Preventing Falls
Volume 5, Number 2 - February, 2001
Editors: Carol A. Rice, Ph.D., RN, Professor and Extension Health Specialist, and Janet M. Pollard, MPH, Extension Associate-Health
Inside HealthHints....
- Preventing Falls
- How Serious is the Problem of Falling?
- Risk Factors: History, Drop Attacks, Dizziness, Balance and Gait
- Important Types of Exercise
- Neurological and Musculoskeletal Disabilities
- Medication Use
- Confusion
- Visual Impairments
- Fear of Falling
- Footwear
- Environmental Hazards
- Adapting the Home Environment to Reduce Fall Risk
- Adaptation Issues for the Nursing Home Resident
- Extension Resources
- Other Resources
- Programming Ideas
- Websites with Reliable Information
- References
Preventing Falls
A fall is an unintentional loss of balance causing one to make unexpected contact with the ground or floor (Rammel, 1996).
Though this definition may sound simple, the issues surrounding falls are more complex. Falls among older persons are an important cause of injury, disability, and death. Falls are also an important indicator of decline in functional ability. Reducing fall risk requires careful assessment of the person who has fallen, as well as his or her surrounding environment.
Once the risks are identified, actions must be taken to reduce the risks (Hindmarsh, 1989).
Although falls happen at any age, this issue of HealthHints will focus on reducing risks for older adults since they run the greatest risk for decreased quality of life, and death due to injury from falls. Common risks will be identified, followed by suggested interventions.
The older adult population (persons 65 years or older) numbered 34.5 million in 1999. That's 12.7% of the U.S. population. Two million of these individuals reside in Texas. That's 10.1% of the Texas population. (Administration on Aging, 2001; Fedstats, 2001)
How Serious is the Problem of Falling?
According to the Centers for Disease Control and Prevention, in the United States:
- 1 of every 3 adults age 65 or older falls each year.
- Falls are the leading cause of injury deaths among people age 65 and older. In 1997 (the most recent data available), about 9,000 people over the age of 65 died from fall-related injuries.
- Of all fractures, hip fractures cause the greatest number of deaths and lead to the most severe health problems. There were approximately 340,000 hospital admissions for hip fractures in 1996 (the most recent data available).
- Falls account for 87% of all fractures for people age 65 or older. Falls are also the second leading cause of spinal cord and brain injury among older adults.
In addition to the physical and emotional trauma caused by falls, in 1994 (the most recent data available), falls among people age 65 and older cost an estimated $20.2 billion (McGarry, 1999; Stevens, 2000); this number is expected to reach $32.4 billion by 2020. These figures do not include the indirect human and monetary costs of disability, lost productivity, and diminished quality of care (McGarry, 1999).
Risk Factors
Factors contributing to older adults' falls are internal and environmental. Some of these factors include:
- history of a previous fall
- dizziness
- drop attacks
- problems with gait and balance
- neurological and musculoskeletal disabilities
- medication use (side effects)
- problems related to confusion
- visual impairments
- fear of falling
- environmental hazards.
History of a Previous Fall
An important question to ask when assessing someone's fall risk is about previous falls. People who have fallen previously are far more likely to fall again. Many people who fall do so repeatedly. Asking about previous falls is especially important when admitting an older person to either a nursing home or hospital so appropriate precautions are implemented. Older adults with a history of falling should also have a careful physical work-up to identify treatable problems.
Dizziness
Dizziness also raises an older adult's risk for falling. Dizziness may be due to a variety of causes such as medicines, heart arrhythmias, getting up too quickly, or inner ear problems. Whatever the cause, asking about feelings of dizziness is a very important part of assessing an older person's potential for falling. A thorough physical examination should be done to identify treatable causes for dizziness.
Drop Attacks
Drop attacks are sudden spontaneous falls while standing or walking, with complete recovery in seconds or minutes. There is usually no recognized loss of consciousness, and the event is remembered. A person with a history of drop attacks is at very high risk for falls and injury.
Drop attacks can have diverse causes including heart arrhythmias (syncope), seizures, or inner ear disease. In most cases, however, the cause of a drop attack is never identified.
Evaluation by a physician is important to identify a cause, if possible. Treating the identified cause of drop attacks is ideal. Since most causes remain unknown, however, assistance with walking and modifying the environment to remove hazards is all that can be done (Hain, 1999).
