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News Letter

Home Health Education Living With Joint Pain
Fall Prevention May Help Arthritis Patients and the Elderly Print E-mail

Falls and fall related injuries are among the most serious and most common medical problems experienced by the elderly including those with arthritis. Hip fractures can threaten the independence and survival of arthritis patients and the elderly. More than 90 percent of hip fractures occur as a result of falls, with most of these fractures occurring in persons 75 years of age or over, according to Falls in The Elderly, American Academy of Family Physicians (April 2000). This article notes one third of the population greater than 65 years of age and living at home report falling one or more times a year. Also, one out of every 200 home falls produces a hip fracture. Fractures can also occur in the pelvis, spine (vertebrae), upper leg bone (humerus), hand, forearm, lower leg bone (tibia) and ankle.

Falls are a leading cause of death from injury for people over 65 years old. The mortality rate for falls increases dramatically with age in both sexes and in all racial and ethnic groups, with falls accounting for 70 percent of accidental deaths in persons 75 years and older, according to Falls in The Elderly, American Academy of Family Physicians (April 2000).

Falls are often the cause of long-term disability as well.

Causes

Age-related changes may make older persons more susceptible to falls including poor vision, hearing problems, poor balance, and difficulty in walking. In addition, factors related to diseases such as rheumatoid arthritis, cancer, Alzheimer’s, Parkinson’s, cardiovascular and neurological disorders, and osteoporosis may further increase the risk of falls.

Elderly arthritis patients may also be reluctant to go out into the community. Dr. Frances Cuomo, an educator on fall prevention, says “The more older adults stay inside, the less comfortable they feel about having to go out, and the more predisposed they are to injury,” Academy News, American Academy of Orthopedic Surgeons (February 2002).

The article, Prescribed Medications and the Risk of Falling, Top Geriatric Rehabilitation (1990), explains how the use of medications or improper use of canes or walkers may further increase the risk of falling. Side effects from prescribed medications may increase risk of falls and fall related injuries. These medications generally include diuretics, cardiac drugs, steroids, drugs for diabetes, drugs for blood pressure, nervous disorders, or Parkinson’s, narcotics, anticonvulsants and antihistamines. Drugs for nervous disorders can result in excessive sedation, nerve or muscular impairment, confusion, dizziness and loss of balance. These are all side effects that can result in falls.

External factors that may also put the elderly and arthritis patients at risk for falling include:

  • Poor lighting

  • Unsafe stairways

  • Missing handrails

  • Improperly labeled medicines

  • Clutter

  • Poorly designed furniture including unstable or low back chairs

  • Wobbly tables

  • Cold temperatures

  • Wet, waxed or irregular floors

  • Torn or slippery carpets

  • Unstable towel racks or sink tops

  • Difficult to reach cabinets or wall phones

  • Low toilet seats

Frail elderly persons tend to fall and injure themselves in the home during the course of routine activities.

Prevention

Critical steps to reduce the risk of falls in the elderly include eliminating environmental hazards, improving home supports, modifying medications, providing balance training, providing opportunities for socialization and encouragement and involving the family. Older adults may want to consider the following to help reduce their risk of falling:

  • Maintaining a regular exercise program.
  • Making living areas safer.
  • Asking your doctor to review all medicines to reduce side effects and interactions.
  • Having vision checks each year.
  • Wearing hip protectors, a central stiff plastic cup surrounded by polymer foam fixed in an undergarment. Protectors can be of benefit to persons at risk for falls.

For a more complete in-home safety checklist for fall prevention, visit Temple University’s website at http://www.temple.edu/older_adult/IHSCEng.htm

It’s a good idea for elderly patients or their caregivers to talk to their doctor about a periodic review of medications that may affect balance or other health issues putting them at risk for falls. In addition, they should have a plan for what to do if they fall while home alone. This plan may include having a phone accessible from the floor or wearing a personal emergency response device.
 

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