In This Issue:

1. Fall Statistics:  A $27 Billion National Challenge!
2. What are Fall Risk Factors?
3. Taking Charge:  Reducing the Risk of Falls
4. Checklist for Spotting and Correcting Home Safety Hazards
5. Better Balance Means Better Living
6. Fall Prevention Technology
7. Checklist: Health and Home Safety Questions to Answer Before Relocating
8. Ask Dr. Vanessa
9. We're Moving!

This month’s SAFE Aging Newsletter theme is fall prevention, a $27 Billion National Challenge. Fall prevention expert, Dr. Rein Tideikscaar’s fascinating feature article “Taking Charge: Reducing the Risk of Falls”  includes a checklist for spotting home hazards, and a quickie “Self Assessment of Fall Risk in Your Home”. Dr. Dazio explains how better balance makes for better living, and includes balance improvement! New technological advances makes personal emergency response systems a life saver!. Dr. Dazio includes a useful resource called “Relocating Checklist: Health and Home Safety Questions to Answer Before Relocating”. Take a brief quiz to test your knowledge about falls, and learn about falls risk factors and what can be done to control them. Let SAFE Aging know what you think at info@safeaging.com.

1. Falls Statistics: A $27 Billion National Challenge!

According to the National Council on Aging, falls and fall related injuries impose an enormous burden on individuals, society, and the nation’s health care systems.

There are approximately 36.3 million people who are 65 or older living in the United States. This is about 12% of our population. Falls are among the most serious and common problems faced by elderly persons  and can be life changing events. Frequently, elderly persons are not aware of their risks of falling, don’t recognize risk factors and don’t report relevant issues or concerns to their physicians.

WHO FALLS?  Falls can have devastating outcomes, including decreased mobility, function, independence and even death. More than one-third of adults ages 65 years and older (about 12 million people) fall each year. Among older adults, falls are the leading cause of injury deaths and the most common cause of nonfatal injuries and hospital admissions for trauma. In 2001 in the United States, more than 11,600 people ages 65 and older died from fall-related injuries (CDC 2003).

WHAT HAPPENS? More than 60% of people who die from falls are 75 and older. Of those who fall, 20% to 30% suffer moderate to severe injuries such as hip fractures or head traumas that reduce mobility and independence, and increase the risk of premature death. Among people ages 75 years and older, those who fall are four to five times more likely to be admitted to a long-term care facility for a year or longer.

Among older adults, the majority of fractures are caused by falls. This translates to about 360,000 to 480,000 fall-related fractures each year. The total cost of all fall injuries for people age 65 or older in 1994 was $27.3 billion. By 2020, the cost of fall injuries is expected to reach $43.8 billion.

The most common fractures are of the vertebrae, hip, forearm, leg, ankle, pelvis, upper arm, and hand. Women sustain about 80% of all hip fractures. Among both sexes, hip fracture rates increase exponentially with age. People ages 85 years and older are 10 to 15 times more likely to sustain hip fractures than are people ages 60 to 65.

WHERE DO FALLS HAPPEN? Because seniors spend most of their time at home, one-half to two-thirds of all falls occur in or around the home. Most fall injuries are caused by falls on the same level (not from falling down stairs) and from a standing height (for example, by tripping while walking) Therefore, it makes sense to reduce home hazards and make living areas safer.

Resources:

• http://www.cdc.gov/ncipc/pub-res/toolkit/Falls%20BrochCOLORpanels.pdf

• http://www.cdc.gov/ncipc/factsheets/falls.htm

• http://www.cdc.gov/ncipc/duip/spotlite/falltips.htm#2

• JAGS 49:664-672, 2001  NCOA: Falls Free: Promoting a National Falls Prevention Action Plan, (2005)

Ø Back to Top

2. What are Fall Risk Factors?

Risk factors are conditions or variables associated with increased likelihood or probability that harm could occur. Fall risk factors are conditions that increase the likelihood of a fall occurring which could result in harm, disability or even death. Combinations of risk factors increase the likelihood of harm occurring.

Fall Risk Factors

1. Muscle weakness: limited leg/arm/hand strength

2. Problems: balance, walking, vision

3. Loss of abilities in daily life activities

4. Medications: certain types of medications; taking multiple medications

5. Safety hazards:

1. in the home: unstable or unsupportive furniture, electric cords, poor lighting, clutter, unsafe bathrooms, loose rugs or carpet, etc.

