Falling in the Elderly - Causes and Prevention

Dear Dr. Dave and Dr. Dee,

My mom fell and couldn't get up. I just realized how funny that sounded, and I guess I am able to make light of it because she is fine right now. She actually got up about 10 minutes after falling in the living room. I think she was stunned, but she said that she just lay there until she felt better. She was simply watching TV, and got up to go to the kitchen, and the next thing she knows, she was on the floor. She has not had another episode (she says), but she does admit to feeling a little unsteady at times. She is 83 years old, but very healthy. The only medication that she takes is for high blood pressure. Why did this happen and what should I do to help her? I've been stopping by to visit her every day since.

Signed,

Panic about prevention

Dear Panic about prevention,

Your mom is very lucky to have you so close by. It would be a good idea for your mom to see her doctor for a check up to rule out any health conditions such as failing eyesight or balance disorder.

Because your mother fell upon standing up, then it could be that she had an episode of postural hypotension, which results from a decrease in blood flow to the brain, due to a drop in blood pressure upon standing up (for a complete description, see letter: Dizzy When I Stand Up: Postural Hypotension).

One possible reason for postural hypotension in an elderly person is a medication that he or she may be taking such as high blood pressure medication. If medications are the reason, then lowering the dose should help, but consult with a physician. Other medications can also make a person unsteady such as medications for depression, diabetes, or the heart.

According to the American Academy of Family Physicians (AAFP at www.aafp.org), "falls are the top cause of accidents in people over the age of 65. Falls are also the main cause of serious injuries and accidental deaths in older people" (2000).

To help prevent falls in the elderly, the AAFP offers the following guidelines for the home.

PREVENTING FALLS IN THE HOME

1. Shoes: shoes with nonskid soles

2. Lighting: keep home well lit

3. Nightlights: use in bedroom, bathroom, halls, stairways

4. Throw rugs: remove or fasten to floor with carpet tape and tack edges

5. Electrical cords: keep out of pathways

6. Grab bars: bathtub, shower, and toilet area

7. Stools and stepladders: keep off, let someone else help with jobs that require climbing

8. Floor wax: do not use, instead use non-skid wax.

In addition, get regular exercise, avoid smoking and excessive alchohol.