Senior Adults and Falling

From the November 11, 2009 New York Times in an article by Steve Lohr …
“FALLS are so harmful to the elderly and so costly to society that if falling were a disease it be deemed an epidemic.”

Almost every week or so an over 70-year-old acquaintance or friend falls. According to the Centers for Disease Control (CDC) every year one out of three adults who are over 65 will fall. Even the most vigorous individual injured by a fall has a tough time and in the short-term may age more quickly. If the injury is serious and requires hospitalization, the confinement often leads to additional problems which in turn lead to more medical problems. My husband and I have informally labeled this “the cascade.” Unless the person is fairly strong and/or athletic, a fall leads to substantial suffering. dislocation, and expense.

According to a CDC fact sheet on senior adult falls, “…older adults are hospitalized for fall-related injuries five times more often than they are for injuries from other causes.”

My husband’s father had congestive heart failure for five years. Thought he was on many meds, some of which caused dizziness, he overcame the odds by maintaining a careful but vigorous walking schedule during the five years following his diagnosis. In the last months of his life, he fell twice.

The first occurred in late winter as he climbed out of the car while waiting for his wife. Father jumped out of the car too quickly, lost his footing on a slippery spot, and hit his head on the door. In a skilled nursing facility for three weeks, he was in bed for quite a bit of that time, and finally returned home with additional meds to take each day. Father’s weakness and lack of energy kept him from resuming his long walks, and he took many more naps on his bed. So the net result of the fall was that he was weaker, stopped exercising, was much more short of breath, and added a couple of medicines to his already long list. This was the beginning of cascading problems.

Father seemed to be improving, at least a bit, when the second fall occurred less than a month later as he was getting up from the bed. Intent on reaching into his closet, he became dizzy and fell, hitting his head on a piece of furniture, becoming disoriented. As he was once again confined to the skilled nursing facility (SNF) more things began to go wrong. Because he had not been walking he was less vigorous. His chest began to hurt. Next came a urinary tract infection, and father’s chest discomfort turned into respiratory problems. He did not walk enough for his legs to stay strong enough to walk a wheelchair was necessary. After that he did not walk at all.

After beating the many odds of surviving congestive heart failure for five years, father died about five weeks after the second fall, not really from the fall but from all of the problems the fall caused.

While the system did not promote healing as it should have, I am not sure that father would have been receptive to advice about preventing falls. But his falls set the end-of-life process in motion. According to the CDC fact sheet, “Of those who fall, 20% to 30% suffer moderate to severe injuries that make it hard for them to get around or live independently and increase their chances of early death.”

Additional Information About Seniors and Falls