Note: This information is provided for purely educational purposes and does not constitute medical advice. Readers are encouraged to discuss any health questions with their physicians.
Public Health
Fall prevention is an important topic in public health because falls are the leading cause of unintentional injury in adults over the age of 65. According to the CDC, 1 in 3 adults age 65+ falls at some point in their lives and over 25,000 older Americans die each year from falls. Falls can also lead to serious injuries that require emergency room visits (over 3 million in 2016), extended hospitalization, or reduced independence.
Risk Factors for Falls
As we age, our risk factors for falling increase. Risk factors can be:
- Biological – muscle weakness, balance problems, vision changes, changes in sensation in feet, medication side effects
- Behavioral – alcohol/drug use, engaging in unsafe behaviors like climbing onto stools/chairs/ladders
- Environmental – dim lighting, absence of grab bars in shower/tub or stairs, tripping hazards in the home like rugs
There is a greater risk of falling with more risk factors, and risk factors can interact to increase the chance of a fall (lack of grab bars in the shower with poor vision, for example)
How can we prevent falls
Assess and reduce your risk factors
Preventing falls starts with understanding and assessing for risk factors. Physicians can perform individual fall risk assessments that identify factors to be aware of and factors that you can try to modify, especially medication side effects/interactions and vision/balance problems. It is also important to look at the home environment and address poor lighting and trip hazards, such as cords and carpets. After COVID-19 is no longer a concern, you can request a Home Safety Assessment from the SF Department of Public Health by calling 628-206-7696 or emailing CHIPPS@SFDPH.org. An injury prevention specialist will walk through your home, listen to your safety concerns and make suggestions for increased safety.
Learn prevention strategies
There are a growing number of community-based organizations that offer evidence-based fall prevention programs. Some of these programs involve attending workshops run by trained professionals to learn about reducing fall risk while others are at home programs run by physical therapists to improve strength and balance. In almost all these programs, the fall rate decreased by 35% among those who participated.
Take care of your health
Finally, keep moving and look at your diet! Exercising regularly helps maintain muscle strength, flexibility and prevent osteoporosis (weight bearing exercise). Make sure that your diet has adequate calcium and your vitamin D levels are above the recommended levels to help prevent osteoporosis. NEXT Village offers several exercise classes this month, so maybe now is a good time to start a new routine!
If you fall…
Falling can be emotionally and physically stressful. If you do fall, try to remain calm and remain on the floor for a few deep breaths. If you think getting up will worsen injuries, do not move and call for help instead using your mobile phone or emergency assistive device. If you can get up and are alone, do so slowly by rolling to your side and, after a few moments to rest, carefully get on your hands and knees. Crawl carefully to a chair. Use the chair to help you rise, one leg at a time, and sit. Call for assistance with your mobile phone or emergency assistive device, if needed. Please let your physician know about the fall, even if you are not hurt, because a fall could be a sign of issues with medications, vision or balance.
A fall (or a fear of potentially falling) can create anxiety which can be debilitating and prevent activity/exercise. It is important to discuss this anxiety with your physician. Having a plan, such as always having a mobile phone on you, wearing a personal alarm, or leaving a spare key with a friend, may help you feel safer. Assistive devices such as canes and walkers can also be very useful after a fall to walk more safely and confidently. A physical therapist can help assess which device would be the most appropriate to help you maintain independence.
Resources:
http://stopfalls.org/individuals-families/
https://www.ucsfhealth.org/clinics/balance-and-falls-center
Fall Prevention Exercises: https://www.hopkinsmedicine.org/health/wellness-and-prevention/fall-prevention-exercises
This article is brought to you by Nandini Joseph, MD, a UC Berkeley student volunteering for NEXT Village SF this fall!
“I’m originally from Texas, but have spent the last 15 years in the Bay Area with my family. I am a physician in endocrinology and I am also completing my MPH (Master’s of Public Health) at UC Berkeley currently. I am interested in how we can change upstream factors to improve health for all. I am excited to be a part of the NEXT Village SF community and share and learn with you all.” – Nandini Joseph, MD