Fall Risk and the Impact of Multiple Falls on the Community-Dwelling Older Adult

Although my strongest passion is enabling older adults to age in place within their homes, a close second is fall prevention. Falls are the number one reason older adults in our country are injured, both fatal and non-fatal. If that doesn’t convince you that this is a big deal, let’s look at the statistics:

“29 million falls, 3 million emergency department (ED) visits, 800,000 hospitalizations, and 28,000 deaths” (CDC, 2017)

This is each year. One in four of our older adults will fall, according to the Centers for Disease Control and Prevention. In addition, these statistics don’t take into account that our baby Boomers are aging and unfortunately, these numbers will only rise. Here’s the real kicker though – they’re preventable. How, you ask? Exercise, medication management, regular eye exams, and (you knew it was coming) home modifications. 

Risk factors associated with falls include:

  • Hospitalizations
  • Broken bones
  • Head injury or traumatic brain injury (TBI)
  • Hip fractures
  • Increased chance of falling again
  • Increased fear of falling

The impact of falls, especially those which result in injury, are debilitating. Fear of falling, however, can be the most detrimental risk factor of all. An older adult who has experienced a fall is understandably more fearful that they will fall again. This can result in activity restriction, decreased community mobility, and isolation, causing weakness and decreased quality of life. This creates a snowball effect of fall after fall, slowly draining the older adult of their independence. 

Prevention

Prevention begins with talking to your doctor. Request a fall risk evaluation and a review of your medications to identify prescriptions which may cause you to feel dizzy or drowsy. You can also seek out a fall risk and home safety assessment by a healthcare professional (i.e. occupational or physical therapist). This includes assessment of a variety of things such as balance, strength, mobility, vision, and the environment. The simplest of risk factors, such as footwear, can be identified and resolved through collaboration of the professional and the client and the result is priceless – your safety, independence, and ability to remain in your home and community.  

Resources:

Important facts about falls (2017). Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html

Take a stand on falls (2017). Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/features/older-adult-falls/index.html

Home for the Holidays

‘Tis the season for holiday gatherings! While many of us find joy in bringing all of the family together, we must consider how our aging loved ones are feeling during this time.  A room filled with laughter, conversation, and hugs can be an exciting experience for some, yet consecutively feel very stressful and overwhelming for others. Conditions such as Alzheimer’s (dementia), visual or hearing deficits, and anxiety create new challenges for both the individual and their caregivers. Below are a few tips to make your holiday gathering more comfortable for each guest at the table.

  • Prepare, Prepare, Prepare
    • Ask your loved one if they would like to be involved in the planning of the gathering and/or meal. This may be a tradition they began and hosted for many years. Completely cutting them out because you do not want to overwhelm them may be hurtful. Even if the only task they wish to take on is setting the table, you have let them know that their contribution is still valued. 
    • Flip through photo albums with your loved one prior to the gathering and prepare them for the guest list. There may be names that are difficult to remember or family members they have not seen in quite some time. Be understanding that they may not be able to recall this information later.
    • Invite your loved one to the gathering early and ask them if there is anything you can do to adjust the lighting or noise in the space to make them more comfortable. Low lighting and a beautifully decorated Christmas tree may be a peaceful scene for a youthful eye, but can create unnecessary barriers for a loved one with low vision. 
    • Update the guests of any new challenges your loved one is experiencing prior to the gathering. 
  • Maximize Visitability
    • Ensure that all of your guests can safely enter and exit the home – it is ideal to have at least one zero-step entrance if possible. 
    • If your loved one uses a walker or wheelchair for mobility, ensure that they can clear doorways and access the serving areas and bathroom safely.
    • Consider easy-open hardware such as lever door handles and faucets.
    • Prepare a comfortable seat for your loved one in the main area that they can transfer in and out of with the least amount of assistance possible.
    • Ensure all traffic areas are adequately lit.
  • Be Prepared for Change
    • Check in with your loved one regarding sound levels. They may be seated at the dining room table, surrounded by multiple different conversations happening around them, struggling to understand the person speaking to them. They may have difficulty distinguishing a person’s words over the swishing of the dishwasher that a guest just turned on in the next room or the squeals of children racing around the table. Offer to move to a quiet space to converse with them one-on-one. 
    • What used to be lengthy conversations with a loved one suffering from dementia may be replaced by an exchange of smiles and a simple touch on the hand. Cherish this form of communication from your loved one and know that your gesture is comforting for them. 
    • Enter the family gathering with the expectation that traditions may need to be adapted. Simplify as needed to make your loved one more comfortable. 
  • Reminisce 
    • Share stories with your loved one of past holiday gatherings.
    • Incorporate food dishes into the gathering that are familiar to them – recipes they used to prepare for the holiday or foods that were familiar to them as a child.
    • Bring familiar photo albums or mementos, or play music that they enjoy. These offer comfortable conversation pieces for your loved one with other guests. 

Each holiday spent with our loved ones is a memory to be cherished. With a little flexibility and consideration, we can ensure our aging loved ones enjoy their time with family and friends. Don’t be afraid to create new traditions, be patient with your loved one and yourself, and remember there is a much bigger reason for the season. 

Thank you for reading, and Merry Christmas!