Each year, 30-40% of people over the age of 65 living in the home and half of all residents living in long-term care facilities experience a fall. These falls can seriously injure older adults and can even be fatal. We spoke to Dr. Karishma Patel, one of our primary care physicians at Tufts Medical Center Primary Care — Woburn with a specialization in geriatric care, on why these falls happen and what we can do to prevent them.
Q: How do falls happen?
A: In the hospital setting, falls usually involve equipment and occur while the patient is seated or is being transferred to/from a chair, bed or toilet. Falls and other injuries can also occur when patients are immobile from being physically restrained, or if a patient is taking multiple medications that are not interacting well together.
Q: What causes falls in older adults?
A: Falls are rarely due to a single cause. Patients who are already impaired by chronic illness or other geriatric syndromes may be more prone to falls than those who are not impaired. Things like changing position and risk taking can also trigger falls.
Q: What is a fall risk assessment?
A: A fall risk assessment includes a physical and targeted examination involving gait, balance, mobility and lower extremity joint function, diagnostic testing and observation by a physician. The assessment will also evaluate any predisposing risk factors, immediate underlying causes, pre-fall circumstances, and the intensity of fear the patient has towards falling. The physician will then help the patient identify which activities are associated with their falls and possibly recommend the use of assistive devices like a walker or wheelchair.
Q: Who should be assessed?
A: Anyone who has injured themselves through falling should be assessed. Older adults living in the home should also be assessed for falls if any of the following is true:
- They have fallen twice or more without injury
- They have sought medical attention because of a fall
- They have difficulties with gait or balance
Q: What kinds of fall-prevention strategies are there?
A: The single best fall prevention strategy is multiple-component group exercise, which aims to target at least two areas of the following:
Other methods include supplementation of Vitamin D, which may reduce falls in older adults who are lower risk. Even small things like wearing an anti-slip shoe device during the winter can reduce falls. For those higher risk individuals, especially those who struggle with their vision, creating a “safe” home is very effective.