6 overlooked risks of falls for seniors and how to prevent them
From hearing loss to handrails, experts outline important factors to consider
Cheryl Zimmerman knows all too well what it's like to fall.
Zimmerman, 75, says she fell three times within a two-week period in April.
The Toronto senior considers herself lucky that she didn't get hurt, but "for a while after that, I was just afraid of going out and walking around," she told White Coat, Black Art host Dr. Brian Goldman.
Falls are the No. 1 cause of injury-related hospitalization for Canadian seniors aged 65 and older, according to a 2014 Public Health Agency of Canada report, with about half of these hospitalizations resulting from a fall in the home. It's estimated that between 20 and 30 per cent of seniors fall each year.
White Coat, Black Art reached out to a number of specialists to find out what they consider to be overlooked risk factors for falls. Here are their tips.
1. Check your hearing and sight
Individuals with hearing loss are three times more likely to fall than those who can hear clearly, said Jennifer Campos, a senior scientist at the KITE Research Institute, part of the Toronto Rehabilitation Institute. But it's unclear why.
"When you have hearing loss, obviously it's a problem with your auditory system and in your inner ear," which helps you keep your balance, she said. "You also have your vestibular system, which [is] your little balance detector," which scientists suspect is also damaged when you have hearing loss.
Campos said that "if we were walking and talking at the same time, and if I had hearing loss, it would be really effortful for me to listen, which may actually compromise my ability to stay stable and be alert to obstacles."
Her team is testing whether wearing a hearing aid will help people keep their balance and avoid falls.
Along with getting our hearing tested, doctors recommend regular eye exams, since poor vision can affect balance.
When it comes to vision changes, "it might become difficult to see the edge of a curb or a stair or realize that a path is sloping downward or upward," Dawn Mackey, associate professor of biomedical physiology and kinesiology at Simon Fraser University (SFU) in Burnaby, B.C., said in an email.
Barbara Kowalski, a Winnipeg occupational therapist, said because night vision decreases with age, proper lighting is needed — especially along pathways used in the dark, such as walking from the bedroom to the bathroom.
She recommends motion-sensor lights "that do not require fumbling or reaching for switches and thereby reducing a fall risk."
2. Handrail shape makes a difference
Stairs are one of the most hazardous places for falls in our homes, said Alison Novak, a scientist at the KITE Research Institute in Toronto.
Her team has studied handrail designs and how they can help us recover our balance during a fall.
A round handrail where you can get a "power grip" that allows you to fit your hand around the bar is the optimal shape to prevent a fall, Novak said.
Handrails with a "graspable portion" are ineffective when you've lost your balance, she said.
3. When it comes to steps, size matters
A step that is too short or too high contributes to the risk of falling, Novak said.
When you're coming down the stairs, you want the step to be long enough so that your foot doesn't "overhang too much to slip off of it or to overstep it."
A higher step makes it difficult for older adults who don't have enough strength to pull their foot up and clear that step, Novak said.
4. Use mobility aids and keep them by your side
Sarah Teklet, an occupational therapist based in Dartmouth, N.S., said it's important to use mobility aids and assistive devices correctly — for example, adjust a walker to the appropriate height and keep it within reach — and keep them well maintained, such as ensuring worn cane tips are replaced.
It's best not to dismiss a fall but rather to follow up with a health-care professional.- Dawn Mackey, Simon Fraser University
Occupational therapist Kowalski recommends if you have purchased a walker or cane from a medical supply store, consult with an occupational therapist or physical therapist for adjustments and a demonstration of an effective walking pattern.
For example, don't use a wheeled walker to assist with getting up, she told White Coat in an email. She suggests using a bed rail for help getting on or off a bed, and a transfer pole for assistance getting on or off a chair.
5. Fear of falling can contribute to more falls
Experiencing one or more falls, even if there is no injury, can lead to fear of falling and reduction in physical activity — which in turn can lead to a decline in strength and balance and further increase the risk of future falls, said Mackey, who also leads SFU's Aging and Population Health Lab.
"It's best not to dismiss a fall but rather to follow up with a health-care professional to try and identify and address individual risk factors for falls," she said.
Kowalski said if you have already experienced a fall, it predisposes you to future falls. If you are in this category and live alone, she recommends a personal alarm system that detects a fall. "The morbidity associated with falling and not being able to get up or access emergency services is often a game-changer."
6. Side-effects from some medications can be risk factors
A report looking at seniors and falls risk suggests a "strong association between the occurrence of falls and fractures in older people" and the use of certain medications.
Occupational therapist Teklet points to side-effects, such as drowsiness and dizziness, associated with these drugs that may increase the risk of falling. She recommends people review their medications and side-effects with the prescribing physician.
Written by Ruby Buiza. Produced by Amina Zafar and Jeff Goodes. Video by Sinisa Jolic.
