GHS Cares: Why Falling is Worth Talking About
Last week we discussed osteoporosis or bone thinning, which combined with a fall can lead to a debilitating broken bone. In fact we, like most primary care doctors, have memories of many patients we have cared for who had fatal falls. This week we’ll discuss how to prevent falls for adults who live at home. It may not seem like it, but chances are you or a loved one is at risk!
Fact#1 A U.S. data analysis showed that 30-40% of adults over age 65 and 50% of those over age 80 fall every year.
Everyone over age 65 is at risk of falling. Aging makes it more difficult to have good balance, and most adults lose muscle strength as they age. Additionally, people are at higher risk of falling if they contract an illness, change medications, or are in a new environment. Falls often result in injury, although most are minor like bruises or scrapes. Only 5-10% of falls in community adults result in hospital visits for major injuries like broken bones, concussion, or bleeding. When there is a more serious injury, there is almost always a decline in function and a greater likelihood of nursing home placement, need for medical services, and death. These are things our patients do not wish for, so we want to assist the community in preventing these serious outcomes.
Fact #2 Falls usually go without health care attention.
Maybe it won’t surprise you to know that most falls never get mentioned to a doctor. Patients often don’t mention a fall to anyone when there was no injury or if there was only minor injuries at the time of the incident. Even when patients do seek emergency care for injuries from a fall, there is no investigation into what caused the fall to happen in the first place. However, this is not recommended.
Fact #3 It is very important to mention all falls, even ones without any injury, to your doctor.
Like many primary care offices, Granville Primary Care, Butner-Creedmoor is making an effort to ask all of our patients over age 65 about falls at every annual wellness visit, or at least once a year if they don’t schedule a wellness exam. Nevertheless, it is still easy to miss an important opportunity to hear about a new fall. Do not hesitate to share that information with your doctor.
Fact #4 There are certain “best practices” to help prevent falls, but each approach is based on each person’s situation.
One of the first things we think of which can help prevent falls is simplifying medications. There is a list of medications we try to avoid called the “Beers” list. Some common medications which can cause falls are Benadryl™ or Diphenhydramine, sleep medications and muscle relaxants. There are more than 30 other medication classes, as well. Physical therapy exercises, such as strength or balance training, is one of the most consistent ways to reduce future falls. Movement activities like tai chi, dance or yoga also reduce falls. I recommend considering referral to physical therapy, such as Granville Rehabilitation near Quality Drug in Butner, and local programs offered through our Granville County Senior Center. Taking at least 800-1000 IU daily of Vitamin D may also help prevent falls in older adults. Finally, keeping a safe home-- with good lighting and without a lot of area rugs or clutter-- is important, as well as safe use of canes and walkers. Your doctor and rehab therapist can all help answer questions about keeping a safe environment.
We hope this has given you some new ideas to help you or your loved ones stay well and avoid falls. Most importantly-- if you have fallen more than once in the past year or feel worried about falling, please consider making a visit to your primary care provider today. Now is the best time to review your medications and consider ways we might help you avoid future falls that could cause major injuries.
Dr. Liz Baltaro and Dr. Amy Nayo are primary care physicians expanding community access to quality pediatric and family medicine at Granville Primary Care, Butner-Creedmoor, located at 1614 NC Highway 56, Butner. To schedule your primary care appointment, please call 919-575-6103 or schedule online at ghshospital.org. You can schedule a primary care appointment with a provider as far as 12 months in advance through online scheduling.