Project Description

Be Informed About Falling Down

Fall Facts

  • Fall rates are highest for children age 0 to 4 years and adults age 75 and older. 3,4
  • Among older people, the risk of falling increases with age and is greater for women than for men. 3,4
  • Two-thirds of those who experience a fall will fall again within six months. 3,4
  • At least one-third of all falls among older people involve environmental hazards in the home. 3,4
  • 55% of falls occur inside the house and 23% occur outside but near the house. 5
  • Falls and fall-related injuries have been the leading cause of injury deaths among older adults 12,13
  • Fall-related hip fractures account for approximately 25 percent of injury deaths among those over age 65, and 34 percent of injury deaths among those aged 85 or older. 9

Falls and Traumatic Brain Injury

  • Falls are the most common cause of traumatic brain injuries (TBI).1 out of 5 falls causes a serious injury such as a TBI or broken bone.  1
  • People with TBI often have problems with balance. Between 30% and 65% of people with TBI suffer from dizziness and problems with balance while sitting or standing. Dizziness includes symptoms such as lightheadedness, vertigo (the sensation that you or your surroundings are moving), and being “off balance”. 1
  • Other injuries you had along with your brain injury can affect the ability to maintain balance. For example, in a car accident, you could also injury your spine, arms, or legs in addition to your brain. 1,7
  • Every individual with a brain injury is different, with a unique recovery process and outcome. However, the older the person with the injury, the more likely it is that he or she will have a poorer prognosis or outcome.

Studies reveal that individuals with brain injuries who are age 55 and older7:

  • Have significantly longer, more costly stays on rehabilitation units
  • Recover approximately half as quickly as younger people with similar injuries
  • Have greater cognitive impairment at discharge than younger people with similar injuries

Fall risk factors

People are at risk for a fall if they 2,3:

  • Have had a previous fall
  • Are older than 60
  • Have physical limitations (including visual problems)
  • Have more than one chronic disease
  • Take more than four medications or use psychoactive medications (such as antidepressants)
  • Are cognitively impaired
  • Have lower body weakness, problems walking, or have balance problems
  • Have decreased feeling in legs or feet
  • Get dizzy after sitting up from lying down

How to prevent a fall

Make your home safer1,2,3

About half of all falls happen at home.  Take the following steps to make falls at home less likely:

  • Put handrails on both sides of the staircase
  • Watch out for pets!
  • Remove trip hazards (such as papers, books, clothes, and shoes) from stairs and walkways.
  • Turn on the lights when entering your house at night.
  • Use a nightlight in the bedroom and bathroom. Make sure hallways and staircases are well lit.
  • Get rid of rugs or use double-sided tape to keep the rugs in place.
  • Put grab bars next to your toilet and your tub or shower.Do not use towel bars, sink edges, etc. for support because they could break.
  • Use non-slip mats in the bathtub and on shower floors.
  • Immediately wipe spills off the floor
  • Keep the most used items in areas that you can reach easily (without using a step stool).
  • Never stand on chairs or similar items to get to something you can’t reach

Begin a Regular Exercise Program1,2,3

  • Exercise! Work on abs, leg  strength and balance (12,2,3,4)
  • Do Tai Chi !8
  • Ask your doctor about the best type of exercise to meet your needs. 

Review Your Medicines1,2,3

  • Ask your doctor or pharmacist to review all the medications you take, including over the counter medicines, and see if adjustments can be made to minimize your risk of falls.
  • As you get older, medications can have different side effects. Some can lead to falls by making you drowsy or light-headed. Talk to your doctor.
  • Talk to your doctor about reducing or stopping excess or unneeded medications
  • Medications that are the biggest fall risk include:
  • Psychoactive drugs, especially any  “benzodiazepines”
  • Klonopin, Ativan, Xanax, Valium
  • Asthma and anti-spasticity medications called “anticholinergics”
  • Tylenol PM, Benadryl, and medications that make you tired/drowsy

Have Your Eyes Checked1

  • Get your eyes checked every year by an eye doctor
  • Make sure your glasses are still the right prescription

 

References

  1. Brain Injury Association of America (2001). Brain Injury: The Golden Years. Understanding and Preventing Adult Brain Injury. www.biausa.org/publications/goldenyears2.pdf.
  1. Centers for Disease Control and Prevention. (2014). Stopping Elderly Accidents, Deaths & Injuries: Tool Kit for Health Care Providers. http://www.cdc.gov/homeandrecreationalsafety/Falls/steadi/
  1. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. http://www.cdc.gov/injury/wisqars/
  2. Gill TM, Williams CS, Tinetti ME. Environmental hazards and the risk of nonsyncopal falls in the homes of community-living older persons. Medical Care. 2000; 38(12): 1174-1183.
  3. Gillespie LD, Robertson MC, Gillespie WH, et al. Interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews. 2012; 9. DOI: 10.1002/14651858.CD007146.pub3.
  4. Kochera A. (2002). Falls among older persons and the role of the home: an analysis of cost, incidence, and potential savings from home modification. Issue Brief (AARP Public Policy Institute), (IB56), 1-14. http://assets.aarp.org/rgcenter/il/ib56_falls.pdf
  1. Maskell F, Chiarelli P, Isles R. Dizziness after traumatic brain injury: overview and measurement in the  clinical setting. Brain Inj. 2006; 20(3): 293-305.
  2. Li F, Harmer P, Fisher KJ, et al. Tai Chi and fall reductions in older adults: a randomized controlled trial. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2005; 60(2): 187-194.
  3. Moyer, VA. Prevention of Falls in Community-Dwelling Older Adults: U.S. Preventive Services Task Force Recommendation Statement. Annals of Internal Medicine. 2012; 157(3): 197–204.
  4. Peek-Asa C, & Zwerling C. Role of environmental interventions in injury control and prevention. Epidemiologic Reviews.2003; 25(1): 77-89.
  5. Guideline for the prevention of falls in older persons. American Geriatric Society, British Geriatric Society, & American Academy of Orthopedic Surgeons Panel on Falls Prevention. J Am Geriatr Society. 2001; 49(5): 664-672.
  6. Steinberg M, Cartwright C, Peel N, Williams G. A sustainable program to prevent falls and near falls in community dwelling older people: Results of a randomized trial. Journal of Epidemiology and Community Health. 2000; 54(3): 227-232.
  7. Sterling DA, O’Connor JA, Bonadies J. Geriatric falls: Injury severity is high and disproportionate to mechanism. Journal of Trauma–Injury, Infection and Critical Care. 2001; 50(1): 116–9.
  8. Stevens, JA. Falls among older adults—risk factors and prevention strategies. Journal of Safety Research. 2005; 36(4): 409-411.
  9. Stevens JA, Ballesteros MF, Mack KA, Rudd RA, DeCaro E, Adler G. Gender differences in seeking care for falls in the aged Medicare population. American Journal of Preventive Medicine. 2012; 43: 59–62.
  10. Stevens JA, Corso PS, Finkelstein EA, Miller TR. The costs of fatal and nonfatal falls among older adults. Injury Prevention. 2006; 12: 290–5.
  11. Stevens JA, Phelan, EA. Development of STEADI A Fall Prevention Resource for Health Care Providers. Health Promotion Practice. 2013; 14(5): 706-714.
  12. Tromp AM, Pluijm SMF, Smit JH, et al. (2001). Fall-risk screening test: A prospective study on predictors for falls in community-dwelling elderly. J Clin Epidemiol 2001; 54(8): 837–844.