Fall Risk in older adults
We all are aware that we have a growing aging population in Canada, not only in the total number of people aged 65+, but we are also living longer. Unfortunately, between the years of 2017-2022, death resulting from falls rose by 51%. With 20-30% of seniors experiencing at least one fall each year. It isn’t all bad though, there are a lot of ways to minimize our risk and maintain our function and mobility as we get older. Lets dive into what risks there are, how we can reduce these risks and how to stay stable and independent.
So what can we do to minimize risk and stay healthy and independent as we age?
It’s important to start with some factors that can affect our stability. There are many factors to consider in evaluating fall risk in older adults, including:
- Balance and/or walking problems: impairment in our vision can have a large impact on our balance. Vestibular problems or altered sensation in our feet can impact our steadiness on our feet as well. Keeping our leg muscles strong to maintain muscle mass/strength is very important.
- Medication: Studies have shown that taking 5 or more medications lead to a higher risk of falling. Certain medications can have side effects such as drowsiness, dizziness or feeling light headed.
- Home hazards: tripping hazards like throw rugs, poor lighting and slip risks. Making sure to remove hazards, improve lighting, install grab bars and use non-slip mats can be simple things to keep you safe in your own home.
- Blood pressure: sometimes folks have a drop in blood pressure when they stand up quickly. This is referred to as positional hypotension and can be from medication effects or other factors. You may experience light-headedness or spots in your vision. Take care and go slow!
- Footwear: well-filling footwear in the house and outside can give extra traction and stability for walking.
Changes in our vision, muscle weakness, balance or mobility changes are big factors for fall risk. Medications also impact our stability. As such, having a multi-faceted approach to maintaining independence is necessary.
What can I do at home to reduce my risk of falling?
Remove tripping hazards like throw rugs and coffee tables. Improving lighting so you can see where you are going – such as having a night light on in the halls/bathroom to see where you are going at night. Look into installing grab bars, especially in the bathroom. Using a non-slip mat in the bathtub along with the grab bars can really help prevent slippage into/out of the bath and shower. Consider using a shower seat to feel stable while washing.
Make sure to carry a cell phone or medic alert device to call for help if living alone in case you experience a fall.
What exercises are helpful to maintain my strength and balance?
Your best defence against falls is to maintain your physical health. Exercise classes like tai chi, yoga, pilates, aquafit and even getting out for a good walk are all fantastic ways to stay moving and maintain your mobility. There are also home exercises that can work on specific aspects to strengthen your legs and balance. Whenever you change your exercise program it is important to check with your health provider first.
Some simple exercises for leg strength and balance can include:
Sit-to-Stand Exercise
The sit to stand exercise builds muscle and coordinates balance. To do this activity, start with a sturdy chair. Position the chair in front of a desk, table or counter to have the safety to be able to use for support if needed. Make sure your feet are flat on the floor, shoulder width apart.
Lean forwards from your hips, plant your feet on the floor and push up to standing. You should feel your glute muscle firing to help with this movement. There are 3 options for modification to this exercise.
- Level 1: use a chair with arms to help you push up to standing. Try to focus on using mostly legs and minimize the amount of assistance your arms perform.
- Level 2: Keep your arms crossed on your chest so you use only legs
- Level 3: you can use a small weight to add difficulty and resistance to the movement.
Returning back to sitting, make sure you sit back down slowly, avoiding plopping down without control.
Perform a set of 10 repetitions and try to do 2 times a day.
If you are having pain in your back, hips or knees it is best to get assessed by your healthcare provider.
Balance
Stand in front of your sink in the kitchen or in a corner. Having stable supports is important in performing balance exercises safely. As you improve, there are always steps to make this more challenging, but it is key to start simple and work your way up. If you are needing to use the counter or wall frequently to maintain balance, that’s okay. Keep working on it, even 5 seconds at a time, working up to holding for 30 seconds.
- Level 1: Feet are shoulder width apart, stand without holding on to anything with your eyes open, holding steady for 30 seconds.
- Level 2: Feet together, eyes open, stand steady for 30 seconds before moving up.
- Level 3: One foot in front of the other: start with lining the ball of one foot in line with the heel of the other. Perform with eyes open up to 30 seconds and switch feet. Once that feels solid, move to lining your feet up in a straight line. Toe of the back foot to the heel of the front foot.
- Level 4: Single leg stand. Stand on one foot for up to 30 seconds, then switch to the other foot.
- We have done all these balance exercises thus far with our eyes open, next step is trying with eyes closed. If you can do the first exercises with little to no support, try closing your eyes for 5-10 seconds to start. Working up to 30 seconds at a time.
What else can I do?
Talk to your healthcare provider if you have experienced a fall.
Review your medications with your pharmacist or doctor.
Make sure to have regular eye exams and note any changes to your vision.
Have your strength, balance and steadiness assessed by your chiropractor.
f you would like to learn more or book an appointment with one of our chiropractors email us at info@evolvevancouver.ca.
Please note that any advice in this article doesn’t replace personalized medical advice from a professional.
Article by Dr. Kathryn Baker