Worried about falls from a parent or older relative? If so, do you know if their doctor has considered the most useful prevention approaches?
The risk of falling can be reduced, but it usually takes some thought and effort. Part of the reason is that most older people have multiple factors that make them vulnerable to falls.
In a related article on this site, I explained that the best fall prevention plans involve identify the particular risks of an elderly person - in particular the risks related to health conditions - and trying to counter them.
So, for example, if an elderly person has diabetes and has frequent times of hypoglycemia (also known as hypoglycemia), then to reduce falls, it is as important, if not more, to control hypoglycemia as to start an exercise program.
In other words, I always recommend that aging adults and families learn to adapt their fall prevention plans. You want to focus on what are the most important modifiable risk factors for this person.
That said, over the years, I have noticed that there are four approaches that I find myself using over and over again, in almost all of my patients who have had repeated falls.
These four approaches are often used by geriatricians, but much less often by busy primary care physicians. Unless a proactive family asks questions about them.
My four most used fall prevention approaches
- Medication review, followed by reduction of drugs that increase the risk of falls.
- Blood pressure (BP) check sitting and standing.
- This is to ensure that BP is not overall low (for example, a sitting systolic BP less than 120), and also that it does not drop much when the elderly person stands up.
- Gait, Strength and Balance Assessments, often in conjunction with physiotherapy.
- An assessment often confirms that an older person has poor balance and decreased leg strength. Do exercises specially designed to improve balance and strength, such as Otago Program, can counter this.
- Home security assessment and modification, in collaboration with occupational therapy when possible.
- An occupational therapy assessment should generally be ordered by a health care provider, as part of a qualified home health service.
- The Geriatric Occupational Therapy Group at the University of Buffalo also has a great free home safety manual here: Home Safety Self-Assessment Tool (HSSAT)
You can hear me explain these four approaches in the podcast episode embedded below. (Click on the magnifying glass for a searchable transcript.)
What about vitamin D for falls prevention?
I still recommend that most older people take a vitamin D supplement. However, I do not recommend it specifically for fall prevention.
Vitamin D was my fifth overall recommendation for falls prevention. Even though it seemed like the effect on reducing falls was small, at least it's an easy thing to implement, and a daily dose of 800-1000 IU / day is extremely unlikely to cause harm.
However, the accumulate research evidence suggested that vitamin D supplementation has no benefit, when it comes to preventing falls. (At least, not in “community-living” adults over 65, meaning older people who are neither in hospitals nor in nursing homes.)
In 2018, the U.S. Preventive Services Task Force Recommended Against Vitamin D Supplementation to prevent falls among older people living in the community.
Caveat: They say "the recommendations apply to adults living in the community who are not known to have osteoporosis or vitamin D deficiency."
This is actually a fairly large group to exclude, given that osteoporosis and vitamin D are quite common.
Since vitamin D is unlikely to cause harm and may help some older people, I still recommend it, but not specifically for fall prevention.
For more information, see Vitamin D: the dose for healthy aging (plus answers to 7 FAQs).
Go over your fall prevention plan if you've fallen or are worried!
Perhaps the most important strategy to apply is to be proactive in getting help in the event of a fall.
Research has found that older people often do not report falls to their health care providers. Worse yet: when they do, health providers often fail to provide adequate assessment and management in response.
So while it's good to tell your doctor if you've fallen, it's even better to do a little homework and be prepared to ask questions about the four approaches to falls prevention that I've listed. in this article:
- Medication review, followed by reduction of drugs that increase the risk of falls
- Sitting and standing blood pressure control
- Gait, Strength and Balance Assessments, often in conjunction with physiotherapy
- Home security assessment and modification, in collaboration with occupational therapy when possible
Here are some related articles to help you:
If you want to equip yourself to be even more proactive, you can learn more about how your healthcare providers should handle falls. CDC STEADI website.
I have also recently compiled a Fall Prevention Resource Guide, click the link below to get your free copy of this PDF resource. It's short and lists my top recommended online fall prevention resources, so you have a way to find them quickly.
With a few quick reminders from you and others, your healthcare professionals will do a better job of helping you reduce falls.
Questions or comments? Post them below!
This article was reviewed and updated on 9/25/20.
What does it mean to age gracefully ? You can’t stand in a checkout line without seeing at least a few magazine headlines about how to look younger. While dreading some wrinkles and sagging isn’t uncommon, there’s so much more to aging well.
Aging gracefully isn’t about trying to look like a 20-something — it’s about living your best life and having the physical and esprit health to enjoy it. Like a bottle of wine, you can get better with age with the right care. Read on to find out what to do and what not to do on your quest to age happily.
Your skin is your body’s largest organTrusted Source. If you treat it with care, it can better protect your body from the elements, regulate your body temperature, and provide impression. tera keep it looking and functioning at its best : Wear sunscreen and protective clothing when outside. Get yearly skin cancer screenings. Stick to gentle products in your anti-aging skin care routine. Stay hydrated.