Balance and Gait
A combination of internal and external factors can create a loss of balance and gait (i.e., stride).
Muscle atrophy is one common reason for balance and gait problems. If we become less active in old age, our muscles atrophy, or get smaller and reduce our strength. This can reduce the mobility and balance we need to maneuver effectively and continue tasks of daily living, ultimately making us dependent on others.
One way to counteract muscle deterioration is through exercise, particularly a combination of aerobic, strength, and flexibility-type exercises. One example of exercise shown to improve balance among older adults is Tai Chi, a form of Eastern movement sequences. (For more on exercise see the box entitled "Important Types of Exercise" below.)
Since falls occur when balance and normal gait are disrupted, it can be beneficial to:
- participate in balance training, (e.g., weight shifting and anticipation of needed adjustments in response to gait/balance disruption)
- obtain a referral to a balance disorder clinic from your doctor to help assess whether your balance problem is related to an underlying medical problem
- remove hazards from the everyday environment
- improve accessibility in the everyday environment.
By making some simple lifestyle changes to promote safety, the likelihood of falling can be decreased. (Hinman 1996; Rammel 1996 ). See "Adapting the Home Environment" for more information.
Important Types of Exercise
Maintaining a regular exercise program can improve strength, balance and coordination. Making and maintaining these improvements requires three important types of exercise that can be done individually, as a single routine/program, or through daily tasks.
- Aerobic exercise (e.g., walking, swimming, cycling) -- exercises that maintain the heart and muscle function. These exercises can help one continue in activities of daily living, such as climbing a flight of stairs or walking through a grocery store pushing a cart without getting out of breath and/or requiring assistance.
- Strength exercise (e.g., weight training, resistive fitness bands, etc. ) -- exercise that uses your weight, free weights, or weight machines to cause resistance against your muscles, maintaining and building muscle strength (as well as increasing your metabolism). You need muscle strength to do simple tasks of daily living, such as rising from a chair or climbing a flight of stairs. Programs of strength training and physical therapy can produce increases in muscle strength in less than 2 months. These exercises can increase reaction time and decrease atrophy (Freedman 1996, Hinman 1996).
- Flexibility exercise (e.g., stretching, yoga) -- exercises that stretch your muscles and help you maintain or gain more flexibility. By maintaining flexibility one can continue necessary tasks, such as reaching a top shelf, or zipping the back of a dress.
It can be fun to join an exercise class or do your own routine at home or elsewhere. You might consider joining a local recreational facility, YMCA, or swimming pool. You can also check out exercise videos from a library, or rent or buy them at your local video or entertainment store. Still, if you find these ideas unappealing or too time-consuming, consider some of the following suggestions for incorporating physical activity into your daily life:
- Park a distance from the grocery door and walk.
- Walk the stairs instead of taking the elevator.
- Do your own gardening -- it can be enjoyable and good for building and maintaining strength and flexibility.
- If you enjoy golfing -- walk, don't ride in a golf cart.
- Mow the lawn -- this builds and maintains strength and is also good for the heart (aerobic) -- no riding mowers, please!
- Instead of picking up the phone to talk to a friend -- arrange a time and go walking or cycling together while talking.
Remember: Always consult a physician before starting any exercise program. If you find any activity uncomfortable, or get out of breath, stop immediately! Your doctor can help you with an appropriate exercise or physical therapy program as needed.
Neurological and Musculoskeletal Disabilities
Certain neurological and musculoskeletal disabilities can put an individual at increased risk for falls. Some of the diseases influencing falls include:
Neurological Diseases
Multiple Sclerosis
Multiple sclerosis is a chronic, often disabling disease of the central nervous system. Symptoms may be mild such as numbness in the limbs or severe, including paralysis or loss of vision (National Multiple Sclerosis Society, 2001). Other symptoms that may put a person with multiple sclerosis at higher risk for falling include blurred or double vision, muscle weakness, impaired balance, spasticity, and tremors (National Multiple Sclerosis Society, 2001)
Parkinson's Disease
Parkinson's disease is a slowly progressive neurological disorder resulting from a loss of cells in areas of the brain that control movement, posture, balance, and walking. Some of the symptoms of Parkinson's disease that increase fall risk are:
- stiffness, uncontrollable stalling or "freezing"
- blood pressure drop upon standing, known as orthostatic hypotension (note: this also occurs more often as we age, even among healthy individuals)
- tremors
- stooped posture
- gait and balance problems.
