Fall prevention Q&A: The facts, the causes & how to react if you do fall

Falls are a major health issue in Tennessee,

Each year, 1 in 4 older adults falls.
1 in 5 falls causes serious injury.
People who fall are 2-3X more likely to fall again.
The likelihood of injury or death increases with each fall.

While many of us know the basics of fall prevention, there are many factors — from medications to hearing loss to lighting — that we may not consider.

Senior health spotlight: Fall prevention guide

To find out more, WellTuned spoke with two BlueCross experts:

Angeline Brunetto, medical director and emergency medicine physician
Ann Rakes, registered nurse and director of quality improvement

What are the most common causes of falls?

Rakes: The most common falls we see happen is when people get up in the middle of the night to go to the bathroom, or people having trouble navigating stairs or furniture. A lot of people don’t realize that arranging furniture for aesthetics can cause real problems.

Dr. Brunetto: In the emergency room, we break falls into 3 areas.

1. Mechanical or environment

So many things in our daily lives can contribute to falls, including:

Ill-fitting or unstable shoes (heels, floppy slippers, shoes with slick soles)
Loose clothing, which catches on furniture, doorknobs, handrails, etc.
Pets getting under foot
Home layout (rugs, lighting, clutter, cords, etc.)

2. Medications

As we age, our bodies process medications differently, which can affect our balance, reflexes and reaction time. (It’s the same reason alcohol affects us more quickly as we age.)

Medications that can contribute to falls include those for:

Sleep
Mood (depression, anxiety)
Pain (opioids, muscle relaxers)
Allergies
Blood pressure
Diabetes

3. Underlying medical problems

Medical issues can interfere with mobility, reaction time, depth perception and other motor skills.

Common examples of issues that contribute to falls are:

Loss of vision
Arthritis
Osteoporosis
Memory issues (dementia, Alzheimer’s disease)
Sleep disorders
Circulation problems
Hearing loss

At what age do falls typically become an issue?

Rakes: Earlier than what’s considered “senior.” It’s not 65; more often it’s late 50s/early 60s. Your reaction time gets longer as you age, and that makes you more likely to fall.

Dr. Brunetto: Most of us don’t even get the moment of, “Oh no, I’m falling!” It happens so fast that we never even recognize it. We just find ourselves on the ground and think, “How did that happen?”

What’s the safest way to react if you do fall?

Dr. Brunetto: This is far easier said than done, but if you recognize you’re falling and have time, don’t stiffen up. If you’re rigid, you can hurt yourself more.

In general:

Try to stay loose and flexible
Try to land on the “meat” of your body — buttocks, thighs or on your side
Protect the most important areas, such as your head
If you fall backward, tuck your chin and stay flexible
If you fall forward, turn your head to the side and keep your elbows and knees bent so you’re more loose

Should you talk with your doctor about falls?

The Mayo Clinic recommends making an appointment with your doctor to discuss medications, previous falls, health conditions, etc. Do you think this is necessary? At what age?

Dr. Brunetto: By the time you’re in your mid-50s, it’s a good idea to take time — maybe during your annual physical — to talk through medications with your provider. Between visits, you can also ask your pharmacist about any effects you’re feeling from new medications, such as dizziness.

For any medication, you and your provider can discuss:

Do you really need the medication?
Is this the correct dosage?
What are the side effects?
Are there any swaps?
Is there anything you’re taking — over-the-counter, herb supplements — that could interfere with it?

When it comes to fall prevention, what are the biggest things people need to look out for?

Dr. Brunetto: In addition to environment, medication and health conditions, look out for:

Home hazards
- Use non-slip mats and grab bars in the bathtub
- Bundle up cords against walls and/or tape them down
- Add brighter lighting to dark areas
Put commonly used items in easy-to-reach area so you’re not getting on stools or ladders often
Put down your devices
- In your home, don’t use your phone or tablet while moving
- Outside, don’t look down at your device while trying to navigate sidewalks, stairs, etc.
Address physical issues that can contribute to falls
- Get your eyes tested to ensure you’re seeing your environment clearly
- Talk with your doctor about problems holding urine
- Add strength exercises to your routine

Rakes: Incontinence is a big contributor to falls. People rush to the bathroom because the urge comes on so quickly, which can easily cause trips and falls.

Urinary incontinence: Signs, treatments & when to talk to your doctor

When it comes to exercise, reconditioning or rebuilding strength that we all lose with age, is important.

The BlueCross Silver&Fit program is personalized and offers balance classes.
If you’re not a BlueCross member, your local YMCA or community center should offer strength-building classes by age group.
Tai chi is a low-impact exercise that can help seniors build strength.
Build core strength with simple exercises, such as standing and lifting one foot off the ground 1 inch for 30 seconds at a time.

5 easy exercises to strengthen core muscles

Anything else people don’t know about falls that they should?

Dr. Brunetto: People don’t realize how dangerous falls are, especially for older populations. More than 35 million older adults fall each year, resulting in more than 32,000 deaths. We just want everyone to realize how serious even one fall can be and work to prevent it.

If you’re concerned about a loved one falling, how should you approach that?

Rakes: So much of that conversation has to do with your loved one’s ability to accept what you’re telling them. No one wants to grow old! But when I ask patients, “Have you fallen in the past 3 months?” the answer I get most often is, “Well, which fall do you want to hear about?”

Falls are happening, and you’re doing the right thing by helping your loved one learn to protect themselves.

Dr. Brunetto: Communication is key. Start by asking if they’re worried about falling, and express your concerns clearly. Offer recommendations one by one if they’re resistant. But don’t give up. Every little change helps.

More on aging from WellTuned

Ashley Brantley

Ashley Brantley has been writing about food, culture and health for more than a decade, and has lived in three of Tennessee’s four major cities (Memphis, Nashville and Knoxville).