Take the Right Steps to Prevent Falls

Falls are one of the major causes of trauma, and while most common in older adults, they can happen to anyone – young or old.

As people age, they become more susceptible to falls, especially those 65 and older who experience more than one out of four falls each year. And falling once doubles their chances of falling again.

The numbers tell the story

• One out of five falls causes a serious injury such as broken bones or a head injury.
• Each year, 3 million older people are treated in emergency departments for fall injuries.
• Over 800,000 patients a year are hospitalized because of a fall injury, most often because of a head injury or hip fracture.
• Each year at least 300,000 older people are hospitalized for hip fractures, and more than 95% of hip fractures are caused by falling, usually from falling sideways.
• Falls are the most common cause of traumatic brain injuries. 

Falls are common and have a multitude of causes

Falls are common and can change the course of an older person’s life, notes Dr. Maura Brennan, geriatric hospital medicine physician at Baystate Health.

“Things may never be the same after a hip fracture or serious head injury. It is important to get a prompt, thoughtful and broad evaluation of all the problems that may be contributing to falls even if there is no apparent injury. Common contributing factors include decreased vision, overuse of alcohol, some prescription or over-the counter drugs, problems with balance and strength, confusion or memory problems, hazards in the home, pain, or a new medical problem such as an infection. Once the evaluation is done, the doctor and patient can agree on a plan to decrease risk. This will make it more likely that the older person remains as independent as possible and can continue the activities that bring joy and meaning to life,” she said.

Dr. Brennan notes that it is important to do a comprehensive assessment and improve as many of the contributing factors as possible leading to falls.

“The time to focus on the problem is before an injury occurs. Prevention is critical. Much useful information, safety checklists and resources are available on the Centers for Disease Control and Prevention’s (CDC) STEADI (Stopping Elderly Accidents, Deaths and Injuries) website,” she said.

Make Your Home Safe from Falls

The American Geriatrics Society recommends the following tips for making your home safe from falls:

• Keep cords away from areas where you walk.
• Remove loose carpets and rugs or tack down the carpets and only use rugs with nonskid backing.
• Add lights in dimly lit areas and at the top and bottom of stairs.
• Use nightlights in bedrooms, halls and bathrooms.
• Clean up clutter – especially near staircases.
• Put hand rails on both sides of any steps or stairs in or outside of your home.
• Add “grab bars” near the toilet and bathtub, and no slip decals or a rubber mat in the tub or shower.
• Wear firm shoes that are not slippery on the bottom.
• Don’t walk around in loose slippers or socks.

Limit Your Risk of Falling Outdoors

Preventing falls outside, or in icy or rainy conditions, presents other challenges. Dr. Joseph Schmidt of Baystate Emergency Medicine offers the following tips to prevent slips outdoors or in hazardous conditions:

• Don’t carry items which can put you off balance or block your view.
• Take baby steps.
• Wear footwear with slip resistant soles.
• Use handrails if possible.
• Swing both legs out of your vehicle, then place both feet on the ground and place your hands on the car for support.
• Watch for slippery floors when you enter your home or elsewhere.

How to Fall Safely

Dr. Schmidt notes that there are ways to fall which will lessen your chances of serious injury:

• Bend you knees so you are closer to the ground, helping to break your fall somewhat.
• Tuck your chin into your chest while falling to the back or side to keep your head from hitting the ground.
• It’s better to fall on your side.

Children are also at risk of falling

Falls are also the leading cause of non-fatal injuries for all children ages 0 to 19. Every day some 8,000 children are treated in U.S. emergency rooms for fall-related injuries.

“Keeping children safe and healthy is our top priority. There are many things that parents can do to reduce their child’s risk of potential injury from falls,” says Dr. John O’Reilly, chief, General Pediatrics, Baystate Children’s Hospital. “It is sometimes impossible to keep an eye on your child at all times, so there are some important ways parents can ‘baby proof’ their homes to decrease their child’s risk of falls.”

Fall Safety for Kids

Stairs: Falling down stairs is a common childhood injury. Placing gates at the top and bottom of stairs is a key safety measure. Using doorknob covers to prevent children from opening the basement or other doors that open onto stairs will also prevent falls.

Windows: Falling out of a window can be fatal to children. Installing window guards or mechanisms to prevent the window from opening more than a few inches can prevent these catastrophic events. You cannot depend on window screens to prevent a child falling out a window. Moving furniture away from windows may also help prevent an accidental fall.

Outdoor heights: Don’t leave your child unsupervised on a balcony, deck, or a fire escape. Falls from heights can cause significant brain trauma. Lock the doors to these areas.

Baby furniture and changing tables: Baby furniture and changing tables have seat belts for a reason - infants and toddlers like to roll and squirm, and that can lead to falls.

“Buckle up" in the home as well as in the car.

Beds: Bed rails are an important safety feature, especially if your child’s bed is above the floor. Bunk beds are of particular concern because of the potential height of the fall, so children in the upper bunk need to be protected with bed rails

Baby walkers: Baby walkers do not help your child learn to walk, but they do help your child fall and be injured. A stationary walker is a much safer alternative.

Strollers and shopping carts: Buckle your child, and also avoid situations where the stroller or shopping cart might tip over and injure your child.

Play safely: Falls on the playground are a common cause of injury. Check to make sure that the surfaces under playground equipment are safe, soft, and consist of appropriate materials (such as wood chips or sand, not dirt or grass). The surface materials should be an appropriate depth and well-maintained.

Keep sports safe: Make sure your child wears protective gear during sports and recreation. For example, when in-line skating, use wrist guards, knee and elbow pads, and a helmet.

Next Steps

It’s a good idea to talk with your doctor if you have been experiencing falls, which could be the sign of a new medical problem that needs attention, or that a medication might need to be changed. If you don't have a primary care provider, find one now. To learn more about preventing falls, join us for a free virtual event with four experts from Baystate Rehabilitation Care. 

Register for "The Balancing Act" Virtual Event