Stroke
A stroke (also known as a "brain attack") occurs when blood circulation to the brain is interrupted or fails. A few minutes without oxygen and important nutrients from the blood to the brain can damage or kill affected brain cells. Though cell damage can sometimes be repaired, and some skills can be regained, the death of brain cells is permanent -- dead brain cells are not replaced. Thus, the devastating effects of stroke on the body are often permanent. If the cells affected are those responsible for mobility, balance, or gait, falls may result. (For more information on stroke, see HealthHints Vol. 4 No. 7.)
Musculoskeletal Diseases
Arthritis
Arthritis refers to over 100 different diseases that cause pain, swelling, and limited movement in and around the body's joints, thus, increasing risk for falls. Arthritis is one of the most prevalent chronic health problems and the number one cause of limitation in movement in the United States. Because arthritis limits movement, it often limits the ability to do tasks of daily living. Nearly 3 million Americans have arthritis that limits their ability to do such tasks as walking, dressing, or bathing. (For more information on arthritis, see HealthHints Vol. 1 No. 5.)
Osteoporosis
Osteoporosis is a disease that causes bones to become more porous, which gradually makes them weaker and more brittle. Healthy bone is dense and strong, able to withstand a great deal of pressure. When osteoporosis, literally meaning porous bone, sets in, bones thin and become fragile, making them more likely to break, and putting one at greater risk for falls. (For more information on osteoporosis, see HealthHints Vol. 4 No. 5.)
Medication Use
Medications may raise the probability of falling for a number of reasons. As we age, we may be affected by chronic disease, resulting in the use of multiple drugs. This multiple drug use can be a problem because the older adult body is less able to process and detoxify medications than it was at a younger age.
Taking multiple drugs also raises the possibility of harmful interactions, possibly leading to increased confusion, sedation, or dizziness. Additionally, reactions to drugs may be altered by the presence of more body fat and less muscle mass that are common as we age.
Medications may also stay in the body longer because of decreased kidney and liver function. As a result, a "normal dose," which produces no problems for a middle-aged person, may produce dizziness, drowsiness, unsteadiness, confusion, blurred vision, slowed reactions, and fatigue for an older adult.
Some categories of drugs also raise fall risk. For example:
- diuretics (water pills) or laxatives increase the urgency to get to the bathroom
- digitalis can slow the heart so much that dizziness results
- blood pressure medication can produce dizziness, especially when changing positions from lying or sitting to standing
- sedatives can decrease judgment and reaction time.
Self-treatment may also produce problems leading to increased fall risk. To save money on prescriptions, individuals may be tempted to share medications. Herbals may also be used instead of, or in addition to, prescribed medications. Still others may choose to go to Mexico and purchase medicines for self-treatment.
To prevent falls related to medication use:
- Avoid self-treatment.
- Take a list of all over the counter (OTC) and prescription drugs to each doctor's visit.
- Review your medications with your doctor or pharmacist often.
- Discuss with your doctor effects of taking different types of medicines at the same time in order to evaluate possible interactions between the medicines.
- Tell your doctor about any problems you are having with side effects or with taking your medications as directed.
Confusion
If an individual suffers from confusion, he or she is more likely to fall. Falls result because the confused person is often:
- unaware of his/her surroundings
- unable to think clearly or react fast enough to catch him- or herself.
Confusion can be brought on by many conditions including:
- Dementia -- An irrecoverable deteriorative mental state. One common type of dementia is Alzheimer's Disease.
- Delirium -- A sudden or acute disorientation of time and place, or confused state. This can sometimes be brought on by injury to the head, electrolyte imbalance, or endocrine malfunction.
- Depression -- A mental state characterized by despair, lack of hope, absence of cheerfulness, and sometimes confusion -- distinguished from grief, which is realistic and proportionate to that which has been lost.
Visual Impairments
As we age, less light reaches the back of our eyes where vision is located. Acuity, or the ability to distinguish objects, also declines as we age, and as we reach age 90, our acuity may decline as much as 80%. This decline in acuity impairs the ability to perceive an object in contrast and spatial detail. Older persons may require three times more light for detection of objects in the environment.
Additionally, as we age our light-dark adaptation is slowed, there is more glare because of cataracts, and our accommodation to distance changes can decline.
What can be done to combat changes in vision and prevent falls?
- See your eye doctor once a year. Cataracts and ill-fitting glasses can cause you to fall if you do not see well.
