Although fall risk is not limited to the elderly, it is especially concerning for the elderly populations in our communities. The Centers for Disease Control and Preventions (CDC) reports 1 in 4 (28%) Americans over the age of 65 years old fall every year. Each year in the U.S. every 11 seconds an elderly person is admitted to the emergency room (E.R.) due to a fall and every 19 minutes one of these falls result in death.
Falls are a growing concern for both the elderly as well as their families, as it will cost them precious financial and emotional capital. The CDC reports that every year there is a staggering 50 billion dollar healthcare bill for falls that do not lead to death as well as 754 million healthcare dollars spent on falls that do lead to death. These numbers are as astounding as they are sobering. So, what can we do within our circle of influence to address this falls crisis?
In a recent training, sponsored by Wright Physical Therapy, an interesting concept of limiting beliefs was discussed. It was intriguing to consider limiting beliefs because often we can so easily see the limiting beliefs in others, but it is much harder to locate them within ourselves.This training led to the following question, “What are the limiting beliefs my patients hold regarding their treatment and recovery?” as well as, “How well am I mentoring my patients to overcome such limiting beliefs?” The most common limiting beliefs relating to falls are:
Myth #1 – Falls are an expected part of aging.
This limiting belief is simply not true. Yes, we are at higher risk for falls as we age and become deconditioned, but falls should never be considered a new normal for anyone in our community. We can prevent fall risk as we age and do not have to accept higher fall risk with aging. This limiting belief will, as evidenced in the past, lead to higher mortality rates in our communities. According to the CDC, “Falls are the leading cause of injury death for Americans 65 years or older.” We also have learned that yearly fall deaths have increased by 30% since 2007. This is heading towards an astounding 7 fall deaths every hour in the USA per year.
Myth #2 – If I limit my activity, I won’t have as high of a chance of falling.
This is a tough limiting belief to resolve because it carries a partial truth, but with devastating consequences if brought to fruition. The part of this myth that is true is that if you don’t stand up then you definitely will not fall. The bigger and accompanying reality is that if you are not active, your risk for falls increases. Thus, if you limit your activity you might think you are doing yourself a favor. In reality you are increasing your risk for future falls and the potential injuries that follow.
Myth #3 – There isn’t much I can do to improve my balance.
Balance can, in fact, be trained! Let’s reiterate that… Balance can be trained! Balance, like a muscle can be trained and improved. Balance comes from 3 systems in the body: Vision, Inner ear, and proprioception. Proprioception is the feedback that your joints, muscles, and ligaments give you to let you know where you are in space. If one of the 3 balance systems is not functioning right then the other 2 systems have to pick up the slack. There is only so much slack a system can pick up. As a result of mis-training 1 or all 3 of these, fall risk is increased. An eye doctor can assist with vision problems, your ENT doctor assists with inner ear issues and your physical therapist aides in properly training your lower body and proprioception.
Myth #4 – Medications don’t increase my risk for falling.
Correction to this myth in 6 words: Medications can increase risk of falling. The CDC reports that “the use of medicines, such as tranquilizers, sedatives, antidepressants or even some over-the-counter medicines can affect balance and how steady you are on your feet.
Myth #5 – Minor losses of balance don’t need to be raised to my Primary Care Provider.
Though it might not seem like a big deal, minor losses of balance often lead to increased fall risk over time as they add and multiply on themselves. It is estimated that less than 50% of those who have fallen, report falling to their primary care provider. It is not a stretch to conclude that roughly half of the aging population in our communities are not taking their increasing fall risk seriously enough.
Myth #6 – Balance training is only for the elderly.
You are never too young to train balance. Quoting Mr. Miyagi in the Karate Kid, “Lesson Not Just Karate Only. Lesson For Whole Life! Whole Life Have A Balance, Everything Be Better”. Balance training is recommended for youth on up, beginning with age 10 for males and age 9 for females. This recommendation for general conditioning and development of our children is valuable and especially critical if they are participating in sports. Poor balance and lower body coordination is related to increase risk for injury in our children and youth.
Myth #7 – Muscle strength and balance are harder to train and less effective in the elderly.
Every tissue in the body responds to the stimulus or lack of stimulus applied to it. This means that despite the age of the individual, if the appropriate load is applied the tissue (bone, tendon, muscle, nerve…etc) will become more robust despite the individual’s age. This also means if you are not using or loading that tissue, it will become deconditioned and the body will send its resources to the tissues being used. This is true for balance training. The elderly respond very well to training, just in different ways than youth do.
What can you do to help those at risk for falls?
Consider this quick risk assessment to see if you or a loved one should consult your health care provider about your fall risk.
PERSONAL RISK ASSESSMENT
Do any of the following relate to you or a loved one?
- Have difficulty walking, balancing or have lower body weakness
- Have a vitamin D deficiency
- Take medications including antidepressants, sedatives, or tranquilizers
- Have vision problems
- Have foot pain or poor footwear
- Home hazards i.e. throw rugs, uneven steps, cluttered home…etc.
If you are 65 years old and have 2 or more of the above you should speak to your Primary Care Physician or Doctor of Physical Therapy about getting a fall risk assessment.
Seek out a qualified health care provider to address your fall risk. To schedule an appointment or find additional information, please call any one of our clinics. To learn more visit our website at www.wrightpt.com.
Article Written by: Isaac Carling PT, DPT