2. in the community: lack of or uneven sidewalks, lack of supportive features such as stair railings, ramps, grab bars, benches or places to sit; poor lighting

Barriers to Fall Prevention

1. Lack of awareness by older adults and the community at large

1. inability to recognize risk factors

2. lack of knowledge about risk factor controls

2. Resistance to exercise

3. Fragmented healthcare system that is not oriented toward prevention

Ø Back to Top

3. Taking Charge: Reducing the Risk of Falls by Rein Tideiksaar, PhD

People of all ages fall, but falls are more common for older people. In fact, losing balance and falling down is probably the most common accident that happens to older adults. Although most people are not usually harmed when they fall, the more falls an individual has, the greater the chance of injury. If you do get hurt, the result can harm your health, your sense well being, and your independence.

Risk of Falling

It’s important to understand that falls are not a normal part of aging. In order to stop falls from happening, it will help you to understand who is at greatest risk and why. While anyone can fall, there are certain conditions or situations putting older individuals at higher risk. For example:

• Poor Eyesight. This can keep you from seeing hazards and objects in your path, and lead to trips or slips. 

• Walking and Balance Problems. Disorders such as stroke, arthritis, diabetes, and neurological disease may affect your muscle strength and reaction time. As a result, your balance may not be quite the same as it was.

•  Use of Medications. Taking too much medication or the wrong combination of drugs can sometimes affect your judgment, coordination and balance.

•  Depression or Stress. This often causes people to pay less attention and be less alert to surrounding dangers in the environment.

•  Lack of exercise. Inactivity results in weakened muscles, and lack of flexibility. This can change your balance and the way you walk and increase the chances of falling.

Preventing Falls

The good news is that many falls are preventable. By taking some simple steps you can greatly reduce your chances of falling.

Visit Your Doctor

• Get regular physical exams even if they're feeling fine.

• Ask the doctor to review your medications for any side effects that can affect balance. Make sure the doctor knows about all the medications you are taking (both prescription and over-the-counter drugs) so that harmful combinations of drugs can be prevented.

• Tell the doctor about any falls or balance problems you may have experienced. The doctor may want to check you out for any medical conditions.

Stay Active

• A regular program of physical activity is one of the best ways to decrease your chances of falling and improve your sense of well being and confidence.

• Try to include such activities as walking, dancing, gardening, and stretching exercises to improve flexibility and balance.

Make Your Home Safer

• At least half of all falls happen at home and generally take place when doing ordinary things like walking on stairs, getting up from bed or going to the bathroom.  The best way to deal with any threats to safety in the home is through prevention. It’s a good idea to check your home for hazards that frequently cause slips, trips, or falls and eliminate as many potentially trouble spots as possible. By making your home safe now, you can avoid a fall later.

Rein Tideiksaar, Ph.D is a famous author on fall prevention and has written a number of books. Rein is President of FallPrevent, LLC, a company that provides consulting and marketing services to healthcare professionals, institutions and companies in connection with fall prevention in the elderly. Dr. Tideiksaar is currently writing “Beating Gravity”, a book for older people and family caregivers on fall prevention.

Ø Back to Top

4. Checklist for Spotting and Correcting Home Safety Hazards

You can further decrease your chances of falling by identifying any unsafe activities leading to risk of falls and, trying to eliminate any hazards or obstacles interfering with safety. Use this self-assessment checklist to help you.

Self-Assessment of Fall-Risk in Your Home
 

DOES YOUR LOVED ONE HAVE ANY TROUBLE…?	SUGGESTED SOLUTIONS
Walking about your home?	Keep "traffic lanes" free of clutter and obstacles, allow plenty of walking room. Make sure all rooms have sufficient lighting. Remove slippery scatter and throw rugs or use rubber pads to keep them in place. Secure all carpet edges. Wear shoes and slippers with non-slip soles that grip the floor. Ask your doctor about a cane to help maintain balance.
Walking to the bathroom at night?	Install nightlights in the bedroom and bathroom Keep a light within reach of the bed. Keep a clear path from the bedroom to the bathroom.
Getting up from chairs?	Use sturdy chairs with armrests to help get up and sit down. Add firm foam pads to seats of chairs and sofas to help get up.
Getting up from beds?	Move beds against the wall to prevent the bed from sliding away when getting up. Replace existing mattress with one thinner in width to lower bed height or thicker in width to raise bed height.
Getting up from toilets?	Consider an elevated toilet seat and grab bars to help sit down and get up.
Getting in and out of bathtubs or showers?	Consider using a tub/ shower chairs and grab bars to help get in and out. Towel bars are not designed to be used as grab bars. Place nonskid rubber mats or decals on the floor to prevent slipping.
Getting objects from kitchen cabinets and closet shelves?	Store everyday dishes and kitchen supplies within easy reach. Consider keeping items no lower than waist level or no higher than shoulder height to avoid excessive bending, stooping or reaching.

