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The Prescott Daily Courier | Prescott, Arizona

home : features : features July 09, 2014

7/7/2013 6:00:00 AM
THE GOOD PATIENT: Useful strategies help prevent accidental falls
Elizabeth Bewley
Courier Columnist

Have you ever fallen? If so, and if you are age 65-plus, you have plenty of company. The typical adult aged 65 or older has a one-in-three chance of falling in any given year. Roughly one fall out of four results in a serious problem such as a hip fracture or a head injury.

Dr. Mary Tinetti, a geriatrician (specialist in care of the elderly) at Yale Medical School, found that "for a 75-year-old with high blood pressure, the risk of death or serious disability from a fall is just as high as the risk of death or serious disability caused by a stroke," according to an interview in the Wall Street Journal a few years ago.

But so what -- aren't falls just accidents, unfortunate, but unavoidable?

To answer that question, consider an analogy. Fifty years ago, many people considered almost all automotive injuries and deaths to be simply a matter of bad luck. Today, people wear seatbelts more often and drive drunk less often than they did 30 to 40 years ago. These preventive actions have saved roughly half a million lives, and reduced or prevented an even greater number of injuries. Clearly, some portion of harm from auto accidents can be prevented.

But research shows that people aged 65-plus often feel that falls are simply accidents that can't be prevented. They also believe that they themselves are not at risk for falls; people at risk are surely older and frailer than they are. This view reminds me of the research that shows that people who are in their 30s define "old" as age 60-plus, whereas people who are 65 define "old" as age 74-plus, and so forth.

Perhaps it would help to think of preventing falls as useful for people in general, like wearing seatbelts or not driving drunk, and not something that applies only to "old people" -- a category you will surely never belong to even if you live to be one hundred.

The CDC (federal Centers for Disease Control and Prevention) offers questions and recommendations for each part of your house. These are available at http://www.cdc.gov/ncipc/pub-res/toolkit/checklistforsafety.htm.

An example is, "Do you have only one light switch for your stairs (only at the top or at the bottom of the stairs)? Have an electrician put in a light switch at the top and bottom of the stairs. You can get light switches that glow [in the dark]."

Another example is, "Is there a handrail on only one side of the stairs? Make sure handrails are on both sides of the stairs and are as long as the stairs." When we bought our current house, my husband and I took this advice (even though, of course, we aren't old!)

The CDC also offers a brochure called "What YOU Can Do To Prevent Falls" at http://www.cdc.gov/HomeandRecreationalSafety/pubs/English/brochure_Eng_desktop-a.pdf.

One of their recommendations is to wear shoes, even in the house. You don't have to be elderly to slip on the stairs if you are wearing only socks. Another recommendation, which we are mindful of in our house even when children are visiting, is to keep places where people walk free of papers, books, clothes and shoes (and toys!).

If you have had a fall and weren't hurt, did you brush off the incident as unimportant? About half the people who fall don't tell their doctors. But doing so can create an opportunity for you to hear about strategies that research has proven are successful in preventing further falls, such as getting exercise or physical therapy and taking vitamin D supplements.

You can read other science-based recommendations for preventing falls from the U.S. Preventive Services Task Force at http://www.uspreventiveservicestaskforce.org/uspstf11/fallsprevention/fallsprevfact.pdf.

In Prescott, the Area Agency on Aging (part of NACOG, the Northern Arizona Council of Governments) in collaboration with Bayada Home Health Care offers periodic Fall Risk Clinics in which people who are concerned about falling can get a free risk assessment. Additionally, a workshop called "A Matter of Balance" with two-hour sessions each week for eight weeks can help people improve their balance and reduce the chance of falling. For information about either of these programs, call Georgi Percan of NACOG at (928) 775-9993 ext 4269.

To tell Elizabeth your story, propose a topic, or ask a question, write to: thegoodpatient@pariohealth.net.

Bewley's new book, a collection of forty articles from this column, is available locally at Hastings and at Peregrine Books and online at Amazon. It is titled Not Your Grandmother's Nursing Home: Demystifying Today's Retirement Living Options.

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