Action Plan to Prevent Falls

The buzz in working with older adults is fall prevention. And it’s with good cause. If an older person sustains a fall they are more likely to have a serious injury. That injury could be life altering. It’s no wonder it’s on the front of everyone’s mind. Let's take a pause though and discuss falls, what can lead up to it and really how to prevent them. And more importantly what you can do to bounce back quicker if you do fall.

Falling can happen to anyone at any age. Gravity is not going away and it really wants to pull us down. It’s our job to stay up to the task of moving within it. You’ve seen a person just trip over their own laces, or on winter streets, or over that shoe someone left in the way as you walk into the room. There are so many factors that go into creating a fall that it’s impossible to control them all. So let’s take a look at what we can control and how to improve what we can not.

Fall Risk Factors

1. Fear of Falling. This is one of the top causes of falls. Just the fear of falling can set you up for injury. It’s important to look at why you have fear. Is there a prior fall? Did someone you know fall and have an injury? Are you worried what would happen if you did fall and couldn’t get back up? Taking control of your fear of falling by learning to view falls as controllable and making an action plan can actually help reduce your fall risk.

2. Medicine. Your doctor prescribes you medicine for a reason. You need to take it. As a medicine is added, removed or the dosage is changed it’s important for your doctor or pharmacist to review everything you are taking. Many can interact with each other, with supplements you take or with over the counter medications. Performing an initial review and when there are any changes can help prevent a poor interaction that may cause dizziness, weakness, or cognitive changes. These side effects can put you at a higher fall risk.

3. Vision and Hearing. As we age there are changes in our vision and hearing, it’s inevitable. But they can have an effect on your mobility. Vision looking forward and down can be skewed causing depth perception problems. All of a sudden that step off the curb or up into a building doesn’t line up right and a misstep can lead to a fall. Moving around it the dark becomes harder and you feel like you need to touch the wall to maintain your balance. You may not see an item on the floor in dim lighting or a decline on a ramp that can cause you to stumble. Loss of hearing can also create a disconnect with your environment. You don’t hear someone coming up on you and all of a sudden you have to quickly move out of the way. Tinnitus, or ringing in the ears, can also distort what’s going on around you.

4. Activity Level. This is a big category. Think about how much you move throughout the day. Do you just stay in your home where the ground is nice and level and there are no challenges? Do you walk stairs, uneven ground, in crowds, outside in the weather? Lack of activity can cause loss of flexibility and strength. Think of all the things you did when you were younger. Run, skip, jump, ride a bike, hike, swim, dance, etc. When did those stop? And more importantly why? Was there pain, no time, loss of interest, fear? Our mobility needs to be challenged to be maintained. If your activity level throughout the day is so small that even leaving the house is a challenge then anything unusual in your path can cause a fall risk.

5. The world around you. This one you can not change, but you can adapt to it to reduce your fall risk. It’s a big wonderful world though and you don’t want to miss out on it.

Now the fun part, let’s reduce the risk of falling and help you get back into the world. Added bonus, setting up a plan to reduce your fall risk also helps set you up for success if you do fall.

Action Plan Steps:

1. Reduce the fear of falling. Start here with a conversation with yourself. Do you have a fear of falling? What are the fears? Look at the factors discussed above and think about how they play into your fear. Then set up an action plan, which will start with a visit with your doctor. There are also some great community programs that work on reducing that fear. “A Matter of Balance” program by the National Council on Aging can be found locally. (https://www.ncoa.org/article/evidence-based-program-a-matter-of-balance/).

2. Work with your doctor. Ask for a review of all your medication, supplements, and over the counter meds. Make sure you actually share everything. Honesty is the only way to get the results you want. Routine blood work is important to make sure there is no underlying medical reason for your loss of balance. Get your vision and hearing checked annually. Make sure your prescription for your glasses is up to date. Is it time for hearing aides? Only a professional can really tell.

3. Adapt your environment. It is easiest to start at home. Take a look at the furniture in your home. Is there room to walk? Can you fit your walker or be safe with a cane if you use one? Are there rugs you can trip on? Do you have good lighting? Do you need handrails to be safe on the steps to enter your home or inside? Is the toilet too low and you need a handrail there on in the shower? Take a look at your kitchen. Can you reach the items you need the most safely? Making changes in your home may not be easy, but they will make you safer and that will keep you in your home without injury. Working with an Occupational or Physical Therapist can help you develop a plan for a safe home and can also determine if you would benefit from adaptive equipment when outside the home. If appropriate, using a walker or cane can help you maintain your balance while out in the world.

4. Activity Level. Most likely your activity level needs to change. Building and maintaining your strength and mobility can help you prevent a fall, help you regain your balance if you do start to fall, but can also help you get up if you do fall. It’s important to do something every day that gets you out of your comfort zone and routine movements. To improve your balance and reduce your risk of falling, it's important to develop a program that progresses with you. By starting at your current activity level and gradually increasing the challenge, you will enhance your strength, flexibility, and overall activity. Working with an experienced Physical Therapist to perform these activities safely will help reduce that fear of falling while you build up your mobility.

Set yourself or a family member up for success by creating your fall reduction plan now. That gravity isn’t going away!