Why falls happen and how to prevent them

For many seniors, a fall means more than tripping on the sidewalk and getting a skinned knee. Age also brings changes in balance, vision, reaction time, strength and flexibility, and mental clarity. Some medications have side effects that can further increase the risk of falling.

"Falls cause a decrease in functional status and an increase in nursing home placement and fractures," says Dr. Elene Pilapil of Southeast Internal Medicine.

Steven Logel, a senior physical therapist at Saint Francis' Outpatient Rehabilitation, says the biggest fall injury can't be seen -- it's the fear of falling again.

"Some people get so scared that they literally put themselves on 'house arrest,' leaving the house less and less to avoid getting hurt in public," Vogel explains. "Unfortunately, as people withdraw from life to avoid getting hurt, they not only become weaker and more prone to falling and getting hurt, but they socially lose their identity -- the churchgoer, the grandma who used to go to all of her grandson's ball games, the gentleman who would get together with friends to play cards. It is that invisible injury, the increased fear of falling, that may be the biggest injury of all."

Pilapil and Vogel agree that staying active is key for seniors to avoid falls or lessen the impact of falls. Pilapil recommends a mixture of strength, balance and gait exercises; tai chi and endurance exercises are two good choices. A physical therapist like Vogel can help patients put together a simple, low-cost exercise program at home; he can also teach patients about home safety, fall prevention exercises and how to use canes and walkers.

It's also a good idea for anyone, regardless of age, to "fall-proof" their home. Go room-by-room to make sure each area has adequate lighting, eliminate clutter and install handrails where needed, says Vogel, and don't be afraid to use a cane or walker for safety.

"This may be hard for some individuals, and sometimes people have to swallow a little pride, which to me is more important than allowing yourself to continue the risk of falling," says Vogel.

Pilapil emphasizes wearing low-heeled, firm-soled shoes, checking for uneven surfaces, having regular vision checks and not walking barefoot or in your socks.

"Vitamin D supplementation may improve bone density and muscle function," she adds. "Vitamin B-12 deficiency can cause a decrease in vibration and position sense. Osteoporosis increases the risk of fractures."

If you do fall, says Vogel, take it easy, and don't get up until you're able.

"An individual needs to stay put long enough to make sure they are not hurt. There is no rush to get right back up unless it is an emergency situation," he says. If that's the case, do your best to move, even crawl, to a phone, or to a piece of furniture to pull yourself up. A call alarm button may be useful, especially for those living alone, says Pilapil.

"Falls are unfortunately going to happen -- there is nothing we can do to make them completely go away -- but small steps can go a long way in reducing the number of falls that take place," says Vogel. "If we can eliminate just one fall a day, we have achieved a positive thing for our elderly loved ones."

For friends and family

Too often, says Pilapil, seniors will not admit that they've been falling. If you notice bruises on a friend or family member, ask if he or she has been falling and what you can do to help. Offer to exercise with that person and "fall-proof" the home, and check in often. Remind the individual that if he needs to use a cane or walker, you won't think anything less of him, says Vogel.

"You have to be careful and not try to take charge," he says. "If a person doesn't want to change the setup of their home or use a cane, we have to respect that. All people 'have a right to fall.'"

A Matter of Balance

The University of Missouri Extension in Jackson will offer a fall prevention program on Mondays in October and November. The program, "A Matter of Balance: Managing Concerns about Falls," will teach ways to increase activity, reduce fall factors and practice strength and balance exercises.

Dates are set for Oct. 3, 10, 17, 24 and 31, and Nov. 7, 14 and 21. The fee is $25, and those who complete the program will receive a $10 gift card. A workbook and refreshments will be provided.

For more information or to register for the program, call the Extension Center at 573-243-3581.