Fitness and Fall Prevention Part 1 by Lisa Snow

lisa-snow-2Many people in their 70s, 80s, and 90s are increasingly concerned about falling in their home or out on the sidewalk, and their boomer children are just as concerned for them.  But many falls are preventable.  Increasing various aspects of fitness – strength, balance, coordination, etc. – can significantly reduce fall risk.  But exercise is only part of the story.  Many other factors are equally important.  Here are some tips you can use immediately to reduce fall risk for yourself or for your elderly parents.

When couples have their first child, they know they need to baby-proof their house.  Cover plug-ins, keep cleaners out of the child’s reach, etc.  But how many people think to senior-proof a house?  Extension cords, large bathroom tiles, and lighting that is too dim are all risk factors for falls.  Grab bars and nonslip coatings for bathtubs and showers can reduce risk.  The Centers for Disease Control has a checklist to use when you inspect your home, and also has a guide for fall prevention.  These are all free downloads (PDFs) from the CDC website.

The most overlooked aspect of an older adult’s home is the bathroom door.  If you fall and are unable to get up, family members (or emergency medical staff) have to be able to get in to help.  If the door opens in, they will have to break down the door or take it off the hinges to rescue you, wasting precious minutes.  (Not to mention demolishing the door and possibly causing further injury to you.)  If the door opens out into the hallway or next room, they can more safely assist you.  This one simple and inexpensive change to a home can save tremendous expense later, and have a major quality of life impact.  Needless to say, I’m not a contractor, but at least have the conversation about whether this or any other change makes sense for your home.

Many medications—including prescription painkillers and some cholesterol-lowering drugs—increase fall risk.  When certain pain medications are taken with even small amounts of alcohol, fall risk rises exponentially.  Stopping your meds cold turkey or changing dosages by yourself is NOT a good idea.  But if you (or a parent) are taking a lot of meds, it’s time to go back to your doctor for a medication screen.  If you’ve recently lost weight, your medication doses may be too high.  Some drugs from different doctors may be redundant.  And if you’ve started eating better or exercising more, your doctor may recommend you reduce or eliminate some meds.  If it will be some time before you can return to your doctor, ask your pharmacist which if any of your medications increase your fall risk.  Their advice is free, and you’ll find them amazingly knowledgeable.  Even if you and your doctor decide that you need to stay on the same dose of the same meds, at least you’ll have done all you could to manage this fall risk factor.

How much water are you drinking each day?  (Don’t count tea and coffee.)  Dehydration mimics the symptoms of dementia!  Sadly, many older people purposefully restrict fluids.  Hip and knee pain and muscle weakness may make it uncomfortable to stand up from the toilet.  Decreased bladder control may cause a lot of fear that they won’t make it to a bathroom in time.  Other older adults might just forget to drink enough water.  Some patients truly do need prescription medicines (and diet changes) for Alzheimer’s and other forms of dementia.  However, I wonder how many older people who don’t have any of these conditions mistakenly think they do just because they are dehydrated.

Missed last month’s column? Read it now:

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