BackAvoiding Falls is a Balancing Act
By Michael Bearce Executive Director Fall Prevention clinics of America
Dorothy, an energetic 68-yearold, had an active life that involved family, church, community volunteer work and lots of social time with friends. That is, until she broke her hip from a fall she took in her own home. Her daughter found Dorothy one morning lying helplessly on the kitchen floor unable to call for help.
Dorothy's story is all too common among seniors. Falls are a serious problem among older adults and occur in nearly half of all adults over 65 each year. Of those who fall, 20 to 30 percent suffer injuries that reduce mobility and independence, and increase the risk of premature death. The injury resulting from a fall often marks the beginning of the need for a caregiver, perhaps on a permanent basis.
Older adults are well aware of the danger falls present. Surveys show that falls are so feared among older adults that many limit their activities or alter their lifestyle to avoid a possible spill. But ironically, the vast majority of falls occur in or around home. Common environmental factors that contribute to falls include poorly lit areas, throw rugs on the floor, extension cords, slippery surfaces and lack of handrails on stairways.
Older adults are often affected by many health conditions that can increase the risk of falls, including: Poor vision: Cataracts, macular degeneration and glaucoma can affect perception or make it difficult to see obstacles. Gait and balance disorders: Stroke, Parkinson's disease and hypothyroidism, among others, can affect balance and the ability to walk. Weakness or a general lack of conditioning can also have an effect. Cardiovascular disease: Congestive heart failure, arrhythmia and other conditions affecting heart and blood vessels can cause fainting or lead to inactive lifestyles. Disorders affecting your legs and feet: Arthritis, foot problems, muscle weakness and nerve damage can cause unsteadiness and numbness, tingling, weakness and pain in feet or hands. Bladder conditions: Incontinence or the need to urinate frequently, especially at night, can lead to falls in several ways. Standing up too quickly can lead to faintness from a momentary drop in blood pressure. Medications: Diuretics, sedatives or other sleeping medications, high blood pressure medications or drugs for some psychological conditions such as depression can increase the risk for falls.
An often overlooked reason for the decline in balance involves the vestibular system. The vestibular system is the part of the inner ear that works with our eyes, ears and muscles to send instantaneous information to the brain about our body position. For instance, if you step on an uneven surface, your vestibular system immediately senses the shift in body weight, sends a message to your brain and helps you compensate to avoid falling. All of this happens in a split second.
When we are young and active our balance is finely tuned to every movement we make. This is why kids can hang upside down on jungle gyms and spin around endlessly on amusement park rides and think it is "fun." They may wobble a bit when they get off the ride but are able to regain their equilibrium quickly. Their vestibular system is finely tuned and makes all of the necessary adjustments. But by the time we reach our fifth or sixth decade, the vestibular system has weakened considerably. On average, a person loses about one-half a percept of their overall balance every year starting from about the age of 20 mostly due to decreasing levels of activity, not aging.
Inactivity causes the vestibular system to weaken much like a muscle that isn't used. Over time, the muscles and inner ear equilibrium don't work in harmony because they are out of practice. Vestibular testing can also be very helpful. It usually involves a three step diagnostic process to test how the eyes, ears, muscles and brain are working together using computerized diagnostic equipment. Once the weaknesses are identified, balance correction treatments can be prescribed to strengthen, retrain or compensate for the balance problem. Research results show the treatments to be successful 87% of the time.
Frequent medical check-ups, physical activities, mental challenges and changing daily routine; when combined with a safe environment is the best bet for getting back on solid ground.