Each year across the country, one out of every three adults age 65 or older falls, and in this age group, falls are the leading cause of injury and death. Falling outdoors is of particular concern because trips and stumbles outside are more common than those indoors.
The Centers for Disease Control and Prevention reported that in 2010, emergency departments treated 2.3 million older adults with nonfatal fall injuries. More than 662,000 of these patients were admitted to the hospital. Adjusted for inflation, the direct medical cost of these falls was $30 billion. Falling at any age is costly, but older Americans pay a heavier toll on their bodies and their pocketbooks.
The CDC found 20 to 30 percent of people who fall sustain moderate to severe injuries, including fractures (among the most common: hip, spine, forearm, ankle and leg), lacerations or head traumas. Fall-related fractures are more than double for older women than for older men, and taking a spill is the leading cause of traumatic brain injuries. CDC statistics also show 95 percent of hip fractures originate from a fall. For the elderly, injuries from a fall often limit mobility and increase the risk of early death.
Seniors who fall, even if they are not injured, often develop a fear of falling. This fear can keep a person from enjoying regular activities, which then reduces mobility and physical fitness. With less muscle tone and confidence, the senior’s actual risk of falling increases. Falls also keep older adults from living independently, a concern for seniors and their family members.
Men tend to fall outdoors more than women, and those seniors who are most active fall more often than those with physical limitations. Nearly half of falls outdoors are related to walking, particularly on uneven sidewalks or tripping over curbs. Parks, gardens, patios, decks and porches also prove difficult for older adults to remain steady on their feet. More than 70 percent of people who fall outside land on a hard surface such as concrete, asphalt or stone.
Those at highest risk for falling outdoors are individuals with balance, vision or cognitive impairment, or weakness in the lower extremities. Fortunately, many of the slips and spills outside for elders can be prevented. Dr. Rein Tideiksaar, a gerontologist and president of FallPrevent in Blackwood, N.J., a consulting company that specializes in fall prevention for the elderly, recommends a number of steps to reduce the chances of older adults falling outdoors:
• Stay aware of uneven terrain or slippery surfaces (watch for holes, tree roots and ice).
• Check the height of curbs and steps before stepping up on them or down from them (curbs with inclines or cutaways for bikes can be misleading).
• Walk on grass if sidewalks or roads appear to be slippery or uneven (grassy areas provide more traction and solid footing).
• Wear correct eyewear when walking (reading glasses or bifocals can distort the ability to see potential hazards).
• Wear sunglasses (glare from the sun can hide areas, which can lead to falls).
• Walk in well-lit areas in the evening to provide the most visibility for hazards.
• Walk hands-free using a fanny pack or an over-the-shoulder bag instead of a clutch purse.
• Wear hip pads or protectors while walking to ensure the protection of bones and to avoid hip fractures.
• Wear sturdy, low-heeled shoes for better balance (shoes that have rubber soles provide more traction).
If balance is a problem, Dr. Tideiksaar recommends the use of a walker or cane or holding hands of caregivers when stepping onto curbs or up steps. In dark restaurants, movie theaters and other places with limited lighting, he suggests asking for help upfront.
To safeguard the outdoor environment around the homes of seniors, Dr. Tideiksaar stresses the use of handrails and good lighting on stairs and walkways. Steps, decks and porches need to remain in good shape with no worn-down areas or loose nails. For extra safety and traction, porches and steps can be covered with weatherproof and textured paint. Adding abrasive strips or rubber stair treads also can make steps less of a fall hazard.
• Jeanette Palmer is president of Right at Home in Algonquin, which offers in-home companionship and personal care and assistance to seniors and disabled adults. Reach her at 847-458-8656 or firstname.lastname@example.org.