Ø Back to Top

5. Better Balance Means Better Living by Vanessa M. Dazio, OTD

With age, balance can unnoticeably decline. Decline in balance can significantly affect daily life abilities. As fitness levels, strength and flexibility decline, balance loss becomes a serious threat to safety, health and well being.

Balance is necessary to perform all basic daily life activities. Balance is needed to move around, stand and sit still.  Walking, running, sitting, bending, reaching, climbing, kneeling, holding, lifting and driving an automobile all require good balance abilities.  Poor balance will cause falls, will affect driving skills and other important daily life activities such as bathing, dressing, grooming oneself, preparing meals, cleaning the house, home management activities, etc. It only takes one fall or one accident to hurt, permanently injure or kill. 

Good balance depends on cardiovascular health, good strength and flexibility!

Balance can be improved at any age. There are many fun and interesting options to develop or maintain balance.

RISK CONTROL TIPS for Better Balance

1. Seek the advice of health care professionals: Before starting any exercise or fitness program, it is wise to seek the advice of trained health care professionals who can refer you to the appropriate programs based on your personal health background. There are many ways to develop balance. Find the best choice for your circumstances. Some medical conditions require protective actions to assure safety. Working with skilled and knowledgeable professionals is important to begin a fitness or rehabilitation program.
    

2. Consider Tai Chi classes: Tai Chi uses slow, gentle movements in a quiet calm environment to develop muscle strength, balance and flexibility. This pleasant environment can reduce anxiety, stress and blood pressure!

The various actions In Tai Chi cause weight bearing and weight shifting, both are very important for health of muscles and joints. Tai chi causes the muscles to stretch, which helps the joints to keep their maximum range of motion. As a result, joint pain can be reduced. Tai Chi helps to strengthen the muscles. This in turn can improve balance. It causes muscle contractions which increase the pumping rate of the heart. This in turn increases blood circulation, which increases oxygen to the muscles and to the lungs. Tai Chi is a wonderful cardiovascular activity for people of all ages. Tai chi can be done on land and in water.

3. Consider joining a balance training program offered by health care professionals. Programs should include activities to develop strength, flexibility and range of motion. Contact your local rehabilitation out-patient clinics for details.
    

4. Develop lower leg strength: Your leg muscles are especially important for walking, maintaining balance and preventing falls. It is very important that these muscles stay strong throughout life. Swimming and pool exercises are a great way to develop or maintain leg strength. Bicycling is another good activity. There are many more options. Seek the advice of a physical therapist or a qualified fitness trainer.
    

5. Develop flexibility: Learn stretching exercises that keep all muscles working at the maximum range of motion. Staying flexible in the hips, ankles and shoulders is very important to maintain balance, decrease joint limitations and reduce or eliminate pain. Pool exercises for the shoulder, trunk, hips, knees and ankles can be a wonderful source to develop flexibility. A great activity is a water fitness program. Check your local aquatics therapy centers, YMCA’s or other community centers for more information.

6. Balance activities:

1. Try single leg standing:  Start very carefully by standing next to the kitchen counter top for support. Stand on one single leg on a solid hard floor (no carpet), and hold that position. Switch to the other leg. Repeat as tolerated to increase the level of difficulty, progress to carpets, foam surfaces, and uneven surfaces. Always take a partner for safety, or stand by a solid support with good hand grips.

2. Practice shifting from side to side: Standing at the kitchen counter. Place your feet a comfortable distance apart. Then shift your weight from side to side. You can increase the level of difficulty with this by increasing the distance your feet are apart, or moving the feet into diagonal patterns.

3. Practice walking fast: Use a partner for safety. Never walk beyond your abilities.

4. Practice walking over obstacles: Use a partner for a safety.

Precaution: if you have had recent surgery, have fall risk medical conditions such as Parkinson’s disease, arthritis, cardiac conditions or others; are taking medications, or have sensory, vestibular or any other difficulties affecting balance, check with your doctor or therapist BEFORE trying any of the following balance activities! Avoid doing these activities without support.

Ø Back to Top

6. Fall Prevention Technology

Recent technological advances address many home safety concerns. One type of life saving fall prevention technology is called a personal emergency response system or PERS. PERS are electronic devices designed to summon help in an emergency. These have a small radio transmitter which is a device (such as a watch or a necklace) worn by the user; a console connected to the telephone; and an emergency response center that monitors calls.

