Karen’s 72-year-old mother has fallen twice in the past year. Although neither fall resulted in serious injury—and in fact, her lively, active mother brushed off both incidents, reassuring her daughter, “I’m fine, stop fussing!”—Karen is concerned.
She has good reason to be. While most falls in adults over age 60 are little more than a spill, requiring a bit of dusting off and clambering back to their feet, you should take every fall seriously, especially as your parent ages. Not only do bones become more brittle with age, making a fracture more likely (and the ensuing recovery time lengthier), falling can erode confidence and strike fear into the heart of an aging person—and often their closest family members—that they will soon lose their independence.
According to the American Academy of Family Physicians, falls in persons over the age of 65 are the leading cause of fatal and nonfatal injuries. And someone who falls once will usually fall again, with each successive episode increasing the risk of injury by six-fold. Even without injury, a fall can signal other problems, such as balance, gait, or improper medication.
HOW TO HELP AN OLDER PERSON WHO HAS FALLEN
In the moment, the first thing to do is see if the older person can get up on their own. If there is any hesitation, reassure him or her and help them to remain calm. Check for injuries, indicated by bruising, skin discoloration, or evidence of a break. If the person grimaces or cries out when they try to move or when you touch their limbs, call for an ambulance. Keep them calm and lying down until help arrives.
If there are no obvious signs of injury, offer to assist the person in getting back on their feet. It’s important that you only assist and not try to do it for them. Encourage them to take their time getting up gradually and carefully. Stay close and be ready to help if they have difficulty. If they struggle to get up on their own, they need to see a doctor that day.
Once they are back on their feet and seem to be fine, keep a close eye on them for 24 hours. Older people may hide an injury because they are embarrassed about losing control and fear loss of their independence. Reassure them that even if they might need additional help in the form of a walker or a home aide, their dignity will be honored.
EVALUATE HEALTH, STRENGTH, AND BALANCE
If the older person has fallen before, even once, or if you have any doubts about their well-being, arrange a visit to the doctor as soon as possible. Her feet or knees might be causing pain and affecting the way she walks. She might be experiencing early symptoms of dementia and simply forgot to use her cane or walker on the way to the bathroom. A geriatrician or a family physician will look for underlying conditions, such as dehydration, anemia, heart disease, neurological conditions, stroke, or UTI.
Bring a list of their medications to show the doctor, who will evaluate them for any combinations or dosages that might be causing lightheadedness or affecting balance. This includes blood pressure and diabetes medications; anticholinergic medications (for treating allergies, overactive bladder, nausea, depression, etc.), and pain and sleep medications. Some antipsychotic medications aimed at relieving dementia behaviors can have a sedative effect, leading to balance issues and fall risk.
Tell the doctor if you’ve noticed anything unusual, such as loss of appetite, weakness, vision problems, limping or shuffling of the feet. The doctor may refer the older person for a gait assessment or prescribe physical therapy to correct issues that can affect balance. If no such referral is necessary, bring up the subject of good health guidelines, such as nutrition, hydration, and exercise, and follow the doctor’s instructions.
PREVENTING FUTURE FALLS
A day or so after your older parent has fallen is an ideal time to have a frank discussion about fall prevention. Explain your concern for their safety and good health and remind them that their future independence hinges on avoiding falls. Then begin making the rounds of their healthcare providers to evaluate and correct whatever might increase the risk of another fall.
- Visit the ophthalmologist for a complete vision check.
- See a podiatrist to determine if your elder parent might be wearing loose or painful shoes that can affect gait and balance.
- Scan the home for proper lighting and trip hazards. Fix or remove loose rugs or carpeting, peeling linoleum, dangling cords, or other obstructions that may impinge on pathways to the bedroom, bathroom, and front door.
- Minimize the need to get up and cross the room to fetch glasses, the TV remote, or a magazine. Older people like to keep things handy where they can reach them, but it can lead to clutter. Help them by providing handy storage, such as an inexpensive bin with drawers next to the person’s favorite chair.
- Introduce the idea of using a cane or walker. While convincing an older person to use these aids in no easy task, it beats a trip to the emergency room.
It’s important to take every fall seriously, investigating causes and evaluating for future risk of another fall. But with prompt attention and good preventive practices, your aging parent will enjoy good health and quality of life for years to come.
“What to do if an elderly person falls.” CareWatch UK Blog. Jan 20, 2020. https://www.carewatch.co.uk/what-to-do-if-an-elderly-person-falls/
Bergen, PhD, Gwen; Mark R. Stevens, MA, MSPH; Elizabeth R. Burns, MPH. “Falls and Fall Injuries Among Adults Aged ≥65 Years.” Morbidity and Mortality Weekly Report, Centers for Disease Control and Prevention, September 23, 2016. https://www.cdc.gov/mmwr/volumes/65/wr/mm6537a2.htm?s_cid=mm6537a2_w
Hargarten, MD, MPH, Stephen. “Guest Post: Falls Prevention Awareness Day.” The Academy of Family Physicians Community Blog. Sep 22, 2016. https://afpjournal.blogspot.com/2016/09/guest-post-falls-prevention-awareness.html
Mayo Clinic Staff. “Fall Prevention: Simple Tips to Prevent Falls.” Healthy Lifestyle/Healthy Aging Blog, Oct 4, 2019. https://www.mayoclinic.org/healthy-lifestyle/healthy-aging/in-depth/fall-prevention/art-20047358
Van Voast Moncada, MD, Lainie, and L. Glen Mire, MD “Preventing Falls in Older Persons.” American Family Physician, Aug 15, 2017. https://www.aafp.org/afp/2017/0815/p240.html