Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: TUESDAY, January 11, 1994 TAG: 9401110096
SECTION: EXTRA PAGE: 1 EDITION: METRO
SOURCE: Jane Brody
DATELINE: LENGTH: Medium
As people age, the risk of falling rises linearly and the risk of injury from a fall rises exponentially. One in three adults 65 or older falls each year.
Among those over 75 who live independently, a quarter of the falls result in a serious injury. Falls are the immediate reason for 40 percent of all admissions to nursing homes, and they are the sixth-leading cause of death for people over 70.
Even when an older person who lives alone is not hurt by a fall, the resulting fright can prompt a voluntary restriction of activity and a loss of mobility, self-confidence and independence.
Restricted activity also leads to a decline in physical strength, which further increases the risk of falling, as well as the chance that the next fall will result in a serious injury.
Even in a nursing home or other adult-care center, where the environment has been arranged for the safety of people with limited physical ability and agility, the risk of falling persists.
Researchers at the State University of New York at Buffalo studied the incidence of falls at one center that provides custodial care for relatively well elderly people.
Of the 348 residents who lived in the center during a three-year period, falls were reported for 95, or 27 percent. What the researchers learned can help make living safer for those in special residences as well as for older people who live independently or in another person's home.
The researchers, Beth Erasmus Fleming and David Prendergast, both rehabilitation physiologists, were astonished to find that even in a center arranged with the safety of elderly residents in mind, half the falls were attributed to "environmental hazards."
Elderly residents tripped over furniture, slipped on polished floors and fell over their walkers, which are designed to help the frail remain upright.
Furthermore, nearly 60 percent of the accidents occurred in the most familiar environment, the elderly person's own room, with only about 14 percent occurring in the person's bathroom and 4 percent on steps, which are generally considered the most likely places for an older person to fall.
"Clearly, aspects of the environment that appear to be safe for fully functioning individuals present hazards to an ambulatory, but frailer, older population requiring custodial care," the researchers wrote in their report, which was published last summer in The Archives of Physical Medicine and Rehabilitation.
Not surprisingly, nearly a quarter of the falls occurred at night, usually when the people had left their beds to use the toilet.
As for personal frailties, nearly a quarter of the falls were attributable to physical conditions like arthritis, loss of balance, dizziness and "collapsed" knees, the term used when a knee buckled for some reason.
Many older people have poor vision or one or more chronic ailments - like heart disease, high blood pressure, diabetes, Parkinson's disease or the residual effects of a stroke - that can contribute to the risk of falling directly or indirectly, through the side effects of the drugs used to treat them.
In addition, medications given to many elderly people to counter depression or insomnia can result in disorientation, grogginess or coordination difficulties that add to the risk of falling.
In another analysis, the researchers found that those who fell had significantly weaker muscles than those who did not fall. They also found that many residents for whom walkers had been prescribed did not use them because they considered them more of an impediment than an aid to mobility.
Many measures to help prevent falls are easy to put into effect . To
fall-proof the environment, cover floors with tacked-down carpets; keep walking areas clear of obstacles like shoes, footstools, toys and wastebaskets; avoid slippery fabric on beds, chairs and sofas; wipe up all spills on floors immediately and thoroughly; equip bathrooms with grab bars around the toilet and tub or shower; cover the floor of the tub or shower with glued-on non-slip strips; keep stairways well lit and covered with non-skid treads; mark top and bottom steps with glow-in-the-dark tape; place night lights along the route from the bed to the bathroom, and leave a light on in the bathroom during the night.
Pajamas and knee-length nightgowns, robes and coats are safer than longer ones for someone who is likely to climb stairs while wearing them. All shoes and slippers should have non-slip rubber soles, and rain and snow boots should have non-slip treads.
Symptoms like dizziness and loss of balance should be brought to a physician's attention.
by CNB