- Add additional lights to your home to avoid tripping over objects that are not easy to see. Night lights should be put in the hallway, bedroom, and bathroom.
- Use multiple lamps (three 100 watt bulbs are more functional than one 300 watt bulb).
- Outdoor lighting is just as important as indoor lighting. Use all outdoor lights available when possible. Sensor lights that turn on whenever there is movement may be a good idea, as well (Steinweg,1997; American Academy of Family Physicians, 1998).
Fear of Falling
A fear of falls contributes to the problem by causing inactivity and deconditioning, further increasing the danger of falls (Hindmarsh, 1989).
The fear of falling can create tremendous anxiety among the older adult population, particularly among those who have fallen before. This fear has been paralleled to the intensity of fear of missing an important appointment. Additionally, families often become overly protective and attempt to restrict their older relative's autonomy. In some cases, a family's reaction may lead to unnecessary institutionalization (Christenson, 1990; Howland, et. al., 1998).
The fear of falling is not restricted to those who have already had a fall, however. Others who have friends or relatives who have fallen may also exhibit an intense fear of falling.
The problem in both cases is not just the fear, but the reactions the fear causes. Fear of falling can cause one to be so cautious that he or she refuses to go out, or even go to the bathroom. When people move less based on fear, muscles begin to deteriorate more quickly, boredom and depression may set in, and the person becomes increasingly and prematurely dependent upon others, often leading to institutionalization (Christenson, 1990, Warren, 1996).
Fear can be useful when it causes us to exercise necessary caution, but a person can be cautious without letting fear dictate a lower level of activity and community involvement (Warren, 1996).
Here are some keys to reducing fear:
- Learn ways to avoid falls -- Use assistive devices (e.g., canes, walkers) properly, have them fitted properly, wear proper footwear, modify your environment for safety.
- Learn and practice ways to get up if you should fall -- Consult a physical therapist to show you ways to get up.
- Have an emergency response plan -- Have a neighbor, friend, or relative who will call daily to check in on you; discuss what the plan is were you to fall and be injured; or, use a commercial personal emergency response system (Warren, 1996).
Note: As an educator to the public, it is important to create awareness about falls and not fear. Pay special attention to your words and illustrations when presenting a program on fall prevention. Place the emphasis on positive actions one can take to reduce the risk of falling.
Footwear
Wearing improper shoes or foot coverings such as socks or hosiery without shoes may cause a fall. When looking for proper footwear, consider the following tips:
- Choose shoes that are comfortable (a "comfy" pair of shoes is more likely to be worn).
- Choose shoes that fit correctly -- shoes that are too snug are uncomfortable and promote sores and corns; shoes that are too loose may slip and cause instability when moving about.
- Wear shoes that are low-heeled (high heels are notable for causing falls).
- Choose shoes with adjustable fasteners for the best, most comfortable fit.
- Choose shoes that have firm support (athletic shoes or shoes with a low, leather sole are usually good choices).
- Choose slippers that fit snugly around the foot and have a non-skid sole.
(Fleck, 1995, Hinman, 1997)
Environmental Hazards
Environmental hazards, such as slippery surfaces, uneven floors, poor lighting, loose rugs, unstable furniture, improper bed height, and clutter, can lead to falls (Centers for Disease Control and Prevention, 1999). According to the Centers for Disease Control and Prevention, among individuals age 65 and older:
- 60% of fatal falls happen at home,
- 30% occur in public places, and
- 10% occur in health care institutions (Centers for Disease Control and Prevention, 1999).
Though falls most commonly occur in and around the home, falls are also common when an older adult changes environments, particularly to a health care institution. This most likely results because surroundings are initially unfamiliar and/or these individuals are more frail than those living elsewhere.
Thus, to reduce the risk of falling, it is important to assess each individual and make appropriate adaptations in his or her environment.
Adapting the Home Environment to Reduce Fall Risk
Each room in the home can be adapted and modified to create a safer environment and reduce the potential for falls. Below are some general suggestions.
Bathroom
The bathroom is the room in the home where most falls take place. Problems occur due to difficulties getting in and out of the tub, on and off the toilet, difficulty seeing in dim lighting, slippery or wet surfaces, and dizziness standing at the sink. With minor modifications, the bathroom can become protected. Modifications include:
- Grab bars or side bars around toilet, tub, and sink areas. (Note: vertical bars are often easier to catch in case of a fall than those installed horizontally.)
