Los Angeles Jewish Home

Taking the steps necessary to prevent falls are among the most important things to do for seniors. Unfortunately, nearly a third of all seniors will experience a fall. In the majority of those cases, if a senior fractures a bone from a serious fall, it is either fatal or significantly shortens his or her life (page 6). The good news, thankfully, is the vast majority of falls are completely preventable!

National Fall Prevention Day happens tomorrow, September 22nd—appropriately during the Fall. Organizations from coast to coast are reaching out with helpful information for seniors and their families to help stave off slips and tumbles.

Many of the most common causes of falls are well known, and the Jewish Home has been sharing the recommended ways to stay upright for a number of years. (The hyperlinked story is from December 2010.) From fall-proofing a senior's home to simply wearing sturdier shoes, the ways to prevent these catastrophic spills are relatively easy to do. Also important is physical fitness. Taking the time to keep leg, core, and balance muscles stimulated and healthy will go a long way to keeping seniors on their feet.

Recently, McKnight's, a leading long-term care and senior living magazine, published an interesting article about a new study on fall prevention. Researchers from UCLA found that among "Medicare beneficiaries [i.e., seniors] who had their cataracts removed, 16% fewer had hip fractures within the first year of surgery than those who did not."

And that percentage climbs the older the sample group gets. "Study participants between the ages of 80 and 84 experienced the biggest benefit of the surgery, with a 28% reduced risk of fractures."

So take a moment tomorrow to assess your surroundings and the living situations of the seniors you care about. A couple of simple changes could save lives.

Labels: Aging, Balance, Cataracts, Fall Prevention, Falling, Healthy Aging, Home Safety, McKnight's, National Fall Prevention Day, Safety, Seniors, September 22, UCLA

For a senior, a hip fracture can be as life-threatening as heart disease or cancer. Sadly, nearly one in four older women who fracture a hip will die within a year. For men, the odds are even worse. A year after a hip fracture, one-third will not survive. Of those who do, many will not be able to walk without a cane or walker.

The reasons for such poor outcomes after hip fractures are not clear, however loss of mobility and independence play an important role. Immobility also leads to depression, a loss of motivation, and, in many cases, even the will to thrive and live.

Since we don’t want one, let’s look at ways to prevent these potentially devastating accidents.

Fall Proofing Your Home

Most falls occur in the homes, that were built without the needs of senior residents in mind. Many contain slippery floors and poorly-lit hallways, and stairs.

To fall-proof your home, start with your kitchen and your bathroom, the two most common sites for falls. Grab rails are a must in the shower and next to the shower, bathtub and sink. They don’t have to look industrial. There are nice designer shapes and colors from which to choose.

If you use throw rugs in the bathroom or kitchen, make sure they are fixed to the floor. Re-organize your kitchen to ensure that commonly-used items can be easily reached. And don’t store anything so high that you need to stand on a chair or stool to reach it.

Be sure hallways and staircases are well-lit and clutter-free. For more information on how to make your home safer, visit www.homemods.org.

Change Those Shoes

High heels and smooth-soled shoes must go. Personally, I prefer the security of shoes with non-skid bottoms. If you encounter a wet or slippery surface, your shoes can make the difference.

While you’re at it, retire those running shoes with lots of elevation. They simply put too much space between the soles of your feet and the surface on which you’re walking.

Improve Your Balance

There are several ways to improve your balance and thereby prevent falls. Perhaps the best method was devised by the Chinese, and is called T’ai Chi. The gentle motions of T’ai Chi have been shown in clinical trials to reduce falls and their resultant hip fractures in seniors.

If T’ai Chi is not for you, there are other balance exercises that a physical therapist can show you. Your physical therapist or physician can also coach you on how to avoid landing on your hip if you do take a fall.

Strengthen Your Bones

We all lose bone mass after the age of 40 or so. For women, this process accelerates after menopause due to a loss of estrogen. What can we do to slow down and even reverse this process so that we’re not at risk for fractures?

