When you hear the words “fall prevention” what’s the first thing that comes to mind?
For many people, the idea of falling is so scary they don’t want to even think about falls. For many others, they’re tired of being told to remove all throw rugs and are confident they’re healthy and fit enough to avoid falls without being lectured about it.
Admittedly, healthcare providers don’t always do the best job explaining the reality of falls and fall prevention to older adults.
This article will explain fall risk and how age factors into risk, why it’s important to get a fall screening (even if you’re healthy and fit), and how to increase home safety without compromising the things you enjoy.
Are Falls a Normal Part of Aging?
The short answer is no.
What gets confusing is that as we get older, our risk for falls- particularly injury-inducing falls- increases.
There are natural (or “normal”) age-related changes that occur in all individuals. These include things like decreased muscle mass, vision changes, and changes to cardiac and nervous systems.
The result may be decreased ability to get up from a low chair, difficulty seeing a step, or orthostatic hypotension (light-headedness upon changing positions quickly). All of which increase the risk of a fall.
If Aging Increases Fall Risk, Can Falls Really Be Prevented?
Fortunately, the short answer here is YES!
Having an increased risk doesn’t guarantee it will happen.
It’s important to think of risk on a scale from lower to higher risk. The reality is anyone (myself included) can have a fall. But working to keep ourselves in the lower risk category.
Increased risk with age just means we want to be aware and act to reduce the risk as much as possible.
Who Needs to Complete a Fall Screening?
My advice is all older adults should complete a fall screening annually. The Center for Disease Control (CDC) and American Geriatric Society as recommend a yearly fall screening for those 65 and older.1
Why Complete a Fall Screening?
As previously mentioned, anyone can have a fall- even if you’re fit and healthy and have never experienced one before!
Just like getting an annual physical or eye exam, a yearly fall screening just helps you know what your risk is and if you should make any adjustments to help decrease your risk.
According to the National Council on Aging, “On average, 1,800 older adults die from a fall annually and 1.5 million are treated in the emergency department for injuries caused by a fall.”2 Falls not only are a leading cause of injury, but also a leading cause of nursing home placement.3
This statistic is not meant to invoke fear, rather it’s intended to highlight the severity of falls.
Getting a fall screening annually (even if you think you don’t need it) is the best place to start if you want to prevent a fall.
What If You Think You Really Don’t Need a Fall Screening?
You do.
Let’s take another condition as an example to highlight the importance of getting screened yearly.
Glaucoma is a condition where one loses vision. The scary thing with glaucoma is that vision loss starts in the periphery, so it typically goes unnoticed for an extended period of time.
Once vision loss due to glaucoma occurs, it’s irreversible.
This is one of the reasons it’s so important to get your eyes checked annually. Waiting until you have symptoms is too late.
Similarly, when you think you need a fall screening, you likely are at an even higher risk for falls.
Getting screened early and consistently is extremely important!
Fall Screenings Are Even Easier Than A Yearly Physical
So you’ve decided (after a little convincing) to get screened for fall risk.
Congratulations! I’m so proud of you and you won’t regret it!
These tests are typically done by physical and/or occupational therapists. You can always ask your therapist to do a screening for you. If you don’t have a therapist currently, there may be a fall screening in your area or you can reach out to your primary care provider or local PT clinic to set one up.
Here’s what you can expect at a fall screening:
- You’ll likely fill out a questionnaire. There are some questionnaires that are lengthier than others, but all will take about 5-10 minutes at the most. The three most common questions are: Are you afraid of falling? Do you feel unsteady or use an assistive device? Have you fallen in the last year?
- Your strength, balance, and gait will be assessed. Three tests are used to assess these items- the 30-Second Chair Stand Test, Four Stage Balance Test, and the Timed Up and Go (TUG).
Common Fall Assessments
The 30-Second Chair Test assesses balance and lower body strength. You will sit down in a chair and when the therapist says “Go” you will stand up and sit down as many times as you can safely in 30 seconds. The therapist counts the number of times you can complete this. A lower number indicates higher risk for falls.
The Four Square Balance Test assesses balance. In this assessment, the therapist will ask you to stand in four different positions- feet together, one foot in front with separation between heel and toe, one foot in front with heel and toe touching, and standing on one leg. If you’re unable to hold positions 2 or 3 for 10 seconds or single leg stand for 5 seconds, you’re at higher risk for fall.
The TUG assesses gait. The therapist will have you sit in a chair, stand up, then walk ten feet at your normal pace, and return to sitting in the chair. A score of greater than 12 seconds indicates higher fall risk.
Once you complete these assessments, the therapist will discuss your fall risk and what specifically you can do to decrease that risk.
Falls Free Check Up
If you’re still not ready to sign up for an assessment, another great place to start is with this questionnaire from the National Council on Aging!
The Key to Fall Prevention
Knowing your fall risk is the first step in fall prevention. The next step is knowing what to do about your risk or how to keep your risk low.
The key to fall prevention is working with your therapist or healthcare provider team to come up with solutions that are attainable for you.
For example, I’ve been guilty of telling my clients to get rid of all of their throw rugs. While they may trash the rugs while I’m treating them, I know some of them just purchase new ones once their therapy is complete.
A better solution may be using double sided tape to ensure that all the corners/edges of the rug are secure.
Similarly, exercising regularly to build strength can help reduce fall risk. But saying you’ll go to the gym five times a week and never actually doing that won’t impact your risk for falls at all.
Maybe you prefer to do videos at home and want recommendations on which muscle groups to focus on.
Remember that your therapist is a movement expert with a lot of skills and strategies to effectively reduce fall risk, but you are the one who needs to implement the plan. So make sure it’s actually something you are able to do!
For more specific tips for decreasing fall risk, check out my article HERE! Or check out the National Council on Aging website for a ton of information on fall prevention!
Check Out This Video
Click HERE to see Dr. Katie Landier, PT, DPT, GCS interview fall prevention expert Dr. Jen Nash, PT, DPT, NCS.
Have the Strength to Live Life to the Fullest!
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Sources:
- Fall Risk Assessment: MedlinePlus Medical Test. (2021). Retrieved 24 August 2022, from https://medlineplus.gov/lab-tests/fall-risk-assessment/#:~:text=The%20Centers%20for%20Disease%20Control,years%20of%20age%20and%20older.
- Crosswhite-Chigbue, K. (2022). The National Council on Aging. Retrieved 24 August 2022, from https://www.ncoa.org/article/hidden-home-hazards-older-adults-more-likely-to-die-from-falls-and-fires
- Stark, S. (2022). The National Council on Aging. Retrieved 24 August 2022, from https://www.ncoa.org/article/how-removing-hazards-from-the-home-using-harp-can-prevent-falls
