April 5, 2012

By Sarah Folk

Each year, many people visit the hospital for treatment of injuries associated with falls. Classified as an event that results in a person unintentionally coming to rest on the ground, a fall is a serious health concern for people of all ages.

Azeena Ratansi, occupational therapist with the Multidisciplinary Osteoporosis and Osteoarthritis Programs at Women’s College Hospital, provides tips for safe practices and information on the importance of fall prevention for all ages. 

Ratansi notes that approximately 25 per cent of middle-aged adults reported having at least one fall in the past two years, and according to statistics, falls are the most common cause of injury and the sixth leading cause of death for seniors. Furthermore, women are three times more likely than men to be hospitalized for a fall-related injury.

Watch your step

“According to ER data, every 10 minutes, at least one senior goes to the emergency room due to a fall,” says Ratansi. “In Ontario, approximately 24,000 people over the age of 65 fall annually.” Although older adults are more commonly associated with falls, latest research shows that they aren’t the only ones who should be concerned.

“Falls in middle-aged adults are often an overlooked yet important problem,” says Ratansi. “Few studies have looked at this particular age group and the prevalence of falls; however the studies that have been done have found that the rate of falls in this population is concerning.” For middle-aged adults, walking was found to be the most common fall related activity.

Although falls in these age groups may occur in different ways, one thing’s for certain: falls will generally occur where people spend most of their time. For seniors, this is usually at home, specifically in the bathroom and on stairs. On the other hand, middle-aged adults typically fall outside their homes, usually on sidewalks and curbs, due to uneven surfaces such as cracks or height changes.  

Injuries related to falls can be serious and sometimes fatal. According to the Centers for Disease Control and Prevention, approximately 20 to 30 per cent of people who fall suffer moderate to severe injuries. The most common of these injuries include fractures, lacerations and head trauma.

“For seniors, fractures are the most serious consequence of falls, short of death,” explains Ratansi. Of these injuries, the hip, wrist and humerus are the most common. In fact, 90 per cent of all hip fractures are the direct result of a fall.

Falls are also the most common cause of traumatic brain injuries (TBI), with falls accounting for 46 per cent of TBI among older adults. Psychological effects – such as a fear of falling – can dramatically limit activities, leading to reduced mobility and loss of physical fitness, which in turn can increase the fear.

Falls are preventable

“Falls usually happen because of the combined effects of a number of factors, such as a loss of balance, side-effects of medicine, impaired vision or mobility, and environmental hazards,” explains Ratansi. Fall prevention should be taken seriously, as a history of falls may increase the risk of future falls by threefold.

Ratansi lists the most common reasons for falling and the ways you can minimize your risk for each factor:

1.      Inattentiveness

• Do one thing at a time. Texting while walking can prevent you from noticing physical barriers and obstacles that may cause you to trip and fall.

2.      Loss of balance

• If you use public transit, try standing with your feet shoulder width apart. A wider base of support decreases your chance of falling. This can be helpful when there is a sudden lurch on a bus or subway.
• Install a seat at the entrance of your home for removing and putting on shoes.

3.      Rushing or hurrying

• Slow down when approaching curbs or steps to allow for adjusting to the height difference.
• Purchase a cordless phone to carry with you so that you are not rushing to answer the phone in another room when it rings.

4.      Footwear at home

• Ratansi advises against wearing only socks at home – even on carpet. Use footwear with good support, an enclosed back, and soles that have non-slip treads. The Foot Care Centre at Women’s College Hospital recommends Pedors Classic and Foamtreads for use as indoor slippers.

5.      Carrying an object

• Try to keep your hands free whenever possible. Try using a backpack or bundle buggy, or carry your bags higher on your forearms or shoulders.
• Carrying objects in both hands can interfere with balance and righting reactions, and can block your field of vision. Studies of seniors who had experienced a hip fracture as result of a fall compared to those who didn’t found that having your hands free will give you the opportunity to grab onto something to maintain balance, decreasing the chance of a hip fracture.

6.      Changing position

• Getting up too quickly can affect your balance. Ratansi advises us to move slowly when changing from lying to sitting, or from sitting to standing.

7.      Going up and down stairs

• Use a handrail when going up and down stairs. It was found that middle-aged adults tend to fall going both ways on the stairs, while older adults generally fall going down stairs.
• Ensure that you remove your reading glasses when using the stairs.

8.      Reaching or leaning

• Store frequently used items and heavier objects in easily accessible areas between waist and shoulder height.

9.      Uneven surface

• If you walk in ravines or trails, take extra precautions. These areas are typically uneven and can often have roots or fallen trees on the path. Ratansi recommends that you frequently scan your environment for tripping hazards. This will allow you to make the necessary adjustments to keep you safe.
• The environmental factors contributing to the highest percentage of falls were uneven surfaces and steps.

10.  Obstacles in the path

• To avoid tripping over unforeseen obstacles, install motion-activated or timed lighting outside your home. Place a night light in poorly lit halls and rooms so that you can find your way in the dark. Ratansi recommends keeping a flashlight on your bedside table, especially if you go to the bathroom during the night.

These tips will minimize your risk for falling, however you should use caution in every activity and chore. Surprisingly, November has the highest rate of falls, due to the seasonal cleaning of eavestroughs and the decorating of houses, including putting up Christmas lights.

It’s important for people of all ages to participate in fall prevention, as it could stop you from experiencing an unnecessary and devastating injury.