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Elderly Falls: How to Reduce the Risk and Choose an Alert System

Elderly falls impact the physical and psychological health of millions of older adults. In fact, falls are the leading cause of injury to seniors.1 Although we can't know for certain how many seniors fall each year (since they don't always tell other people about their accidents), senior falls lead to over 2.8 million emergency room visits annually.2

But many falls are preventable. With a few simple steps, you can reduce your odds of falling. In this article, you'll learn why seniors are at high risk for falls. You'll also discover tips for preventing falls and learn the steps to take if you do slip or tumble. As well, you'll learn about medical alert systems that help seniors get assistance in emergency situations.

Falls in the Elderly: Statistics You Should Know

Everyone falls sometimes. But falling can have dire consequences for the elderly. Fall statistics show the seriousness of the problem:

  • One in 10 elderly falls causes a serious injury, such as a broken hip or brain trauma. 3
  • Every 11 seconds, a senior is treated in an emergency room for injuries from a fall. 2
  • Senior falls cost the U.S. healthcare system about $50 billion each year. Medicare and Medicaid are responsible for about 75 percent of that total. 2

But when it comes to measuring the aftereffects of a senior citizen fall, statistics don't always tell the whole story. One reason is that many seniors don't tell anyone when they fall. (They don't want to appear "old.") And the numbers don't always account for the long-term effects of a nonfatal fall, particularly on a senior's sense of pride and independence.

A fall can be a minor incident, especially for young people. But many falls are dangerous for elderly people because seniors often have existing health issues, such as osteoporosis (which makes them more vulnerable to bone fractures) or heart problems (which can make recovery from an injury more difficult, especially if surgery is required).

Of course, the most serious consequence of a fall is death. Every year, about 27,000 seniors die from injuries caused by falling.2 That makes fatal falls the leading cause of accidental death for seniors. (The overall leading cause of death for seniors is heart disease.4)

The consequences of falls for the elderly often go beyond short-term injuries. Even seniors who don't have injurious falls can experience declines in their quality of life after falling. Fear is part of the reason why: Up to 70 percent of seniors who have experienced a fall are worried about it happening again.3 And half of those seniors reduce their activity in response to their fears, which can lead to other physical and emotional health problems.3 For example, after a hip fracture, 20 to 30 percent of seniors die within 12 months—not directly from the hip injury, but often from the negative effects of the resulting inactivity.5

If you're worried about elderly falls, statistics like these may seem daunting. But you can take action to avoid future falls. Prevention can easily fit into your plans for positive aging and a healthy lifestyle.

Why Seniors Fall

Many falls are "multifactorial." That means a combination of factors causes elderly people to fall.

For example, consider an older woman who fell while going to the bathroom at night. All of these factors could be responsible:

  • Physical—She felt dizzy when she stood up because of her blood pressure medication.
  • Environmental—Her bedroom floor was cluttered because she can no longer bend over to pick things up.
  • Situational—Her room was very dark, and there wasn't a light in the bathroom, so she couldn't see the things on the floor.
  • Cognitive—She felt confused when she woke up because her husband is in the hospital and she's not used to sleeping alone.

In other words, if her adult children wonder why their elderly mother keeps falling, they might not find one simple explanation. Fortunately, however, some of those causes can be avoided in the future.

Preventing Falls

Many falls can be prevented. And the steps for reducing a senior's risk of falling are often quite simple. Plus, some fall precautions for elderly people can actually increase their quality of life in other ways.

Seniors can prevent falls by examining three areas in their lives:

  • Overall health
  • Physical activity and daily habits
  • Environment
  • Overall health

    The first step in proactive elderly fall prevention is talking to a doctor.

    Because more and more older Americans are falling, new research in geriatrics focuses on ways to prevent slips and tumbles. For example, one risk improvement initiative used by doctors is STEADI (Stopping Elderly Accidents, Deaths & Injuries) from the Centers for Disease Control and Prevention (CDC). The publicly available materials include resources such as a fall-prevention handout for physicians to pass on to patients and tips for evaluating elderly patients' fall risk.

    Your doctor can perform a geriatric fall risk assessment and make recommendations to protect you. So tell your doctor if you would like this done. (Many doctors don't conduct fall risk assessments unless their patients specifically request them.)

