Dear Doctors: My dad is 77 and still steady on his feet. But he tripped on a throw rug recently and sprained his wrist. He won’t let me declutter his house, and he won’t get serious about preventing another fall. Can you please explain how falls are dangerous for older adults and ways to prevent them?
Dear Reader: Falling — a danger at any age — is the leading cause of preventable injury in the United States and, for all injury-related deaths, second only to motor vehicle accidents.
For older adults, it’s a particular danger. Every year, 36 million adults over 65 suffer a fall in the United States, with more than three million ending up in an emergency room, more than 800,000 needing hospitalization and 32,000 dying.
Some of the injuries are from head trauma or internal bleeding. But suffering a fracture in a fall also can take a toll, with prolonged immobility, a risk factor for respiratory and other infections.
For some older adults, balance and stability issues cause their falls. Declining strength and flexibility as well as poor vision also can play a role.
As happened with your dad, falls also can involve obstacles and conditions in the home and environment, like tripping hazards such as loose carpets and rugs, slick wood floors, electrical cords, unsteady tables or chairs, toilet seats that are too low and slippery tubs and showers.
Dim lighting, ill-fitting or slippery footwear and not putting on your glasses add to the risk.
Outdoors, a steep driveway, uneven walkways and wet or icy conditions can lead to a fall.
It’s not unusual for older adults to resist assistance, which they can see as a loss of independence. You might have better luck persuading your dad to accept your help if you discuss fall-proofing his home as a way to protect and prolong his autonomy. If he agrees, start with the flooring issues that already affected him. Then, room by room, identify potential dangers.
Make sure floors are free of clutter and trip hazards. Stairs should have secure handrails on both sides. All areas, indoors and outside, need to be brightly lighted.
Install grab bars and slip-proof surfaces in the bathrooms. A sturdy shower chair and a handheld showerhead reduce the risk of a fall while bathing.
And, if possible, persuade him to use a medical-alert device he can use to summon help in an emergency.
Dr. Eve Glazier and Dr. Elizabeth Ko are internists at UCLA Health.
