Senior Care Questions: What Causes Seniors to Fall?

We talk a lot about fall prevention here at EasyLiving. We even co-founded a local falls prevention coalition (now the Pinellas Pasco Fall Prevention Coalition). Why do we feel the topic of falls is so important? Why does this issue particularly affect seniors?

A few facts on falls and the elderly:

  • 1 in 3 older adults falls each year.
  • Only about 1/2 of those who fall talk about it with their healthcare providers.
  • The direct medical costs of falls (2010) was $30 billion.
  • Falls are the most common cause of traumatic brain injury in elders.
  • The death rate from falls has risen sharply over the last decade.
What causes falls?
Falls in elders are caused by many factors (and often multiple factors work together to cause a fall). A few of the major causes for falls include: muscle weakness, dizziness, environmental/safety hazards, and eyesight issues. Because there are so many different factors in falls, and because so many falls go unreported, causes can be a little difficult to pinpoint. A great study on this subject used videotape analysis (from a long-term care facility) to more objectively analyze direct causes (i.e. the “activity reason” the fall occurred). Their data showed that 70% of falls resulted from failed attempts to complete activities of daily life (i.e. slipping in the shower, falling over when putting on socks). Another major reason was loss of support from an external object (i.e. failure of a cane or walker, leaning on an unsteady table/household object). Check out the video about the study:

This research makes it clear that it is important to understand both functional/immediate causes and underlying causes when looking at what causes a senior to fall (and thus how to prevent them). Clearly, adjustments to daily routines and environmental safety are key factors in falls. Therefore, an environmental safety assessment is very important. The assessment should look at how the elder does tasks throughout the day to pinpoint some of these potential problems as shown in the video.

For example, is the elder having trouble getting up and down from a chair? Is the person “furniture walking”, i.e. using furniture as a support to get around (and how stable is that furniture)? All of these things can indicate areas for change, which could keep the senior much safer. This is also a great result that can come from having a home care assessment, as professionals can help you identify the best areas to get help. In other words, as in this study, if an elder is struggling or most unsafe during certain ADLs (activities of daily living) then some help during those tasks could be most useful. For example, we often have clients who need help with morning routines and bathing. When they are waking up, they may be prone to weakness and the bathroom can be particularly dangerous due to slipping issues. Therefore, we set up a caregiver to come help them with this part of their routine only. For a minimal cost each week, they reduce their likelihood of falling greatly.

Focusing on such a practical assessment of daily life will quickly help to pinpoint problem areas. Many of these can be addressed simply, with solutions like home care assistance for ADLs, changes to the environment (improved lighting, removing rugs) and safety/support equipment (walkers, grab bars). However, such a functional assessment will also bring to light other problems that might be present such as dizziness and weakness. These can then be further addressed with healthcare professionals to find underlying causes and solutions. For example, the dizziness may be related to medications or an inner ear problem. Weakness may be addressed through physical therapy and an exercise routine.

The causes for falls in seniors are varied, and often multi-factorial. The biggest challenge, however, in understanding the cause of a senior’s falls is to know they are even happening (and therefore when/how). Most falls do not result in major injuries…so why are there so many fall-related injuries and fatalities in seniors? Simply because they are happening so frequently (many of the minor ones are unreported). If we can better understand that these minor falls are happening and how/when, we can take steps to prevent those “big falls” that cause all the problems. The first step in falls prevention is opening up a dialog with your elder loved ones and continually assessing how they are doing. This may start with your careful observations and continue with getting an in-home safety assessment from a professional periodically. Take steps to help your loved ones stay falls free!

EasyLiving is here to help with advice, recommendations and in-home safety assessments for seniors throughout Pinellas County. If you are concerned about an aging parent in Florida, give us a call at 727-448-0900 to discuss the situation. We’re here for you!