    As part of a risk assessment, your doctor may monitor the following health issues:

    • Diabetes—Seniors with diabetes have a higher risk of falling.6 That's partly because nerve damage in feet (caused by the disease) can lead to balance and gait problems. In addition, hypoglycemia (i.e., low blood sugar) caused by diabetes treatment can lead to vision problems and confusion.
    • Blood pressure—Orthostatic hypotension is a sudden drop in blood pressure that can happen when a person stands up or changes position suddenly. This drop in blood pressure can lead to dizziness and light-headedness, which in turn can lead to falls. About 20 percent of people over 65 are prone to orthostatic hypotension.7 In addition, many blood pressure medications can lead to dizziness.
    • Medication —Drug side effects are one of the most common causes of frequent falls in elderly people. In short, your risk for falls increases as you take more medications. Drugs that are used to treat the following health issues have been linked to falls:

      Ask your physician for information about specific medications. Taking a prescription drug is, of course, often very necessary. But doing an annual medication review with your doctor can help you determine whether a certain medication is worth the risk. A safer drug may be available, or you may be able to make lifestyle changes that eliminate the need for medication.

      Also, let your doctor know if you are taking any herbal remedies or undergoing any alternative medical treatments. These can also affect your balance, blood pressure, and other factors that contribute to falls.

    In addition to talking to your physician, visit the eye doctor. If you have a prescription for glasses or contact lenses, wear them at all times. And keep your glasses clean. Blurry vision is another one of the most common causes of falls in the elderly, and the solution can be as simple as wiping your lenses on a regular basis.

  • Physical activity and daily habits

    Effective fall prevention doesn't mean limiting activities. It's actually better to be more active.

    As we grow older, we lose up to 30 percent of our muscle strength each decade unless we actively work to maintain it. Our flexibility also decreases. Having good strength, balance, and flexibility can mean the difference between recovering from a misstep and experiencing a major fall.

    In fact, one study found that doing exercise involving balance for more than three hours a week led to a 39-percent decrease in falls for older people.8 Exercise can also reduce the need for prescription medications that contribute to falls.

    Many effective fall-prevention exercise programs are available. In addition, the following activities have positive effects on strength and balance. They're also fun!

    • Swimming—It may seem counterintuitive (after all, you can't fall when you're in the water), but swimming is one of the best exercises for improving balance.9
    • Yoga—This activity improves balance and proprioception (i.e., your awareness of where your body is in space), both of which can lower your risk of falling.10
    • Tai chi—Practicing this Chinese system of calisthenics can reduce elderly persons' risk of falls by up to 45 percent.11 The deliberate movements of tai chi help with balance, proprioception, and mindfulness.
    • Strength training—Improving muscle power and endurance through strength training helps with balance as well as the ability to stand up and sit down smoothly.

    Simple behavioral changes in your daily habits can also help you move through the world with more confidence. For example:

    • Wear nonslip shoes (even inside)—You may have been taught that wearing shoes inside is bad manners, but studies confirm that shoes are safer for seniors than bare feet, socks, or slippers.12 Make sure your shoes are the right size and that the soles are in good condition.
    • Take it slow in wet or icy conditions—Short steps reduce the odds of slipping. Wear solid boots or shoes, and make sure your hat or scarf doesn't interfere with your vision or hearing.
    • Get up slowly—If you have to get out of bed at night, first move to a seated position and place both feet on the floor with your hands at the edge of the bed. Then, sit for a minute or two before you push yourself up from the bed to walk.
    • Avoid carrying too much—If you have to carry something heavy, keep it in front of you, at the center of your body. Try not to carry heavy objects up and down stairs.
    • Don't rush around—For example, if the phone rings and you're worried you might not answer it in time, let your answering machine or voice mail service pick it up. And consider programming the machine or service to allow extra rings before the message plays in order to give yourself a bit more time.
    • Shower safely—Try to have one body part touching a shower wall at all times. This helps with your body awareness.
    • Watch your alcohol intake—Drinking alcohol can significantly weaken your stability, not to mention your judgment.
  • Environment

    Sometimes, older adults are reluctant to fall-proof their homes because they think that doing so makes them look helpless. But most falls among the elderly occur in the home. Making some small changes to your home environment can significantly reduce your fall risk. For example:

    • Declutter—Remove anything you can trip over from the floors and stairs. Make decluttering a habit.
    • Rearrange your furniture—Create clear paths through each room. Consider getting rid of unnecessary furniture, especially if it's not very stable—for example, decorative end tables. Pushing chairs and couches against a wall makes them more stable. And check the corners of all pieces of furniture to make sure they're not too sharp. Buy corner guards if they are.
    • Make everything easy to reach—Ensure that the objects you frequently reach for in your cupboards can be accessed without a ladder or stool.
    • Place a light source near your bed—Many falls happen when seniors get up at night. A nightlight in the bathroom is also a good idea.
    • Evaluate your rugs—Get rid of small throw rugs or replace them with slip-proof rugs.
    • Clean up all spills right away—Even a small spill on the floor can pose a hazard if you've forgotten about it.
    • Use slip-proof mats in all showers and tubs—The most common room for a fall is the bathroom.13
    • Fall-proof your bed—You can stop falling out of bed by installing bed rails. But keep in mind that there are two main reasons for seniors falling out of bed: (1) They roll out while they're asleep or (2) they fall while they're trying to get up out of bed. A bed railing system can make it harder to get out of a bed. That's why some seniors who find rails too confining attach pool noodles to the tops of their mattresses on each side. It's a low-cost and less claustrophobic alternative to rails. This creates enough of a "lip" in a bed to help prevent falls.
    • Install other assistive devices—Many products are designed to help the elderly. Fall-prevention devices include things like:
      • Grab bars beside tubs, showers, and toilets
      • Handrails for all stairs
      • Raised toilet seats (which are more discreet than you might think)
      • Door handles that open easily so that you don't lose your balance
      • Non-skid strips for stairs
      • Contrasting tape to make stairs and door jams more visible
      • Shower chairs

      Do you live in a nursing home, or are you concerned about someone who does? Talk to the managers of the home about their fall-prevention program. Good communication with staff is key to fall prevention for the elderly in nursing homes. Ask if they perform regular fall assessments on residents and find out if they have a plan for what do when elderly residents keep falling while in their care. If you are worried about someone in a nursing home, tell the staff that you want to be informed whenever he or she falls.

Medical Alert Systems: Why They Can Help and How to Choose One

Medical alert systems ensure that you get the help you need after a fall or other medical emergency. A medical alert system can also give you a greater sense of independence (by easing any worries about being alone and unable to help yourself).

Medical alert systems have advantages over other ways of getting help for seniors. The most obvious benefit is that these systems cost less than hiring in-home companions. As well, unlike a cellphone, you wear a medical alert device, so it can be with you everywhere (even in the shower if it's waterproof). Such devices are also easier to use than most cellphones. Typically, you just have to press a button in order to send out an alert.

You can read many medical alert systems reviews online to get a sense of what's offered by different companies. In addition, most companies have comprehensive websites through which you can order everything you need. Most sites also have a way for you to ask questions. (Just be aware that some companies have been accused of using aggressive sales tactics.)

You can also purchase the necessary equipment at stores like Costco or Walmart. Medical alert systems deliver a wide range of services, with a lot of variation in price and technical capability. So, before you invest in one for yourself (or for a friend or relative), spend a little time researching the options.

The best medical alert system is one that matches your lifestyle, safety needs, and budget. Other things to consider before you commit to a system include:

  • Can you test it out? Many companies offer a free trial period that you should take advantage of. After all, you want to make sure the system works for you.
  • Is the system waterproof? Remember that a high percentage of falls happen in the bathroom.
  • Do you have to sign a contract? Many companies permit month-to-month payments instead of binding contracts. Avoid contracts that require long time commitments if you can.
  • Will you actually wear the device? Some seniors don't wear alert pendants or bracelets because they find them embarrassing or uncomfortable. But many companies are now making more stylish and discreet devices.
  • How is the battery life? You don't want to be in a bad situation and discover that the batteries are dead.
  • Does the range extend far enough? Consider your daily activities. For example, will you be covered if you are in your garden, if that's your favorite hobby?

Usually, you don't need a landline for medical alert systems. Many now work through cellular networks. In addition, medical alert systems with GPS technology are a great option if you're an active older person. These systems can locate you if you have a fall while you're away from home.

Medical alert systems are divided into two basic categories: those that offer 24/7 monitoring and those that do not.

With a monitored system, activating an alert connects you to a call center that is staffed by people who can reach out to one of your contacts or call 911 if you need immediate help. The personnel at these centers are trained to communicate with seniors in many situations. Some services also offer help in multiple languages. For example, Philips Lifeline medical alert devices can connect users to support in over 140 languages.

Monitored systems typically require a monthly fee and can be more expensive than unmonitored systems. So if you'd prefer something like an emergency call button for seniors with no monthly fee, systems such as the LogicMark Freedom Alert Emergency System can connect you to preprogrammed contacts after you press a button on a wearable pendant. The system can be programmed to call 911 if none of your contacts are available. It can also be programmed to call 911, by default, immediately after you press the button.