- Bath bench for the tub, hand-held shower nozzle, and rubber mat for the shower.
- Nonskid rugs or mats.
- Adequate lighting.
- Raised toilet seat (an extension that is placed on the toilet seat and raises the height of the seat).
- Stool for sitting at the sink/vanity area.
Bedroom
The bedroom should be thought of as a safe haven. With the following modifications, the bedroom can become a place of rest and relaxation:
- Adjustable height hospital bed.
- Flashlight/night light by the bed. (This light should also be attachable to a walker or cane.)
- Remote control light switches can be a real help if you need to rise in the night (available at hardware or electronics stores).
- Nonskid wax or no wax on the floors if it is not carpeted.
- Secured thresholds with metal stripping, tacked down, or striped with tape to make the change noticeable.
- Make sure edges of rugs and carpets are secure. Remove throw rugs completely.
- Dense, low-pile carpeting offers a safer floor covering and reduces tripping.
- Place assistive devices such as wheelchairs, walkers, or canes next to the bed for easy access and use at night.
- Place clothes or other belongings in easy to reach spaces (shelves or drawers at reachable height), and lower rods in the closet if necessary.
- Step stools with sturdy handrails are a must. Do not stand on a chair to reach objects that are above your reach (don't strain to reach objects).
- Remove caster wheels from furniture, not only in the bedroom, but throughout the home to prevent the furniture from rolling.
- Keep the path from bed to bathroom clutter free.
- Consider a bedside commode or urinal if you are far from the bathroom and awaken nightly to use the restroom.
Living Room
The living room is a place of entertainment and leisure, so safety is not a luxury, but a necessity. Modifications include:
- Moving obstructing furniture in order to create a clear walking path that is free of barriers.
- Extension cords should be anchored to walls, under sturdy furniture, or taped down.
- Light switches that are illuminated are helpful as are touch sensitive or voice activated switches.
- Replace swivel chairs. Chairs at inadequate height may be adjusted by adding a platform to the base of the chair. Automatic lift chairs may be helpful.
Stairways
Stairways and even small steps up and down into rooms can be treacherous at all ages. To help improve safety, modifications may include:
- Handrails on either side of the steps. Handrails 2 to 3 inches from the wall permit good hand grasp.
- Applying nonskid surfaces to steps can prevent slipping.
- A piece of brightly colored tape at the bottom and top step signal the beginning and end of the stairway.
- Ramps and elevators can be used for those who are unable to get up and down the steps safely.
- If unable to use a walker, cane, wheelchair, or other mobility aid on the steps, keep a second aid at the top or bottom of the steps.
Home Management Issues
In addition to room modifications, there are a few home management issues that need to be considered for modification:
- Laundry -- Because there is a lot of bending and stooping involved in doing laundry, try sitting on a stool to access clothes in front loading washers and dryers; fold laundry sitting at a table; carry laundry in bag up and down stairs; use a cart between working areas. If needed, you can also use a professional laundry service.
- Housekeeping -- When doing chores around the house, always clean up spills immediately to avoid a fall on slippery surfaces; keep the floor uncluttered; use no-bend dust pans and mops, or use a lightweight all-surface sweeper/vacuum. If needed, consider using a professional cleaning service.
- Mail -- For easy access, install a mailbox, mail slot, or mail basket on or next to your front door. Also, ask your newspaper carrier to place items in a specific location for easy accessibility.
- Doors -- If you have difficulty opening doors, install lever-type door handles instead of knobs. Automatic door openers are also available (check your hardware or electronics store).
- Windows -- If you have difficulty opening or closing windows, install a lever and crank system window. Remote control options are also available (consult someone at your hardware or electronics store).
- Telephone -- If your phone is difficult to reach or get to in time, choose a cordless phone (headset options are also available). Inform friends to give you 10 rings to get to the phone, and keep the path to the phone clear. Answering machines and call back options are also good to have on hand in case you can't get to the phone in time (Baylor College of Medicine, 1997; Center for Therapeutic Applications of Technology, 1995; Fleck 1995, Southwest Region Health Information Partnership,1998).
Keep in mind, each individual and his or her environment should be assessed to meet individual needs.
Adaptation Issues for the Nursing Home Resident
An older person who is moving to a nursing home faces a totally new environment, in addition to increased physical and cognitive risk factors for falling.
