Protect Your Independence: Create a Fall Prevention Plan
by Audrey Demmitt, RN, VisionAware Peer Advisor
Being Pro-Active
My vision loss has caused me to fall many times in the past. As I get older, this concerns me because I realize the potential for serious injuries. So, I decided to attend a workshop on Fall Prevention. I would like to share the highlights of what I learned.
Falls Are Not a “Normal” Part of the Aging Process
Many people fear falling as they age, especially if they are losing vision. Falls are common among adults aged 65 and older, with one out of three falling yearly. Falls seriously threaten your health and well-being and can result in fractures, head trauma, and even death. A fall can land you in the hospital or a long-term care facility at great cost, threatening your independence. But falls are not a “normal” part of the aging process. They are predictable and preventable.
What Is a Fall?
According to the World Health Organization, a fall is any event when a person inadvertently comes to rest at a lower level, against a supporting surface, or on the ground. It happens when there is an unexpected change of position or loss of balance.
Three Questions to Consider:
- Have you fallen in the past year?
- Do you feel unsteady when standing or walking?
- Do you worry about falling?
According to the Centers for Disease Control and Prevention (CDC) and their STEADI program (Stopping Elderly Accidents, Deaths and Injuries), answering “YES” to any of these questions means you are at increased risk for falls. STEADI was created for healthcare providers who work with older adults at risk of falling or who may have already had a fall. They offer provider training, a stay independent brochure, and many other resources.
What Are the Risk Factors for Falling?
Research shows there are many interacting factors that create increased risks for a fall.
Personal risk factors include:
- Difficulty with walking or balance
- Muscle weakness
- Foot problems
- Heart rate or rhythm problems
- A history of falls and/or a fear of falling
- Taking multiple medications (4 or more)
- Dizziness
- Depression
- Health conditions such as arthritis, stroke, and diabetes
Environmental Conditions Contribute to Increased Fall Risk
Most falls happen due to home hazards such as:
- Stairs without hand-rails
- Clutter
- Poor lighting
- Wet surfaces
- Cords
- Loose rugs and carpets
- Hurrying and rushing
- Uneven pathways
Actions You Can Take to Protect Yourself
The fear of falling can diminish your ability to live an active life. It can lead to less mobility, isolation, and physical decline. The following twelve actions can alleviate this fear of falling and prevent falls.
Begin by talking to your healthcare provider.
If they do not ask about your fall history, bring the subject up yourself. Tell your healthcare provider if you have had a fall or are afraid of falling. They can order physical therapy and/or an occupational therapy evaluation to assess your strength, balance, and home safety issues if needed. These professionals can design a training program and suggest changes to help reduce your fall risks. You may have to ask for these evaluations; most insurance plans cover these services.
Review your medications with your healthcare providers.
Know why you are taking each drug and the correct doses. Be aware of common side effects like drowsiness or dizziness. Ask to be prescribed the lowest dose possible and discuss whether any medications can be discontinued. Take your medicines as prescribed and report any side effects. Check with your provider before using herbal and over-the-counter products.
Engage in healthy movement.
Regular exercise improves muscle strength, balance, coordination and flexibility. Strong core and leg muscles have an “anti-gravity” effect and protect us against falls. Activities like walking, water classes, tai-chi, Pilates, and yoga improve your overall condition and go a long way to prevent falls. If you have other medical conditions that limit your ability to participate in such activities, a physical therapist can help create a custom exercise program aimed at improving your balance, strength, and gait. Ask your healthcare provider for a referral to physical therapy.
Wear sensible shoes.
Evaluate your footwear for safety. High heels, loose slippers, slide-in styles, and slippery-soled shoes can make you stumble and fall. Do not go barefoot or walk in stocking feet. Choose properly fitting, supportive, and non-skid shoes to reduce the risk of falls.
Have your vision and hearing checked.
Changes in vision and hearing can affect your balance and cause falls. Discuss with your healthcare team any conditions you have that affect these senses.
Consult with a vision rehabilitation therapist or audiologist.
Learn strategies to keep you safe.
Make modifications in your home environment to reduce fall hazards.
Many simple changes can be made to improve your independence. Learn ways to reduce clutter, maximize lighting and contrast, make repairs, and reorganize. Check out VisionAware’s home modification section for suggestions, and try our home survey checklist. Consider getting a home assessment by an occupational therapist or vision rehabilitation therapist for significant needs.
Light up your home.
Aging and low vision usually call for increased lighting. Add additional lighting in hallways, stairways, and outdoor walkways. Use the highest safe wattage in fixtures. Place nightlights in the bedroom, hallways, and bathroom. Learn more about lighting in the home.
Use a mobility cane.
If you are blind or have low vision and do not use a cane, consider orientation and mobility instruction and the importance of using the white cane for fall prevention.
There are many resources to help you prevent falls. Involve family members in a conversation and brainstorm which strategies fit your needs.
Some programs are offered through the Area Agencies on Aging in each state. “Stepping On” and “A Matter of Balance” are two national evidence-based programs for older adults. The Matter of Balance program has a low vision translation.
Consider getting a medical alert device.
Especially if you live alone, consider a medical alert device with fall detection features.
Conclusion
It is largely up to you to prevent a debilitating fall. Take the first steps toward eliminating the fear of falling so you can live safely and confidently. The saying “An ounce of prevention is worth a pound of cure” by Ben Franklin is certainly true when referring to a fall. Make a plan to practice fall prevention and protect your independence.
Learn More
Six Steps to Prevent a Fall
Older Adult Falls | Fall Prevention | Injury Center | CDC
Mayo Clinic Fall Prevention