Fall detection is also an option with many alert systems, both monitored and unmonitored. Systems with fall detection sense when a person wearing a fall-alert bracelet or pendant has fallen, then they activate a preprogrammed alert.

With a combination of features, a medical alert system can help seniors like you feel safe and independent. For example, products such as many ADT medical alert systems offer both fall detection and GPS capabilities, so a senior can quickly get help if he or she falls while outside the home.

Plus, some popular smart watches now offer features that can act as fall alarms for elderly people. For example, the Apple Watch Series 4 automatically enables fall-detection capabilities for users who have entered their age as over 65 in the user profile. (This feature can easily be manually enabled if you're under 65.) If the watch senses that you are not moving after a fall, it asks if you're OK. If you don't answer, the watch calls emergency services (i.e., 911), then it lets your emergency contacts know what's happening.

Other alert systems can track movement, send out an alert if an elderly person leaves the house, and monitor smoke and carbon monoxide levels in a home. You can even find systems that remind seniors to take their medication.

By now, you might be wondering how much a medical alert system is going to cost. Different price ranges reflect different levels of service. In general, monitored medical alert systems are $20 to $65 per month or more, depending on the features you choose. Some companies also charge set-up fees. As an example, the monthly charge for Life Alert is about $50 a month for a basic monitored system, in addition to a set-up fee ranging from $95 to $198.

You may qualify for assistance in covering the costs. Some companies offer discounts for veterans or members of organizations such as AARP. Medical alert systems are also often tax deductible, so check with your accountant for more information.

As well, in many states, Medicaid covers medical alert systems through special programs. For instance, Medicaid's Home and Community Based Services (HCBS) waivers can help cover the cost of emergency assistance devices. Generally, medical alert systems aren't covered by Medicare, although some Medicare Advantage programs might pay for part of the cost. Review your private insurance policy to see if this an option for you.

Recovering From Elderly Falls: What to Do to Stay Healthy

Even with careful fall and injury prevention, it's possible that you'll experience an accident at some point. Here are some steps to help you stay safe:

  1. Remain calm. Don't panic. You'll be OK.
  2. Take a quick inventory. Before you start to move, assess your situation. Can you feel any pain? Are you dizzy at all? Are you near any kind of help? Err on the side of caution if you're not sure whether or not you're injured.

If you aren't injured and feel as if you can get up:

  1. Look for the nearest secure object or piece of furniture that you can use to pull yourself up.
  2. Roll onto one side. Bend your top leg and push yourself to a crawling position.
  3. Crawl carefully over to the furniture or object.
  4. Put your strongest leg in front, then place your hands on the furniture and pull yourself up.
  5. Carefully turn around so that you can sit down.

If you think you might be injured, or if you feel dizzy:

  1. Activate your elderly-fall-alert device or other medical monitoring system if you have one. Don't worry about bothering anyone. Now is the time to use it!
  2. Try to slide yourself toward the best place to be heard if you don't have a medical alert system. If a phone is in the room, try to move toward it.
  3. Make noise if a phone isn't nearby. Tap the floor or cry out.

Even if you feel fine immediately after a fall, symptoms can appear afterwards. Tell someone right away that you've fallen. And watch for symptoms such as:

  • Unusual sleepiness
  • An increase in headaches
  • Dizziness
  • Pain in any part of your body
  • Feelings of nausea
  • Vision problems

Also, be sure to tell your doctor that you had a fall. Don't be embarrassed: Everyone falls at some point. Your doctor can help you make a plan for avoiding future falls. He or she may also want to order some blood tests and review your medications.

Having a fall can be an upsetting experience. Many seniors feel helpless and discouraged. But a fall can also be a reminder to stay on top of any health concerns, and it can act as a prompt for making positive changes.

Once you have recovered from a fall, continue with your activities as much as you can (incorporating any new fall-prevention techniques, of course). Remember that staying active can ultimately reduce your risk of falling. Many seniors reduce their activity after a fall because they are afraid it will happen again. But a fear of falls, in older adults especially, can actually increase the risk. The result can be a vicious cycle. So if fear of falling is holding you back from any activities, talk to your doctor or a mental health professional.

Elderly falls are not inevitable as we age. With a fall-prevention plan, you can protect yourself from the short- and long-term effects of falling. Talk to your doctor about ways to stay safe. And if you think a personal safety alert system is a good fit for you, research some options. Investing a little time right now in fall-proofing your life will benefit you significantly in the run long.

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