Of the 1.5 million nursing home residents in this nation, approximately 50% fall at least once a year (Centers for Disease Control and Prevention, 1999). Some of the factors associated with this large percentage of falls are that nursing home residents tend to be:
- more frail,
- more cognitively impaired, and
- more limited in activities of daily living than older adults living in the community.
Like the general older adult population, weakness and gait problems, problems with medications, and environmental hazards all increase the nursing home residents' risk for falling. Other causes of falls among nursing home residents include:
- poor foot care, and
- difficulty in transferring (e.g., transferring from wheelchair to bed, or chair to walking aid).
Thus, fall prevention among nursing home residents requires a combination of the following:
- careful assessment during admissions (and as conditions change) -- individuals should be assessed for past fall history and history of dizziness; special precautions are needed for these individuals, such as prompt response for transfer from bed to chair or calls for help to the bathroom
- extra staffing, especially during shift changes to respond to residents' requests for help
- medical treatment to review medications and any physical problems, such as foot care issues
- physical conditioning and rehabilitation, such as physical therapy, gait training, walking programs, and exercises to improve strength, endurance, and flexibility
- environmental modification, such as no wax floors, adequate lighting, grab bars, handrails in hallways, lowered beds, and raised toilet seats
- technological interventions, such as lifts for safe transfer, alarm systems activated when a person is transferring out of bed, or moving unassisted, and protective hip pads used to reduce risk of hip fracture should a fall occur (Centers for Disease Control and Prevention, 1999).
Note: Restraints and assistive devices can actually contribute to fall-related injuries and deaths. These restraints can actually limit freedom of movement and personal autonomy resulting in de-conditioning and muscle atrophy that can increase functional decline. For this reason, in 1990 a federal regulation took effect, reducing the use of physical restraints in nursing homes. In most nursing homes, fall-related injuries have decreased (Centers for Disease Control and Prevention, 1999).
Extension Resources
Leader Lesson
- Fall Prevention in the Home: Changes for Healthy Living (Both leader lesson and video [below] are available to Texas County Extension Agents in District and Urban Offices or by contacting Dr. Judith Warren.) Lesson reinforces self-assessment of risk and encourages specific behavioral and environmental changes.
Audio/Visuals
- Fall Prevention in the Home: Changes for Healthy Living (VHS 2254 [English], VHS 2264S [Spanish], 15 minutes). Focuses on solutions to six high-risk situations involving balance and environmental hazards.
- Assessing Older Persons for Assistive Devices and Environmental Interventions (VHS 1052, sound, color, 14:53 minutes). Professionals describe an approach to assessing older persons.
- Helpful Products for Older Persons: Bath Devices (VHS 1048, 12:57 minutes). Shows various bath options available for seniors.
- Helpful Products for Older Persons: Canes and Walkers (VHS 1050, 1932 minutes). Program describes canes and walkers available and how to get the proper size.
- Helpful Products for Older Persons: Phones (VHS 1049, sound, color, 22:50 minutes). Provides cases and solutions to the problems older persons may encounter in using the telephone.
- Home Is Where the Care Is (AC 1004, 5 audio cassettes, manual, 1989). Program designed to furnish information to family caregivers on ways of providing care more easily in the home.
- Use of Assistive Devices by Older Persons with Disabilities (VHS 1051, sound, color, 6:30 minutes, 1993). Illustrates different types of assistive devices being used by older persons, grouped by type of disability.
Kits
Order from Janie Harris, Extension Housing Specialist, phone (979) 845-3850, fax (979) 845-6496.
- Assistive Devices Kit: Examples of devices that make tasks manageable at home.
- Assistive Device Exhibit: Safety features in the home.
Other Resources
Brochures/Pamphlets
- A Tool Kit to Prevent Senior Falls (Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Atlanta, GA 30333 [one free copy with request].)
Guidebooks
- Remembering When: A Fire and Fall Prevention Program for Older Adults (Contains materials needed to conduct a comprehensive fire and fall prevention program for older adults. National Fire Protection Association, 1 Batterymarch Park, Quincy, MA 02269.)
Programming Ideas
The Texas Extension Education Association (TEEA) trained 85 leaders on Safety in the Home at their 2000 State Conference. Contact your TEEA representative to schedule community programs on fall prevention. Also, contact your local AARP to collaborate on issues of independent living, including fall prevention and other issues concerning adults ages 50+.