Surprisingly, the best way to strengthen bone is through exercise, both the aerobic and strength-training types. Just 30 minutes of walking at two to three miles per hour will build bone mass. Light weight training will strengthen your bones as well as improve your balance.

Get Sufficient Vitamin D

Another way to prevent fractures is by getting enough vitamin D, which has been shown to prevent falls. Your skin manufactures vitamin D after exposure to the UV rays in sunlight.

Unless you get out in the sun for a considerable amount of time each day, it is unlikely that you are getting enough vitamin D, and you will need to take a supplement of 1,000 IU a day.

Have a Bone Scan

If you are over age 50, you should have a DEXA scan. This x-ray of your hip and spine will determine if you have osteoporosis (severe loss of bone matrix) or osteopenia (moderate loss of bone matrix). If you do have these conditions, you are at greater risk for hip fracture.

There are several options for treating osteopenia and osteoporosis. Consult with your physician to see if estrogen, etidrionates such as Fosamax, SERMs such as Rolaxifene, calcitonin, or parathyroid hormone, are right for you.

Reducing the risk of a hip fracture and its consequences is something you can start working on today. By taking the steps outlined above, you should be able to protect yourself from this potentially devastating injury.

Labels: Aging, Bones, Falling, Feature Articles, For the Body, Hip Fracture, Schneider

Cross posted from The New York Times blog, The New Old Age.


By Karen Stabiner

Robert F. Bukaty/Associated Press

For the first time since 2001, the American Geriatrics Society and the British Geriatrics Society have updated their guidelines for preventing falls in older people. The update includes two notable changes: One recommends tai chi — the meditative, slow-motion Chinese exercise — as an effective way to prevent falls, while another suggests that doctors review medication use by all elderly patients, with an eye toward reducing use of those drugs that increase the risk of falling.

The earlier guidelines did not single out any particular exercise regimen and endorsed prescription reviews only for patients taking more than four medications.

Exercise is essential for any older person who can manage it, according to Dr. Mary Tinetti of the Yale University School of Medicine, a chairwoman of the panel that issued the new guidelines. Tai chi gets the nod because several trials have suggested that it seems to help reduce the risk of falling, she said, although it is possible that other forms of balance training work just as well.

Greg Fuller teaches tai chi at the Jewish Home in Los Angeles. “The basic underlying philosophy is that balance is everything,” he said. Most important for his students, whose average age is 90, tai chi involves small, slow, controlled motions.


“With beginners, we spend a lot of time working while seated, bringing attention to the proper alignment of the pelvis, chest and head,” said Mr. Fuller. Once that is accomplished, “finding strength and balance while standing is much easier.”

Even then, many students work standing just behind a chair. “The presence of the chair back within reach gives them a sense of security and confidence,” Mr. Fuller said. “They forget about the possibility of falling and concentrate on the movements.”

Confidence is important to fall prevention, according to Dr. Tinetti, who said that fear of falling can itself lead older people to cut back on activities they used to enjoy. The less they do, sadly, the less they eventually are able to do.

The geriatrics groups also have long recommended that the medication regimens of older patients be reviewed and, if possible, scaled back. Earlier guidelines called for reviewing medications only if a patient takes more than four. This time around, researchers say that all older patients ought to have their doctors review their prescriptions for any that might increase the risk of falling.

“The evidence is strongest that medications that affect the brain — these include antidepressants, sleep medications and medications for anxiety — increase the risk of falling,” said Dr. Tinetti. “There is also a suggestion, not yet proven, that narcotics and some blood pressure medications may increase the risk of falls, as well.”

The updated guidelines distinguish between a fall that requires intervention and one that might be a isolated incident. The updated criteria for getting a risk evaluation are:

• An elderly person worried or frightened by a fall.
• Two or more falls in the past year.
• One or more falls with injury.
• Repeated difficulty with balance when walking.

Read the original blog post here.

Labels: Aging, Balance, Cross Post, Falling, Fitness, For the Body, Health, New York Times, Stabiner, Staff, T'ai Chi, The New Old Age