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Simple Ways To Prevent Falls In Older Adults

16 hours ago
Originally published on July 14, 2019 1:37 pm

As we age, the risk of falling increases and becomes increasingly perilous. A fall can be a real health setback for a frail, elderly person. And, more older adults are dying from falls today than 20 years ago. A recent study showed that more than 25,000 U.S. adults age 75 or above died from a fall in 2016, up from more than 8,600 deaths in 2000, and the rate of fatal falls for this age group roughly doubled.

But the risk of falling can be minimized, says Dr. Elizabeth Eckstrom, professor and chief of geriatrics at Oregon Health & Science University. "A lot of older adults and a lot of physicians think that falling is inevitable as you age, but in reality it's not."

NPR's Lulu Garcia-Navarro and Luisa Torres spoke to Eckstrom about the most common causes of falling among seniors and the best ways to prevent them.

This interview combines two separate conversations with Eckstrom and has been edited for clarity and length.

Are seniors falling more than they used to? Or are there more seniors? Does something else explain this increase?

I think it might be a little bit of both. There are so many more seniors, and there's probably better reporting than there used to be. There's more awareness about falls as older adults and doctors are starting to think about it a little bit more. I think our older adults are starting to [be more active], and that also is going to put you at risk for falling. I always tell people to please not be sedentary to prevent falls. That's the worst thing you can do. You've got to be out and active, but being out and doing things does allow you to put yourself in a position where you could fall.

Also, I think one of the biggest problems for falls is that so many older adults are on risky medications. Those sleeping pills, pain pills, a lot of the drugs that older adults have been prescribed for years and years have markedly increased risk for falling. And if we could get everybody off of those pills, it would be so helpful.

How do pain pills increase the risk of falls?

Pain pills have similar side effects [compared to] sleeping pills. They can make you dizzy. They can make you confused. They can make you lethargic. They can cause you to not be as sharp so that you're not paying attention to curbs or uneven sidewalks.

Are there any other drugs that seniors should be aware of?

Yeah, absolutely. There are a lot of drugs that fall into a class called anticholinergics. It's the class that has cold medications in it, like Sudafed, [and] drugs to help control bladder problems, like Detrol. All of those drugs are in that very dangerous anticholinergic class, [which] increases your risk for falling.

The other thing that a lot of older people take is blood pressure pills. Managing blood pressure is a little tricky [because] you don't want your blood pressure to be too high, because that increases your risk for heart attacks and strokes. But if you take too many blood pressure pills, it makes your blood pressure too low, and you get dizzy and you fall.

A study from the Centers for Disease Control and Prevention found that physicians routinely failed to perform basic interventions to help prevent falls. Why do you think that is, and how could doctors help?

Most primary care doctors have no more than 15 minutes with a patient, and they're managing their diabetes, congestive heart failure, their asthma — all of those other medical conditions. And [they] don't recognize the importance of fall prevention in that milieu. It takes a lot of work to help an older adult reduce their risk for falling. You've got to talk about the glasses; you've got to make sure they're wearing the right shoes; you've got to make sure they're using a gait aid [like a cane or a walker] if they need one — and all of those things take time.

The CDC has also done a beautiful job of putting together a fall prevention package in an initiative called STEADI (Stopping Elderly Accidents, Deaths & Injuries). You can go to their website and find all sorts of useful information to help both clinical teams, older adults and families to reduce risk for falling.

Can you remind us why falling is so dangerous for older adults?

About a third of older adults who fall actually have some form of injury, and a lot of those are hip fractures and head injuries. And those can be fatal, of course. A vitally important thing is fear of falling, and many older adults who fall curtail their activities because they're afraid they're going to fall again. And, again, that's kind of the worst thing you can do because now you're losing mobility, you're getting weaker and you're not moving around as much.

What are some of the interventions you've used that can help seniors?

You can do so many things. First of all, I tell everybody you've got to do some balance training. Tai chi is probably the best exercise to prevent falls, but whatever works for you. And, interestingly, just walking does not reduce your risk for falling. So a lot of doctors will say, "Just get out and walk 20 minutes every day, and that'll keep you safe. That'll help you stay healthy." Walking is great for your heart; it's great for your brain; it's great for lots of it. But in order to really reduce your risk for falls, you've got to do something specific to balance.

What makes tai chi a good exercise to prevent falls? And why isn't walking a good alternative?

Walking is kind of just keeping you in one plane moving forward, and it's not doing any kind of postural training. What tai chi does is it gives you an increased area of postural stability, [which is] kind of your being able to remain upright in space. When you do tai chi, you do stepping moves to the front, to the side; you move your arms out, you reach, you bend. And basically that increases the size of your postural stability so that you can catch yourself and not have the fall. You can be a little bit off kilter and right yourself.