Websites with Reliable Information
- Aging and Your Eyes (NIA)
[http://www.niapublications.org/engagepages/eyes.asp] - Exercise: A Guide from the National Institute on Aging (NIA)
[http://www.nia.nih.gov/exercisebook/index.htm] - Exercise: Feeling Fit for Life (NIA)
[http://www.niapublications.org/engagepages/exercise.asp] - Foot Care (NIA)
[http://www.niapublications.org/engagepages/footcare.asp] - Medicines: Use them Safely (NIA)
[http://www.niapublications.org/engagepages/medicine.asp] - National Resource Center on Aging and Injury: Resources on Preventing Falls
[http://www.safeaging.org/] - Preventing Falls Among Seniors (CDC)
[http://www.cdc.gov/ncipc/duip/spotlite/falls.htm] - Preventing Falls Among Seniors: What YOU Can Do to Prevent Falls (CDC)
[http://www.cdc.gov/ncipc/duip/spotlite/falltips.htm] - Preventing Falls in the Elderly (Colorado State Extension)
[http://www.ext.colostate.edu/pubs/consumer/10242.html]
References
- Administration on Aging (2001). Profile of older Americans [on-line]. Available:
http://www.aoa.dhhs.gov/aoa/stats/profile/default.htm. - American Academy of Family Physicians (1998). Decreasing Your Risk of Falls [Patient brochure].
- Baylor College of Medicine (1997). Senior Focus [newsletter].
- Centers for Disease Control and Prevention (1999). A Tool Kit to Prevent Senior Falls. National Center for Injury Prevention and Control, Division of unintentional Injury Prevention.
- Center for Therapeutic Applications of Technology (1995). Assessment and intervention of the home environment for older persons. Buffalo, NY. For more information: (716) 829-3141.
- Christenson, MA (1990). Enhancing independence in the home setting. In Aging in the Designed Environment. Hawthorn Press, pp 49-64.
- FedStats (2001). People Mapstats: Texas [on-line]. Available: http://www.fedstats.gov/qf/states/48000.html.
- Fleck, J (1995). Prevention of falls in the elderly [on-line]. Available: http://www.family.med.ualberta.ca/newsletter/autumn_1995?prevention.html.
- Freedman, ML. Building muscles can reduce the risk of falls. In: Bryan-College Station Eagle, May 31, 1996.
- Hain, TC (1999). Drop Attacks [on-line]. Available: http://www.cscd.nwu.edu/public/balance/drop.html.
- Hindmarsh, JJ and Harvey Jr., E (1989). Falls in the older person. Archives of Internal Medicine, Vol 149, PP 2217-2222.
- Hinman, MR (1997). A comparison of balance between measures in ambulatory older adults while wearing two types of footwear [presentation]. University of Texas Medical Branch.
- Hinman, MR (1996). Etiology of falls. University of Texas Medical Branch. Healthwise, Inc., Boise, Idaho.
- Howland, J, Lachman, ME, Peterson, EW, Cote, J, Kasten, L, and Jette, A. Covariates of fear of falling and associated activity curtailment, The Gerontologist, Vol 38 (5), 1998, PP 549-555.
- McGarry, N. New Efforts are underway. Aging Today, November/December, 1999, p. 9.
- Mettler, M and Kempner, DW (1996). Healthwise for Life: Medical Self-Care for Healthy Aging. Healthwise, Inc., Boise, Idaho.
- National Multiple Sclerosis Society, What is Multiple Sclerosis (2001) [on-line]. Available:
http://www.nmss.org/What%20is%20MS.asp. - Neurology Research and Education Center (1998). Preventing falls: A defensive approach. Saint Mary of the Plains Hospital.
- Rammel, ML (1996). Epidemiology of falls in older adults. Texas Consortium of Geriatric Education Centers and University of Texas Medical Branch.
- Southwest Region Health Information Partnership (1998). Falls in the elderly [on-line]. Available:
http://www.srhip.on.ca/bgoshu/Injury/InjuryFallsReportFS.html. - Steinweg, KK (1997). The changing approach to falls in the elderly [on-line]. Available:
http://www.aafp.org/afp/971101ap/steinweg.html. - Stevens, J (2000). Preventing falls among older adults. In: Yohn, S (ed.) Injury Control Update, Summer, 2000.
- Warren, J. (1996). Fall Prevention in the Home: Changes for Healthy Living (VHS 2264).
