Today is National Injury Prevention Day. Although this awareness day was created by the Injury Free Coalition for Kids to focus on injuries in that population, this year, UAB’s Division of Trauma and Acute Care Surgery is focusing on fall safety in older adults.
In 2021, UAB’s trauma center saw 4,579 admissions. 662 of those patients – nearly 15% – were 65 years of age or older that had injuries due to falls. With an aging population, the number of injuries due to falls is expected to rise.
Kimberly Hendershot, M.D., FACS, a professor in the division and state chair of the American College of Surgeons Alabama Committee on Trauma, says common injuries in the elderly from falls include rib fractures, hip fractures, and broken ribs. Also common, and dangerous, are brain injuries and brain bleeding due to falls, especially with many older adults on anticoagulants. Falls can lead many patients to extended stays in in-patient rehabilitation centers or skilled nursing facilities.
Andrew Duxbury, M.D., a professor in the Division of Gerontology, Geriatrics, and Palliative Care, says that although falls become a concern in general in those 80-years-old and older, it really comes down to individual functionality, physical strength, genetic factors, and nervous system health. He says balance naturally declines with age – and starting in middle age, there’s a slowing down in the communication between brain and body and reflexes slow.
“It takes less of an abnormal event for someone to tumble,” he said.
Duxbury explained that the psychological ramifications of a fall can be as impactful as the physical injuries and lead to “body betrayal.”
“After a very bad fall, it makes your brain lose confidence in your physical abilities,” he said. “You might become less likely to do something that you think is a risk for a fall – you don’t go out, or take that trip.”
As a part of its injury prevention efforts across central Alabama, the division offers two evidence-based fall prevention programs: Bingocize and Matter of Balance. Injury prevention coordinator Libby Kellen, RN, BSN, has completed Bingocize programs, which combine fall prevention facts, stretching and mobility exercises, and bingo, in Hoover and Trussville, and is currently offering classes at Hoopersville Senior Center and Episcopal Place. In 2023, Kellen will continue offering Bingocize throughout Jefferson County.
Kellen has also trained volunteers in Trussville in Matter of Balance, another fall prevention education course. By training other trainers, Kellen hopes that there will be a ripple effect of fall prevention education throughout central Alabama.
“The response from Bingocize participants has been overwhelmingly positive,” Kellen said.
Below, see tips from three UAB experts in protecting yourself and your loved ones from a fall.
Be proactive
Don’t wait until a fall happens to discuss fall safety or make critical changes. “Family members can bring this up and be honest with their family member and talk about any limitations that they might have,” Hendershot said.
Get a walking stick
“If you’re getting to the point where you realize your balance isn’t what it once was, invest in a good old-fashioned walking stick,” said Duxbury. He explains the word “cane” is loaded and invokes images of frailty and weakness. He recommends using positive language to invoke health and robustness – people can find a ‘hiking stick,’ ‘shepherd’s crook,’ or ‘wizard’s staff’ for extra balance.
Meet with a health care provider to check medications and balance
“Make sure that you’re talking to your doctor about any medications that may up your fall risk and what they do for you in a good way and whether or not the dosage should be changed,” Duxbury said.
Get an eye exam every year
Check your eyesight every year and updated eyeglass prescriptions as needed.
Stay active with an exercise program
Connect with a local senior or recreation center to see what classes are available in your area. “Some of our participants who were apprehensive about taking a fall prevention course have been pleasantly surprised at how much they enjoyed it and learned from it,” Kellen said. A course like Bingocize is fun and social, while also being educational.
Remove tripping hazards
Go through the home to identify and remove tripping hazards – like clutter, rugs, or cords.
Be weather- and holiday-aware
Whether you’re walking on slick or icy paths, or climbing a ladder to hang Christmas lights, be extra aware of fall hazards during this time of year. Wear weather-appropriate shoes. Inspect ladders before use and be sure to have a spotter hold the ladder for extra stability.