Why is Falls Prevention Important?
As discussed in my Beginners Guide to Falls Prevention post falls are a major concern especially for older adults. Falls are a leading cause of injury in older adults, and even non-injury falls lead to fear of falling and reduced mobility in many cases. As a home health physical therapist I help my older adult patients prevent falls everyday. Physical therapy does not only address balance as some may presume.
Why Do Falls Happen?
Falls happen for many reasons; believe me, as a physical therapist I have heard many many stories about falls! Common causes include dizziness, tripping, falling from a step stool or other height, fatigue, or weakness. Our bodies use many factors to prevent falls. Typically, we try to prevent a fall by using ankle mobility and strength, then hip compensation techniques, and finally stepping out to widen our base of support. That is a common series of compensation strategies our bodies use to keep us from going to the ground. If the fall is caused by dizziness or other internal factor these compensation strategies are not applicable. However, managing your overall health is important to preventing any type of fall. Lets discuss my top 9 fall prevention tips.
9 Best Tips to Prevent Falls
Tip #1 – Evaluate Your Environment
As mentioned in the Beginners Guide to Falls Prevention post, most falls occur in the home. This means that evaluating your home environment is a great place to start when it comes to falls prevention.
Are there unsecured floor coverings such as rugs, is there clutter, are there narrow pathways that are difficult to navigate? Some of many questions that can be addressed in preventing falls at home. It is definitely worth making some small changes around the house to prevent an injury. Seek out the help of a family member or home health therapist, or home modification specialist to evaluate your needs.
Tip #2 – Stay Hydrated
Dehydration is a major contributor to falls risk. This study found over 1/3 of those who had fallen were dehydrated. Dehydration is not always about just drinking more water either. There are other important electrolytes that can lead to dizziness, falls, and need for hospital fluids if out of balance. Read more about it in my hydration post here.
Since fluid limits are applicable in many diseases such as heart failure or diabetes it is important to discuss your recommendations with your personal physician. Ask them about electrolytes as well. Many electrolyte supplements have a lot of sugar or salt so discuss these with your doctor.
Tip #3 – Strengthen Your Body
It may be surprising but I am going to emphasize strengthening exercises before specific balance exercises. Many people think balance exercises are the only way to improve balance. But, our bodies are way more intricate than that. Strengthening exercises help train your muscles and brain to improve muscle bulk, bone strength, reaction times, and the way your brain communicates with your muscles to prevent falls. Read more about how muscles change as you age here.
150 minutes a week is the recommended amount of exercise for older adults. It can be broken down into segments as short as 10 minutes. It is also recommended that at least two days a week include strengthening exercises such as weight lifting, resistance band training, or bodyweight strengthening exercises.
Tip #4 – Improve Your Balance
Included in the 150 minutes a week of recommended exercise includes balance exercises. Today’s Geriatric Medicine recommends balance exercises up to daily. Balance exercises include reaching exercises, activities with a narrowed base of support, or uneven surface to encourage ankle stability training and improvement in proprioception. Having a physical therapy evaluation to identify your particular areas of difficulty can be very helpful to dose balance exercises appropriately.
Tip #5 – Have Your Ears Checked
Some of the above tips may have been things you have considered before. But, did you think about your ears? Hearing loss, deficits in your vestibular sense of space, dizziness can all originate in the ear and cause increased falls risk.
Regular hearing checks, wearing hearing aids that have been prescribed, and dizziness screening can be an important piece in falls prevention.
Tip #6 – Have Your Eyes Checked
Similar to ear health is eye health. Cataracts, glaucoma, retinopathy are all major causes of change in vision and are more common in the older adult. Regular eye exams, wearing prescribed lenses, appropriate lighting in your home can all improve your vision and reduce your falls risk.
Tip #7 – Know Your Medications
I will probably say this many times as Aging with Ability grows. Medication side effects can be a contributor to falls risk. Many medications cause fatigue, dizziness, lightheadedness, change your blood pressure and can lead to a fall. Know your medications and what they are for so they can be adjusted by a physician if they seem to be contributing to your falls risk. Obviously, medications help with disease management, pain, and prevention of complications. But, it is important to know what you are taking and whether you are on excess medication in order to prevent side effects and injury risk from falls. The least therapeutic dose needed is always best.
Tip #8 – Wear Good Shoes
Foot health is another important factor in falls risk management. I have worked with many patients who have reduced sensation in their feet (typically called neuropathy) and this creates challenges with safe walking and mobility. Diabetes is a common condition that leads to neuropathy, neurological diseases can as well as chemotherapy side effects.
Even if you do not have reduced feeling in your feet it is important to wear good shoes when walking. Supportive shoes that are the correct size can help prevent falls. I have worked with many people who wear flimsy slippers, or regular socks that are putting themselves at risk.
During graduate school you could fail an exam if your classmate that was pretending to be your patient had regular socks.
Non-skid socks, slippers with a good sole and full back, or tennis shoes or other supportive shoe are far better for safe walking and preventing falls. If you are diabetic discuss with your doctor or podiatrist your options for diabetic shoes and see if your insurance will help with the cost.
Tip #9 – Use Devices as Needed
Walker, cane, grab bars, hand rails, raised toilet seat, shower bench, walking sticks just to name a few different assistive devices. All of these are great and many people can benefit from them. As a physical therapist I work with people to match their assistive device to their functional level. I would rather have you use a cane or walker then rely on your furniture always being in just the right spot to make it a handhold to get around the room. But, on the other hand, using an assistive device when you don’t need one can keep you at a lower functional level then you need to be in.
Being assessed by a physical or occupational therapist can be useful in identifying the right equipment for your exact needs. Many times they are more aware of what is on the market and what type will work best with your lifestyle and abilities.
The Last Thing You Need to Know About Falls Prevention
I hope these tips provided some food for thought in preventing falls in your life. Some of these are so easy to implement, such as identifying risks in the home. Others, such as addressing foot health deficits may take a primary care physician or podiatrist to get you on the right track. Like I mentioned in the Beginners Guide to Falls Prevention post even one or two of these factors can make a big difference in decreasing your risk.
Remember that you can always discuss these with your primary care doctor or a physical or occupational therapist to identify a plan appropriate for you.
Please leave a comment and let me know what you think!
Check out my home safety checklist here for falls prevention at home!