Should an emergency occur, the user can press the device, which then calls the emergency response center. The center then takes action to provide help or assistance.

For more information on personal emergency response systems refer to this article.

• http://www.ftc.gov/bcp/conline/pubs/services/pers.htm

Ø Back to Top

7. Checklist: Health and Home Safety Questions to Answer Before Relocating  by Vanessa M. Dazio, OTD

Relocating to another place such as an adult living facility or a nursing home may be one of the most emotional and difficult decisions individuals and families make. Many factors influence such a decision including finances, security, personal safety, attitudes, personal capabilities, the neighborhood, health or home safety, or combinations of all of these. Before making a final decision to move, take some time to answer the following questions about your safety and health at home.

Checklist Before Moving - PDF

Ø Back to Top

8. Ask Dr Vanessa

Question:  My feet are killing me! I have fallen a few times, although not seriously, but I am starting to get afraid. I don’t want to go out. I hate to take my shoes off because the pain gets worse.  Do you have any ideas?

Answer:  My first thought is why are you having pain, especially when you remove your shoes? Why are your feet killing you? It is an important first question in trying to solve your question. Your feet support your body, and help you to walk and to maintain your balance. Feet have a huge influence on the ability to actively participate in life. Your feet carry you from one room to another, out of your house, to the grocery store, and to church. Your feet take you to visit friends, to recreational activities and to far off places around the world.

Fear of falling is another big issue!  Avoiding outside activities is still yet another concern. Perhaps, all these concerns are inter-related? If your feet are killing you, the obvious place to start is to look at the shoes you wear.  Many foot conditions are caused or exaggerated due to the type of shoes that are worn or due to an incorrect shoe size. Feet sizes change over the years. Often people just don’t realize this actually happens! As a result, failure to notice an increase in foot size and failure to change shoe sizes can cause the toes to become oddly shaped to conform to the smaller shoe. Toes that have become deformed in appearance can cause severe pain. Foot pain and foot deformities can cause loss of balance and affect walking abilities. Because a fall can be life threatening, it is vitally important that you seek immediate medical attention.  

It is very important to find out the answer to why you are having pain. The appropriate health care professional to see for your foot condition is a podiatrist, otherwise known as a foot doctor! The podiatrist can carefully examine your foot to see exactly what is causing your difficulty. You should be sure to tell your doctor that you are having pain especially after you remove your shoes, have fallen a few times and are afraid of falling, and feel like avoiding outside activities. 

As an occupational therapist, I am very interested in helping you find a way to prevent falls and actively participate in all of your preferred activities. In this case, the very best place to start is with your podiatrist!  For more information about podiatry, refer to the American Podiatric Medical Association. You can locate a podiatrist in your area using their web site. http://www.apma.org/s_apma/sec.asp?CID=8&DID=2819

Footwear Tips - PDF

Ø Back to Top

9. SAFE Aging is Moving!

We are pleased to announce our office re-location to Pasco County, FL!  This move enables us to better serve a far wider range of clients in multiple county areas in the great state of Florida.
 

As of June 1, 2005, our new address will be:

9330 Regency Park Blvd.

Port Richey, FL  34668

PHONE:  727-848-1535

FAX:  727-848-2404

Ø Back to Top

Enjoy our newsletter?

Then get it delivered to your inbox every month, for free!

Simply visit any page on our website (www.safeaging.com) and enter your email address in the "Join Our Mailing List" sign up box. It's that easy!  SAFE Aging will never share your information with other companies--confidentiality is assured. Refer your friends, families, and associates too!

Ø Back to Top

Wherever You Go! 
Carry Your Medical & Emergency Info!
www.MedicTag911.com

MedicTag is a portable digital medical alert device that plugs into a computer or laptop USB port and provides instant access to vital emergency info when needed the most.

ONLY $34.95 + s/h

No annual fees!

Ø Back to Top

Article Submissions

We invite interested authors to submit theme based articles for the SAFE Aging newsletter. Please send submissions in either .doc or .rtf format, Arial 10pt. font, and with a 300 word maximum. Articles should be written in an easy to read format to meet the needs of a varied readership including seniors, family members of seniors, caregivers and other senior service providers.  

Topics should in some way be related to health, safety or injury prevention. Articles may not be an advertisement for services and must be informative or helpful. Author photo and contact information may be included. 

There is no guarantee that submitted articles will be published. Generally, articles will be held until the appropriate monthly theme. All articles become the property of SAFE Aging and are subject to editing.

We now have advertising opportunities based on monthly, semi-annual or annual advertising rates. Please contact newsletter@safeaging.com for details.

Ø Back to Top