Injuries from falls are among the most frequent and preventable accidents that impact the well-being and health of seniors. Every year, nearly half of adults 65 and older experience a fall; half of those fall repeatedly. Falls are the leading cause of accidental death among seniors 85 and older.
Dr. Steven C. Castle, be.group’s medical director and clinical director of geriatrics at the Veteran Affairs Greater Los Angeles Healthcare Center, has conducted extensive research in fall prevention.
Castle leads the Mobility and Balance Fall Prevention Program, which was launched in 2010 as a pilot program serving residents in three of be.group’s 26 affordable housing communities. Participants in the program saw significant improvement in their balance and mobility.
We asked Castle to share his top five tips for improving balance and mobility while reducing the risk of falls.
1. Find the appropriate balance exercise program. You will see dramatic improvements in mobility, confidence and independence, as a result of such an exercise program in just 12 weeks. There are few things in medicine that can produce such an impressive clinical response.
2. View a fall or near-fall as an opportunity to better understand the causes for the changes in your balance. What were you trying to do? What symptoms did you have? What footwear or mobility aid were you using? What was the lighting, and were you wearing glasses? These are just a few questions to ask yourself. (Note: Injury from one or more falls in a year warrant a detailed assessment by your doctor.)
3. Most risk factors for falls need to be measured and assessed to know if they are significant factors. Check:
- Vision (acuity, field of vision, contrast/depth perception)
- Drop in blood pressure with standing (postural hypotension)
- Problems in mental processing/cognition or problems with mood/depression
- Medications, especially sleep aids/anxiety meds, heart/BP, and blood thinners
4. Resist walking in your bare feet or socks. Walking barefoot or in socks significantly increases your risk of falling. Being barefoot changes your balance and puts you back on your heels; it also becomes more difficult to correct your balance when you lose it, stop or turn. This seemingly minor act has been associated with a significant number of falls in senior living communities.
5. Bad balance is the most common condition related to falls, meaning that any one of three main balance systems is not functioning—you lose balance and fall without lightheadedness, dizziness or legs failing. The main causes for changes in balance are limited in most cases, but can co-exist:
- Cardiovascular—lightheadedness with standing
- Vestibular/inner ear—spinning dizziness with looking up/down or turning
- Bad balance—“I just lost my balance!” usually due to damage in the brain’s balance centers, pinched spinal nerves, neuropathy or nerve damage with loss of “position” sense
- Nerve/muscle/joint problem causing leg to collapse, knee buckle or catch toe
- Poor awareness of balance/mobility changes
Regents Point residents and staff recently bid farewell to dining room host and good friend Hector Morales. The community came together to send him off as well as celebrate his 22 years working in dining services, where he rose from kitchen helper to the main host. “We will miss him!” says Melinda Forney, Regents Point’s executive director.
