Your Patient is Worried about Falling – What Do They Need to Know – JAMA Internal Medicine Patient Page
Are Falls Serious?
Falls are the most common cause of injury among older adults; more than 1 in 4 adults over age 65 years will have a fall in any given year. A quarter of falls lead to serious injury, including broken bones, head injury, and even death. Falls can lead to a fear of falling, which can limit usual activities, lead to a loss of independence, and increase the risk of needing to live in a nursing home.
What Are the Risk Factors for Falling?
The risk of falling increases with age and is higher in people who have fallen before. Many common medications (eg, those used to treat high blood pressure, allergies, sleep disturbance, anxiety, depression) can increase your risk of falling. Taking more than 5 medications increases your fall risk. Other factors that can increase your risk of falling are poor vision and/or hearing; alcohol use; shoes that do not fit well, have heels, or have slippery soles; muscle weakness; poor balance; and a cluttered or unfamiliar environment.
What Can I Do to Prevent Falls?
The best way to prevent falls is to get regular exercise that focuses on building strength and balance.
A physical therapist can help you learn exercises to improve strength and balance.
Group-based activities for improving strength and balance, such as tai chi and dance, are particularly helpful for preventing falls. Many local organizations, such as the YMCA and senior centers, provide exercise classes that target fall prevention.
Consult With Your Doctor and Health Care Team
It is important to tell your doctor when you have a fall, even if you are not injured.
Review your medication regimen with your doctor.
Have your vision and hearing tested.
If you are at a high risk of falls, ask to be assessed for a cane or walker. If you already use one, make sure it is the right size and that you know how to use it correctly.
Make Changes in Your Home and Routine
Make your home safer by removing loose throw rugs, cords, and clutter near your walking path.
Make sure your home has adequate lighting.
Install grab bars in bathrooms and sturdy railings on stairs.
Choose well-fitting shoes with a nonskid sole.
What Can I Do to Reduce My Risk of Injuries From a Fall?
Treatment of osteoporosis reduces the risk of fall-related broken bones. Talk to your doctor if osteoporosis screening and treatment are warranted for you. Some experts recommend that people at high risk of fall-related injuries take a vitamin D supplement (<800 IUs per day), but there is no clear evidence that this reduces the risk of falls or injury. Avoid a higher dose (>800 IUs per day) because it may increase the risk of falling.
What About My Fear of Falling?
Fear of falling is common and can interfere with participation in usual life activities and reduce quality of life. Tell your doctor about your concerns. Your doctor can help identify proven ways to reduce fall risk, increase safety, and help you feel more confident as you engage in physical activity and other daily routines.
For more information:
Centers for Disease Control and Prevention, Home and Recreational Safety: https://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html
STEADI Initiative for Older Adult Fall Prevention: https://www.cdc.gov/steadi/patient.html
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Full link: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2785559