Fall Prevention: How to Help Your Older Adults

Karlis Abuls, PharmD Candidate 2021
The Ohio State University

December 21, 2020

Fall Risk 2

Falling can be life changing for older adults. Every 11 seconds, an older adult is treated for a fall in the emergency room. In 2015 fall related injuries resulted in about 50 billion dollars’ worth of medical expenses. A single fall that leads to an injury like a hip fracture or head trauma can take a long time to recover from, and limit how much older adults are able to do on their own afterwards.

Why are falls for older adults a big deal?

One fall can end up costing a fortune in hospital bills, and even more if they need to recover in a rehab facility for a while. With a growing population of adults over 65, preventing falls is critical for maintaining independence and quality of life, not to mention reducing medical bills.

Why is it easier to fall as we age?

Falling is usually a result of a combination of factors. Adults in general have less physical stability as they get older because of a loss of muscle and balance. Combine these aspects of natural aging with other factors like:

  • medication side effects
  • a new environment
  • changes in mental status,
  • alcohol use

and suddenly you have a perfect recipe for falling. Even if they have never come close to falling, one slip on a loose rug or wet floor can change everything. While some of these risk factors cannot be changed, there are certainly some things that we can do to prevent our older adults from falling.

Reducing the risk of falls in the elderly

Although we can’t always change the physical abilities of those we care for, we can ensure that the environment is safe. Evaluate the surroundings for items that can be tripped over such as loose carpeting or out of place furniture.  Falling in the shower can be very easy to do (even for younger people), so all older adults should have a shower mat to prevent slipping. Blood pressure changes when we change positions (ex. standing up from sitting). This happens more slowly for older adults, often causing dizziness and possibly a fall. Make sure they take their time when changing positions, particularly when getting up at night to use the bathroom.

What can we do about medications?

Many prescription medications have potential side effects that could increase the risk of falls – particularly sleeping medications. The most important thing to do is simply be careful. When starting a new medication, keep an eye out for noticeable side effects like drowsiness or mental status changes, and ask your older adult family member or patient if they are feeling dizzy or lightheaded. Discuss risks of falling with the prescriber whenever starting a new medication, and do not hesitate to reach out again if you notice concerning side effects. Certain over the counter medications, particularly older antihistamines like Bendaryl, should be avoided because they can cause drowsiness and/or confusion. Ask your local pharmacist to look at the older adult’s medications every now and then to assess for fall risk. This kind of periodic check-up can make a huge difference for your patient or family member (or both!).

Resources:

Falls in Older Persons: Risk Factors and Patient Evaluation. UpToDate. Wolters Kluwer. Hudson, OH. Available at uptodate.com. Accessed October 16, 2020.

Falls Prevention Facts. National Council on Aging. https://www.ncoa.org/news/resources-for-reporters/get-the-facts/falls-prevention-facts/#:~:text=According%20to%20the%20U.S.%20Centers,adult%20dies%20from%20a%20fall. Accessed October 16, 2020.

Prevent Falls and Fractures. National Institute on Aging. https://www.nia.nih.gov/health/prevent-falls-and-fractures. Updated March 15, 2017. Accessed October 16, 2020.

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