Why Do Older People Fall and What Can Be Done?

[bfit]

Why do older people fall, and can they improve their balance at even an advanced age so that falling is less likely? My Dad is 93 and just moved to assisted living, in part because he was afraid of falling at home where he was living alone. He's been there in assisted living less than 2 weeks, and they called me today to tell me that he fell when he was going to the door to let someone in. He hit his head on the door handle, but he checked out OK at the ER and only has a bruise on his forehead. He already uses a walker indoors and out so I'm not sure what else he can do. He can't really explain what's going on although supposedly he does not have dementia. He just says "My balance isn't good".

[fatkat555]

Originally Posted by bfit

Why do older people fall, and can they improve their balance at even an advanced age so that falling is less likely? My Dad is 93 and just moved to assisted living, in part because he was afraid of falling at home where he was living alone. He's been there in assisted living less than 2 weeks, and they called me today to tell me that he fell when he was going to the door to let someone in. He hit his head on the door handle, but he checked out OK at the ER and only has a bruise on his forehead. He already uses a walker indoors and out so I'm not sure what else he can do. He can't really explain what's going on although supposedly he does not have dementia. He just says "My balance isn't good".

I think there are so many variables that it’d be hard to answer; however, I can say in my mother’s case that poor nutrition coupled with pernicious anemia (b12 anemia) and muscle atrophy created a perfect storm for her. In the case of my 94-year-old aunt, I’d say it is a combo of poor nutrition and small strokes with overall muscle atrophy.

To improve balance, I’d say start with nutrition. Then work on overall strength.

[bzar]

i read several articles on this and basic factors contribute to loss of spatial awareness:
- vision
- hearing

the articles recommended ensuring that you're (or your loved ones who are elderly) up to date with your eye exams and glasses, etc. and eye exams may reveal many other health issues such as diabetes. Hearing and best ear health contributes to balance and spatial awareness.

physical musculature as others have mentioned will keep your reaction time and confidence in walking and moving at their optimal levels.

another consideration is that since your dad just moved to the facility, perhaps he needs more time to get acclimated and use the facilities such as floorplan layout, doors, ramps, hand-holds (railings), etc. if they offer tai chi classes, that's a good way to beef up his balance strength. perhaps they have safety classes - maybe instruct him that although he means well in opening doors for others, he might put himself at risk in doing so.

[buffmama]

Don't forget to rule out the side effects of any medications he's on.

[rhbrand]

As someone who has worked in nursing homes off and on during her nursing career, I've seen a lot of falls.

Its a lot of things that cause falls.
Loss of balance, poor vision, generalized weakness, poor nutrition, the list goes on.

Ask the AL if your dad can get some physical therapy. Most either have a therapist on staff, or they contract with a company and therapists come in several times a week. I've seen people go from being so weak they need 1-2 people to help them transfer in and out of chairs/bathrooms to walking the hallways alone. A good therapist will work on balance, strength and tips on how to do things to reduce the risk of falls.

Have his doctor or pharmacist go over his medications. He might need adjustments in what he's taking, or dosage adjustments.
Often elderly people are put on blood pressure meds at say, 70, and by 90 they no longer need them or need the dosage to be reduced. A lot of falls are caused by a sudden drop in blood pressure as they get up, change position. I've had a few doctors tell me that in very elderly, people 90+ its almost better for them to have slightly higher blood pressure than younger people.

[yogapam]

Originally Posted by rhbrand

As someone who has worked in nursing homes off and on during her nursing career, I've seen a lot of falls.

Its a lot of things that cause falls.
Loss of balance, poor vision, generalized weakness, poor nutrition, the list goes on.

Ask the AL if your dad can get some physical therapy. Most either have a therapist on staff, or they contract with a company and therapists come in several times a week. I've seen people go from being so weak they need 1-2 people to help them transfer in and out of chairs/bathrooms to walking the hallways alone. A good therapist will work on balance, strength and tips on how to do things to reduce the risk of falls.

Have his doctor or pharmacist go over his medications. He might need adjustments in what he's taking, or dosage adjustments.
Often elderly people are put on blood pressure meds at say, 70, and by 90 they no longer need them or need the dosage to be reduced. A lot of falls are caused by a sudden drop in blood pressure as they get up, change position. I've had a few doctors tell me that in very elderly, people 90+ its almost better for them to have slightly higher blood pressure than younger people.

I also worked as an RN in nursing homes for several years before I retired and I agree with all the above!