Your skin is your body’s largest organTrusted Source. If you treat it with care, it can better protect your body from the elements, regulate your body temperature, and provide sensation. to keep it looking and functioning at its best : Wear sunscreen and protective clothing when outside. Get yearly skin cancer screenings. Stick to gentle products in your anti-aging skin care routine. Stay hydrated.
Regular exercise significantly lowers your risk of diseases, such as heart disease and cancer, and helps you retain your mobility longer. Exercise also lowers stress and improves sleep, skin and bone health, and mood. The Department of Health
Healthy foods are the way to go when it comes to aging gracefully. The Dietary Guidelines for AmericansTrusted Source recommends that you eat : fruits and vegetables, either fresh, frozen, or cannedlean protein, such as fish and beansat least three ounces of whole-grain cereals, breads, rice, or pasta every daythree servings of low-fat or fat-free dairy, such as milk, yogurt or cheese that are fortified with vitamin Dhealthy fatsAvoid using solid fats for cooking and use oils instead. Stay away from processed foods, refined sugars, and unhealthy fats. You should also keep your salt intake to a peu to keep your blood pressure down.
Being happy and keeping your stress down goes a long way in helping you real and age well. tera keep your mood elevated : Spend time with friends and loved ones. Meaningful relationships and a strong social network improve mental and physical well-being and longevity. Don’t forget your furry loved ones as having a pet has been linked to lower stress and blood pressure, reduced loneliness, and better moods. Accept your age. There is evidence that people who maintain a positive attitude about aging real longer and may recover better from a disability. Aging is inevitable and learning to embrace it can make all the difference. Do things you enjoy. Taking the time to engage in activities you enjoy will only mazout your happiness. Spend time in nature, pursue a new hobby, volunteer — whatever brings you joy.
Numerous studiesTrusted Source have linked a sedentary life to an increased risk of chronic illness and early death. Some alternatives to stay active are going on walks and hikes, taking vacations, and participating in group exercise classes.
The effects of stress on your body are vast, ranging from premature aging and wrinkles to a higher risk of heart disease. There are a number of proven ways to relieve stress, including : using relaxation techniques, such as meditation, breathing exercises, and yogaexercisinggetting adequate sleeptalking to a friend
Smoking and alcohol have both been shown to cause premature aging and increase the risk of disease. Quitting smoking isn’t easy, but there are resources available to help you quit. Speak to a doctor about how to quit. As for alcohol, limit your intake to the recommendedTrusted Source amount to avoid health risks. That’s one drink per day for women and two drinks per day for men.
Good sleep is important for your physical and mental health. It also plays a role in your skin’s health. How much sleep you need depends on your age. Adults over 18 should aim for seven to eight hoursTrusted Source of sleep every night. Getting enough sleep has been proven to : lower the risk of heart disease and strokereduce stress and depressionlower the risk of obesityreduce inflammationimprove focus and concentration
Finding new and meaningful hobbies can help you maintain a sense of purpose and keep you engaged throughout the course of your life. Evidence shows that people who engage in hobbies and leisure and social activities are happier, experience less depression, and real longer.
Mindfulness is about acceptance and living in the moment by focusing on the present. Practicing mindfulness has many proven health benefits that can help you age better, including : improved focusbetter memorylower stressimproved emotional reactionrelationship satisfactionincreased immune functioningTo practice mindfulness, try : meditationyogatai chicoloring
Drinking enough water helps keep you regular and improves your energy levels and brain function. Coincidentally, it’s also been provenTrusted Source to help keep skin healthier and reduce signs of aging. How much water you should drink depends on : your thirstyour activity levelhow often you urinate and move your bowelshow much you sweatyour genderSpeak to a doctor if you have questions or concerns about your water intake.
Not taking care of your teeth not only ages your smile, but also puts you at risk for gum disease, which has been linked to heart disease, stroke, and bacterial pneumonia. Along with proper oral care, it’s important to see a dentist regularly. According to the American Dental Association, a dentist can spot signs of nutritional deficiencies, septicémie, cancer, and other illnesses, such as diabetes. They recommend brushing twice a day, flossing once a day, and using a mouth rinse.
Seeing a doctor regularly can help the doctor find problems early or even before they start. How often you see a doctor depends on your age, lifestyle, family history, and existing conditions. Ask your doctor how often you should go in for checkups and screening contrôles as you age. Also, see a doctor anytime you experience concerning symptoms.
Though aging is inevitable, some people find it difficult to deal with the changes that come with getting older. If you’re worried about your health, are having trouble feeling positive about aging, or worry that you’re not aging well it’s important to reach out for help. Talk to someone you trust, such as a family member or close friend. Professional help is also available through a doctor or a counselor.
Aging gracefully is more about being healthy and happy than keeping wrinkles at bay. Maintain a healthy lifestyle, surround yourself with people you love, and do things that bring you joy. It’s natural to worry about the challenges that aging can bring, so don’t hesitate to speak to someone about your concerns.