best strategies to prevent falls

According to the Centers for Disease Control and Prevention, one out of five falls 

by older adults causes serious injury, such as broken bones, hip and pelvic fractures, or head trauma. Moreover, roughly three million people aged 65 and older are treated in emergency departments for fall injuries annually.  

Unfortunately, patients often fear that discussing a recent fall or admitting to feeling unstable could threaten their independence. But that’s exactly why it’s important for health providers to know about falls—even if someone feels just a little unsteady or considers the fall a minor spill. 
Falling is not just part of aging. On the contrary, falls are preventable when you and your physician work together. Nor should anyone assume that falling is no big deal. I find that patients whose gaits have become unstable or whose falls result in only minor injuries tend not to mention them at appointments—when they should!
The most consistent predictor of whether a patient will fall is a prior history of falling. Knowing about your falls (or those close calls) can help your physician put together a plan of preventive action. 
To that point, I recommend the below steps be taken:
Your physician can glean critical information from diagnostic and functional tests, including: 
• Vision screening for cataracts 
• Heart rate and pulse checks 
• “Get up and go” test—rising from a
    chair and walking to an indicated spot 
• Sitting down and standing up repeatedly 
• Balance challenges 
• Studying gait (manner of walking) 
• Foot examination for painful or 
   numb spots 
The results of these tests help us build a plan of action that’s unique for each patient, focusing on interventions that are impactful and sustainable.
Exercise ranks as the intervention that is most beneficial for fall prevention. Both balance exercises like yoga and tai chi, and strength regimens like resistance training and walking, can help tremendously. And don’t be afraid to test your limits; increase the intensity of your workout to enhance your strength, flexibility, and balance.
Working with a physical therapist can help you become aware of how you walk, and make the needed adjustments for better alignment and coordination. 
Certain pills can heighten the risk of feeling dizzy or dehydrated; some common medications, like aspirin, may have side effects that outweigh the benefits. Medicine that aids or induces sleep can also cause dizziness during the day. We review the patient’s current medications to make a shared decision whether to reduce or eliminate them. These medications include aspirin, acid reflux pills, and blood pressure medicine, in particular.
Simple but effective adjustments to living spaces are a powerful prevention tool. Specifically, keep floors clear of obstacles; install grab bars and rails in the bathroom and shower/tub, and place non-slip mats on the floor; keep needed items at a lower level to avoid the use of a stepstool; and plug in nightlights if the light switch isn’t close to your bed. 
[White Plains Hospital]
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