Guest post by Thomas C. Davies MD, CCFP, MSHA, and FACHE
Dr. Davies is a Family Doctor with over 30 years practice experience in the US and Canada. For the past 10 years he has provided inpatient hospital medical care to patients aged 65 or older.
I’m strong on my feet and walk a grassy path to the roadway daily without thinking about it. Having passed age 60 I felt as strong as ever as if the effects of aging would be in the distant future. This day my foot hooked the curb so fast I had no memory of being slung to the asphalt. A bad fall happens that quickly.
I remembered not to get up too quickly which might cause additional injury so I crawled to the curb, sat up and checked myself over. My wrists; hands, knees and face had equally absorbed the impact. There were lots of abrasions but no fractures or broken teeth. As a medical doctor I know falls can be life altering so I began asking myself the tough questions. What are my risks and what should I do about it?
Facts about falling
One out of 3 people over 65 have a significant fall each year. The odds of avoiding this problem are not in our favor. Falls are the leading cause of fatal injuries and non-fatal for the elderly population. An active lifestyle helps maintain mobility but ironically exposes us to falls like mine.
After a serious fall some people limit their activity which adds to the long term risk. An honest assessment of oneself and making an individual fall prevention plan should help avoid injury. I decided on the spot to make myself a personal fall risk plan.
My fall risk plan
These days I consciously consider my footing and terrain. Uneven ground requires more concentration. I have an eye out for broken pavement, cracked sidewalks, chuckholes, and loose rocks – anything that might challenge my balance or traction. Each morning I choose footwear that should be appropriate for the coming day’s activities.
Speaking of footwear I no longer economize. Ankle support is helpful. The synthetic soles on today’s shoes can be super slippery on wet concrete or tile. Oil resistance is not enough; I test footwear I plan to wear on different surfaces wet and dry.
Other balance challenges
It’s a little humbling to realize our sense of balance declines with time. Potentially risky activities such as climbing ladders, walking on rooftops, even riding bicycles challenge our ability to balance. It’s worth heeding advice from your friends and spouse; they often see dangers we don’t.
With age we’re more prone to serious injury from a fall because of declining bone structure and strength. Many of us are deficient in Vitamin D and Calcium causing progressive bone weakness. A Dexa scan for bone density is an objective way to determine the risk of osteopenia and osteoporosis. National guidelines suggest this test for females over 65.
Some age related changes are subtle. Declining balance is a huge problem even when our strength is good. Often this is insidious related to a decline in the brains balance center or blood supply. If balance seems different on looking upwards or during certain activities then some simple tests under professional supervision are advisable.
Blood pressure may drop with changes in posture. Known as “orthostatic hypotension” this may relate to medications or arterial changes. You may discover this at home but if there is any suspicion it is worth a trip to the doctor. It is treatable and could result in avoiding a fall.
What you can do
Our place is free of scatter matts, floor clutter or unstable furniture. I turn a light on when getting up at night and sit on the bedside for a few seconds to allow my cardiovascular system to adjust. Quality of life is enhanced by managing the risks of aging. I don’t worry about falling but build these precautions into daily activities. It’s like insurance for all those future activities I plan to attend on foot.
Useful Links and Data on Falling