires, unsecured throw rugs and low furniture such as coffee tables. All furniture needs to be sturdy and easy for you to get in and out of. Kitchen safety includes making sure that items are easily accessible; this will help you avoid unnecessary climbing or bending. It is also important to clean up any spills and use non-skid floor wax.

Even after taking precautions, it is still possible for a fall to occur. After you fall, panic is often the first reaction. However, how you react after a fall can actually cause more injuries than the fall itself. If you try to get up too quickly or in the wrong position you may make an injury worse. The following advice on getting up from a fall is from the American Orthopedic Surgeons. Remember to take deep breaths and decide if you are hurt. If you think you are injured do not get up, if you can reach a phone call 911 or press your personal response device or ask for help from a family member. If you feel strong enough to get up, roll over naturally to your knees, turning your head in the direction of the roll. If you can, crawl to strong furniture like a chair, put both hands on the seat and pull yourself up onto your knees. Slowly begin to stand using your stronger knee and leg to push your body up, then carefully twist around and sit in the chair.

It is important to document the times that you have fallen or almost fell. Try to remember what you were doing, where you were, when it was and how you fell. Information about your fall can help you and your doctor identify any risk factors for falling and how to manage them.

Getting Up From a Fall
After you fall, panic is often your first reaction. However, how you react after a fall can cause more injuries than the fall itself. If you try to get up too quickly or in the wrong position you may make an injury worse.

Remember to take several deep breaths, assess the situation and determine if you are hurt. If you believe you are injured, do not attempt to get up. Instead, call 911 or get help from a family member. But, if you feel strong enough to get up, follow these steps provided by the American Academy of Orthopedic Surgeons.