Caregiver Corner
By Jennifer Beach
One of the most common events that change the course of our future lives is falling. But we can start now to greatly reduce our risk of falling. Understanding and accepting the big picture of what occurs to our bones as we age is the first step.
The fact is, as we age, our bones lose density and become weaker due to the loss of minerals like calcium, a process known as demineralization. This makes our bones more brittle, increasing the risk of fractures. This means it does not take a major fall to break a bone; a small bump can easily result in a fracture. Other age-related changes include a reduction in bone size and flexibility, which can contribute to a loss of height and stiff joints. There are many factors that contribute to how fast these changes take place, including muscle loss, hormonal changes, medications and many lifestyle factors.
It seems that, as we age, we not only feel these changes taking place but our fear of falling increases, and it should. About 1 million older adults visit emergency departments for fall-related fractures annually, with over 300,000 hip fractures and an increasing number of other fractures. More than 95% of hip fractures are caused by falls, and one out of every five falls results in a serious injury like a broken bone or head injury.
Statistics often overlook the real issue isn’t just fractures, but how frequently people fall and go without help for extended periods of time.
Fall prevention is a billion-dollar industry and not the only real answer to prevention. Many older adults have all the safety devices: grab bars, non-slip mats, motion lights, emergency call devices… and yet, they still fall, typically at night and often in the bathroom. The equipment isn’t the problem, it’s what happens next the nine hours on the floor. If the individual can’t reach their phone or alert device, they often wait until a “more decent hour” to call a friend, neighbor or family member (that may or may not be close by or home). Often feeling too embarrassed to perhaps call 911, as they can move their limbs, they just can’t get up. They just need a boost to get up and think, I’m okay, I feel silly, I don’t have my phone with me, my friend/family/neighbor will soon come.
By morning, they present with dehydration, the onset of pressure ulcers due to prolonged recumbency on the floor, and the emergence of additional complications. They spend more than a week in the hospital and afterwards move to a nursing home until they regain their strength and recover, if they do.
The fall didn’t land them in a nursing home, rather the inability to get up did; 47% of people who can’t get up after a fall die within a year, not from falling, but from lying on the floor waiting for help. The equipment was ineffective on the floor, and balance training didn’t help if they couldn’t get up.
The real solution is the ability to get up from the floor.
When did we lose our ability to get up from the floor? When was the last time we sat on the floor and tried to get up?
Test yourself now. Sit on the floor and get back up, not using anything to help you get up. If you can’t do it, you need to recognize this risk, work on building muscle in your legs and build core strength so you can help your future self. This should be considered when we are trying to determine if someone (including ourselves) is safe to live alone.
Maybe our loved one we are currently caring for has a condition or illness and cannot get on the floor, let alone get up from the floor. Be sure they have support nearby, can call out and be heard if they should fall. What we can do for our own future is work on this simple skill now. If we end up living alone or are currently live alone, we want to be able to get up from a fall and avoid all that comes with not being able to get up. The work is worth it. If you have trouble getting up from the floor, speak with your doctor about your goal. Ask them for advice on how you can successfully work toward it.
