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Falling - The gravity of the situation - (7/17/2018)

By Dr. Ron Gasbarro 

Mary, 71, came into the pharmacy with some new prescriptions. They were for pain, swelling, and insomnia. “What happened to you, Mary?” the pharmacist asked. “Two days ago, I fell going up the stairs. Tripped on the fifth step and whacked my head,” Mary explained. “These old feet don’t always do what I tell them to do!”  

Gravity can be quite helpful. Gravity keeps our cars on the road and our knickknacks on the end table. Without gravity, our coffee would float out the window and the cat would be climbing the walls. Without gravity, Mary would not have fallen. Babies are flexible when it comes to gravity. When a baby falls, he A) does not have far to fall, and B) usually gets right back up again. For older people, falling can be their literal downfall. 

Slips, trips, stumbles, and tumbles in and around the home are frequently the cause of injuries to older adults. Each year, over 3 million older adults received medical treatment for injuries related to falls, with many of these injuries resulting in decreased independence, a need for long-term care support, and increased risk for early death. To wit, there are approximately 25,000 fatal falls in the US each year, states the American Occupational Therapy Association. Given Mary’s age and medical history, which includes her treatment for high blood pressure with medications that may cause dizziness, she was lucky to get away with a few bruises even though they have kept her up all night. 

Older adult falls are increasing and, sadly, often herald the end of independence. Healthcare providers can make fall prevention a routine part of care in their practice, and older adults can take steps to protect themselves. With more than 10,000 Americans turning 65 each day, the number of fall-related injuries and deaths is expected to surge, resulting in healthcare cost increases unless preventive measures are taken, says the Centers for Disease Control and Prevention (CDC). Reduced muscle strength, increased inactivity, more severe chronic health conditions, and increased use of prescription medications are risk factors for falls among older Americans. Even worse, fall injury rates are almost 7 times higher for older adults with poor health than for those with excellent health, the CDC reports.

Older adults also can take simple steps to prevent a fall. For example, talk to your healthcare provider about falls and fall prevention. Tell your provider if you have had a recent fall. Although 1 out of 4 older Americans fall each year, less than half tell their doctor. Talk to your provider or pharmacist about medications that may make you more likely to fall. Have an eye doctor check your vision annually. Update eyeglasses as needed. Participate in evidence-based programs – like tai chi or yoga – that can improve your balance and strengthen your legs. Contact your local Council on Aging for information about what is available in your community. Make your home safer by getting rid of fall hazards, such as throw rugs and other clutter. Wrap Tabby and Fido in Christmas lights so you can see them in the dark. 

Mary lives alone and now intends to get a medical alert system in case she falls again. She is interested in taking yoga to keep herself active and steady on her feet. She realizes that she was lucky – this time. The pharmacist also cautioned her about taking the sleep medication for which her doctor wrote. Sleep medications and other controlled substances may result in loss of coordination, increasing the risk of falling. “I refuse to take this falling business lying down,” she laughed.  

Ron Gasbarro, PharmD, is a registered pharmacist, medical writer, and principal at Rx-Press.com. Read more at www.rx-press.com  


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