Take Steps to Protect Yourself Against Falls

Anyone can take a tumble, but the population most vulnerable to falling and sustaining a serious injury is 65 and older.

“According to the CDC, one in 4 older adults will fall in a year,” says Adrianna Bellamy, injury prevention coordinator in the MUSC Health Adult Care Trauma Program. “Anyone at any age group is susceptible to a fall, but the most vulnerable are 65 and older. One fall increases the chance for more falls.

Falls don’t discriminate where gender is concerned either, Bellamy says. The number of older men and women who fall is equal.

Living environment, drugs that can cause dizziness, and physical factors that are a result of the natural progression of aging increase one’s risk for falling, Bellamy says.

“Weaker bones, low blood pressure, loss of muscle mass, and joint and muscle stiffness all can cause a fall,” she says.

Dr. Katie Schmitt, a physical therapist at the NCI-designated MUSC Hollings Cancer Center, says patients with cancer or neurological disorders are even more susceptible to falling.

“Cancer-related conditions such as neuropathy, low blood pressure and fatigue, as well as impaired motor skills caused by a stroke or a brain tumor can lead to dizziness and unsteadiness,” she says.

A fall can be debilitating and even deadly. Head trauma, shoulder injuries and broken hips are most the most serious injuries. In fact, 90 percent of hip fractures are the result of a fall.

“Any one of these injuries can sideline someone and leave them bedridden, further weakening muscles and making recovery much more difficult,” says Schmitt.

So how do you know if, even though you’re mobile, you’re at risk? Schmitt assesses her patients using the following three tests, which also can be done in your own home: a timed up-and-go test, a 30-second chair/stand test and a 4-stage balance test.

Timed Up and Go (TUG): Start sitting and then stand up from a straight-back chair without using your arms. Walk at a normal pace for 10 feet, turn around and then return to the chair. You should be able to complete this in 12 seconds.

30-second chair/stand test: Sit in a standard-height (17 inches) chair and, without using your arms, stand up and sit down for 30 seconds. On average, you should do between 13 and 15 stands and sits.

4-stage balance test: (1) Feet Together: Stand with feet side by side for 10 seconds without losing your balance. (2) Semi-Tandem Stance: Stand for 10 seconds with both feet on the floor, one foot halfway in front of the other with both feet touching. (3) Tandem stance: Stand for 10 seconds with one foot directly in front of the other with the heel touching the toe. (4) Single Leg Stance: Raise one foot to calf or knee and hold for 10 seconds. If you are unable to hold tandem stance, the literature says, you are at a higher risk for falling.

“These are three main tests to assess someone’s risk for falls,” Schmitt says. “Anyone who cannot complete these tests in the required amount of time is at risk for falling.”

Even if you missed the mark on the tests, Schmitt and Bellamy have encouraging news: You can take steps, literally and figuratively, to reduce your chance of falling, beginning by assessing and safety-proofing your home.

First, assess how well you move and how safely you get on and off your bed and up and down from a chair. Consider whether you need a walking aid, such as a walker, cane or a rollator.

Keep floors and stairs clear of clutter, and have a clear path from bed to bathroom.

Get rid of any loose throw rugs in your home and make sure all rugs have a skid-resistant underside or skid-resistant pads that fit the rug size precisely.

Put railings on each side of steps inside and outside your home and install grab bars next to your toilet and inside and outside the bathtub or shower.

Wear properly fitting shoes and toss the high heels.

Brighten your environment with safe lighting indoors and outdoors.

Get regular vision checks.

Never get on a ladder.

Schmitt says exercises, particularly ones for hips, knees that build strength and control, are essential for improving balance.

Any thorough plan should include a mix of aerobic, cardio and resistance exercises tailored to your physical capabilities and needs. Walking, yoga and tai chi, if done regularly can be incorporated into a plan.

Schmitt says she notices definite improvements in her patients after 2 to 3 months. “We retest them to see if they’re improving, and they definitely are,” she says. “Patients say they feel safer and stronger when going about their routine activities, such as going to the mailbox. One patient recently me he didn’t have to use his cane anymore. That’s fantastic.”

Schmitt and Bellamy caution anyone beginning an exercise regimen, however, to consult a physician or physical therapist for recommendations and a complete physical assessment before heading to the gym or grabbing the yoga mat.

Above all, Bellamy and Schmitt urge patients to be honest with their doctor about their medications, falls and any unsteadiness they’re feeling. “If you’ve had a fall in the last 6 months, or if you’re worried about falling and have curtailed your activities, say so,” Schmitt says. “Don’t pretend it’s no big deal.”

Says Bellamy: “It’s much easier to prevent a fall than to repair injuries from one.”