Do you have any more advice on how seniors can prevent falls?

For most people, it's not just one bad thing. It's not just your balance, or it's not just your vision, or it's not just one pill that you're taking. If somebody wants to reduce their risk of falls, they should really think about all of the various ways: making sure you're wearing the right shoes, using a walker if you need it, getting off those risky medications. It's really important to tend to all of those little details to really get your fall risk as low as possible. I encourage people to just work on that really, really hard. It's worth the trouble.

Francesca Paris and Ed McNulty produced and edited this story for broadcast.

Copyright 2019 NPR. To see more, visit https://www.npr.org.

LULU GARCIA-NAVARRO, HOST:

Immigrant communities across the country braced for ICE raids today. Matthew Albence, the acting director of Immigration and Customs Enforcement, spoke this morning on Fox News.

(SOUNDBITE OF ARCHIVED RECORDING)

MATTHEW ALBENCE: We are doing targeted enforcement actions against specific individuals who have had their day in immigration court and have been ordered removed by an immigration judge. We are merely executing those lawfully issued judges' orders.

GARCIA-NAVARRO: Protests have been held across the country in recent days from New York to San Francisco and Chicago.

(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED PROTESTERS: Immigrants are welcome here. No hate. No fear.

GARCIA-NAVARRO: And so now on the line we have Johnny Kauffman from member station WABE in Atlanta and Maria Zamudio from member station WBEZ in Chicago.

Good morning to you both.

JOHNNY KAUFFMAN, BYLINE: Hello.

MARIA ZAMUDIO, BYLINE: Thank you so much for having me.

GARCIA-NAVARRO: Johnny, let's start with you. What are you hearing from immigrant communities in Atlanta?

KAUFFMAN: There's been nowhere today a sign of increased ICE enforcement. Activists aren't reporting anything. The regional ICE office hasn't said anything. It's been a quiet Sunday here, but, you know, it's hard to know, is that because people are spending normal time with family and at church or is it because of fear of potential ICE activity? And we don't know that exactly. Activists have told me they're hearing from Latinx taxi drivers who are worried about things being quiet and about less business, but they haven't really seen that on the ground yet.

GARCIA-NAVARRO: Immigrant rights groups have been preparing for these arrests for a while now because, of course, the president was broadcasting that they were going to happen. What are they saying today?

KAUFFMAN: Dozens of activists in Atlanta went out into the community, calling themselves ICE chasers today. They were looking to monitor ICE activity and also meeting with people at gas stations and apartment complexes, explaining their rights. The activists seemed wary but focused on continuing to do the same kind of work in the coming days - informing people of their rights. And I spoke with the leader of a Latino human rights group. And she sees this talk coming from the Trump administration about increased enforcement really as a political move and says, you know, we can be political too. We can get people organized, and we'll see you in the presidential election in 2020.

GARCIA-NAVARRO: Chicago immigrant activists have been active this morning as well, so let's bring in Maria from Chicago. What can you tell us about what's happening there?

ZAMUDIO: Yeah. Advocates had been preparing for this for a while. As we speak, local leaders are having brigades in immigrant neighborhoods in Chicago's North and West Sides. I also started my day at a detention center in Broadview, a suburb outside Chicago, where dozens of protesters gathered. This detention is where undocumented immigrants are typically brought in after arrest. And while protesters couldn't get information about who was arrested, they were there to show their support to immigrants inside.

GARCIA-NAVARRO: Have you heard about any arrests?

ZAMUDIO: So there was, like, a rapid-response team that was prepared for this weekend, a hotline that was advertised to community members. And as of right now, there was no call to that hotline. So we haven't seen any activity as of yet.

GARCIA-NAVARRO: When you've been talking to these immigrant advocates - and if these raids don't happen today, are they prepared for the long haul? I mean, if they don't happen today, they may happen this week or later this month.

ZAMUDIO: Yes. They really see this as something they need to continue doing every weekend. They're trying to figure out a way to keep this sustainable for the foreseeable future.

KAUFFMAN: The activists that I spoke to actually seemed kind of energized by today, I think, you know, partially because they didn't see a lot of activity, but they saw a lot of outpourings of support and a lot of people came out. And so they really see it as an opportunity to continue to connect with the community, to continue to get people, like, politically activated and engaged. And definitely, the sort of education efforts in terms of people's rights and how to deal with someone if ICE comes knocking - that is something that they're going to sustain for a long time.

GARCIA-NAVARRO: WABE's Johnny Kauffman is in Atlanta, and WBEZ's Maria Zamudio is in Chicago.

Thank you to you both.

KAUFFMAN: You're welcome.

ZAMUDIO: Thank you. Transcript provided by NPR, Copyright NPR.