Local Column: Know the risks and take steps to stay safe
When we think of how trauma is portrayed in popular movies and TV shows, we often think of serious car crashes, gunshot wounds or other major accidents. However, trauma also occurs in ordinary circumstances.
A fall in your home, a slip in the bathroom or a misstep on the stairs can result in a serious issue and, in some cases, require the same emergency and trauma care as more serious injuries.
At the Lee Health Trauma Center, falls are the number one trauma alert. One in four older adults will experience a fall this year, and 20% of falls result in moderate-to-severe injury. Falls are also the leading cause of injury-related death among adults 65 and older.
A fall may seem minor at first, but the consequences can be significant. A person can suffer a broken hip, head injury, spinal injury or other serious trauma.
As trauma surgeons, we see firsthand that a fall doesn’t have to involve a dramatic accident to be a serious issue. That’s why recognizing the risks and taking simple steps to prevent falls is so important.
How do falls become serious?
A fall can involve a tremendous amount of force. The height of the fall, the surface someone lands on, the position of the body at impact and the part of the body that takes the initial hit can all affect the severity of the injury. A fall from a ladder or roof, a slip on a hard surface, a fall down a flight of stairs or a sports-related fall can result in broken bones, dislocations, spinal injuries, traumatic brain injuries or internal bleeding. These injuries can happen to people of any age.
Even a fall from standing height can cause significant trauma. For children and younger adults, falls may occur during sports, recreational activities, at work or simply from losing their balance. In these situations, injuries can range from fractures and sprains to concussions and more serious injuries to the head, neck or spine.
Older adults face additional risks. As we age, changes in bone strength, balance, vision, muscle strength and reaction time can make it harder to catch ourselves or protect our bodies during a fall. A fall that might cause a bruise in a younger person can result in a fracture or other serious injury in an older adult. Medications that affect blood pressure, alertness or blood clotting can also increase the potential consequences of a fall.
The injuries we see after a fall can be significant. A broken hip, for example, can lead to hospitalization, surgery, loss of mobility and a difficult recovery. A head injury can cause bleeding in the brain, sometimes without obvious symptoms at first. Injuries to the spine can affect mobility and independence, while internal bleeding can become life-threatening if it isn’t recognized and treated quickly.
That is why we take every fall seriously. The circumstances surrounding the fall, the person’s age and medical history, medications, symptoms and the possibility of an underlying injury all help us determine what evaluation and treatment may be needed.
Knowing your risk factors for falls
Falls can happen anywhere, but many occur in the home. Knowing your individual risk factors is one of the best ways to help prevent an injury.
Falls are also not a normal part of aging, and there are steps you can take to reduce your risk and take control of your safety. If you are experiencing any of the following changes or concerns, consider making an appointment with your physician.
Vision and hearing
Changes in vision and hearing can affect balance and awareness of your surroundings. Talk with your doctor about regular eye and hearing exams and whether you need to be evaluated more frequently based on your individual needs.
Medical conditions
Certain health conditions can increase the risk of falling, including a previous stroke, blood pressure issues, neuropathy, dementia, Parkinson’s disease and multiple sclerosis. If you have one of these conditions, talk with your doctor about ways to reduce your risk.
Medications
Medication side effects and interactions can contribute to dizziness, drowsiness or changes in balance. Review all of your medications with your doctor or pharmacist, including over-the-counter and herbal products. Using one pharmacy when possible can also help your pharmacist identify potential interactions.
Keep an up-to-date list of your medications with you and ask about possible side effects and activities you may need to avoid.
Footwear
The right shoes can provide stability and help reduce your risk of slipping. Look for shoes with a secure fastening mechanism, good support, adequate room for your toes and slip-resistant soles. Avoid flip-flops and shoes that are difficult to keep securely on your feet. Supportive footwear should have a treaded outsole, be lightweight and have a rubber beveled heel.
Assistive devices
If you have been prescribed a cane or walker, use it consistently and make sure it fits properly. Your doctor, physical therapist or medical equipment provider can help ensure you are using it safely.
Take a look around your home
Many falls occur in familiar surroundings. Take a walk through your home and look for potential hazards. And remember: never walk through a dark room, regardless of how familiar it may feel.
Keep walkways and stairs free of clutter. Make sure stairs are well-lit, with light switches at both the top and bottom and sturdy handrails on both sides. Keep clutter and electrical cords out of walkways. Avoid throw rugs, or consider rugs with nonslip backing.
Make bathrooms safer. Consider installing professionally secured grab bars in the tub or shower, using a nonslip bathmat, adding a motion-activated night light and using other equipment, such as a shower chair or elevated toilet seat with grab bars, if recommended.
Staying active
Staying active is one of the best ways to help prevent falls. Regular physical activity can improve strength, balance, coordination and flexibility.
At least 30 minutes of physical activity is recommended each day. Check with your doctor to see what works best for you. Whether it’s walking, water exercises or Tai Chi, it’s important to move your body and build strength.
If you’re avoiding activity because you’re afraid of falling, talk with your doctor. A physical therapist can evaluate your needs and develop an exercise program designed to help you stay active while improving your strength and balance.
Start today
Fall prevention doesn’t have to mean making major changes all at once. Start by looking at the areas where you may be most vulnerable, such as your medications, footwear, activity level or home environment, and make one change today. Then make another one tomorrow.
Talk with your doctor about what types and levels of activity are appropriate for you and your fitness level. You may also benefit from working with a physical therapist to improve your strength, balance and coordination. Small changes can add up, and over time, you may find yourself feeling stronger, more confident and better equipped to stay active and independent.
As trauma doctors, we would much rather help you prevent a fall than treat the injuries that can result from one. Taking a few minutes now to identify and address your risks can help protect your health and quality of life. To learn more or make an appointment with a physician, please visit www.leehealth.org.
Dr. Maria Alfaro is the Trauma Surgeon and Medical Director of the Lee Health Trauma Center.