Fall Prevention -
Frequently Asked Questions

1. At what age should I be assessed for risk of falling?

In Sonoma County, the number one cause of non-fatal hospitalizations for age 55 and older is falls. The incidence of falls and fall-related complications rise steadily after age 60.

2. Why is it important that I be assessed for risk of falling?

There is a high possibility for injury when falling. Twenty to thirty percent of falls result in moderate to severe injuries, reducing independence, mobility, and increasing risk of premature death. Roughly 5 percent of older people who fall must be hospitalized. Assessment can identify and predict people at risk for becoming dependent; identify individuals who may need special services and/or treatment; and, plan effective exercises targeting physical weaknesses.

3. Along with physical injury that reduces independence and mobility, what else can occur after a fall?

There can be psychological and social consequences, like loss of self-confidence that leads to loss in mobility, level of activity, and ability to socialize.

4. What are the risk factors for falls?

Risk factors in older adults can be a combination of several factors rather than just one single event. The more risk factors involved, the more likely one is to falling. Internal Risk Factors include, but are not limited to, poor eyesight, hearing loss, lack of balance, stroke, Parkinson's disease, dementia, depression, respiratory and cardiovascular disease, weakness and poor grip strength, rheumatoid and osteoarthritis, and foot disorders. External risk factors include medications, hazards in the home such as stairs, throw rugs, loose cords, poor lighting, poorly fit shoes, insufficient lighting and hazards outside the home like slippery or icy roads, fallen leaves and uneven pavement.

5. Should I be concerned if I have fallen only once?

Yes. A fall may be a symptom that something is wrong with your body. One fall can cause serious injuries; contact your doctor even if you aren't injured. Continue with follow-up care to find any new risk factors for falls that may develop especially if your health gets worse.

6. How can health-care providers help me if I am at risk for falling?

If you have ever fallen, have walking and/or balance problems, and have needed medical attention after a fall then you should request a full fall evaluation. You may need a referral to a geriatrician, a doctor specializing in care of older adults. By talking with your doctor, he or she can assess your risk of falls by reviewing your history of falls and your medications; evaluating the way you walk, checking your heart rate, heart rhythm and blood pressure, examining your vision, and reviewing your use of canes/walkers.

7. What medical tests are used to identify the reason a person falls?

If your health-care provider cannot identify the cause of a fall, then a More detailed evaluation may include some of the following tests: blood tests to rule out infection, anemia, diabetes and thyroid disease; an EKG to rule out heart disease or irregular heartbeat; echocardiogram (heart scan) to check for heart murmur; levels of medication, which can affect risk of falling; brain scan to rule out stroke or tumor; and, x-ray of neck to exclude arthritis of spine and bone density test. If you have joint problems or hearing/vision problems, your doctor may refer you to a specialist.

8. Will physical activity and/or exercises reduce my risk of falling, and how will I know if it is safe for me to exercise?

Physical activity and/or exercises will definitely reduce your risk of falling. Studies show that strength and balance exercises over a 10-week period of time, significantly improve bone, muscle, and neurological weaknesses. Check with your health care provider before you begin a physical activity program.

9. What kinds of exercises would help me to reduce the risk of falling?

Endurance exercises begin by starting slowly and in moderation, by walking a little further each day than you normally do and progressing to walking further and faster as the weeks and months pass. The "six-minute walk" and "two minute marching step" help in shopping, household chores, and recreation. Strength exercises involve a simple "30-second chair lift" to measure lower-body strength and the arm curl which measures upper-body strength. These assist you in getting out of a chair, bathtub, or car and help you rise from a lying down position as well as aid you in dressing, shopping lifting, and much more. Flexibility exercises like the "back scratch" and "sit-and-reach" improve posture and mobility tasks like walking, climbing stairs, combing one's hair, washing one's back, or putting on over-the-head garments.

10. What can I do to prevent falls?

• Begin a regular exercise program
• Make your home safer
  (See our Home Safety Checklist)
• Have your health care provider review your medicines
• Have your vision checked.

FAQ developed by Laurel Michaels, Sonoma State University intern, Gerontology Program, May 2006

Sources:

• Aetna InteliHealth, "Frequently Asked Questions (FAQ's) About Falls"
• NIA ADEAR CENTER; ACSM's "Exercising Safely" and "Three Ways to Test Your Fitness"
• Assessment for Older Adults by Jessie Jones, Ph.D.
• CDC. "What can I do to prevent falls?" National Center for Injury Prevention and Control