Many older adults think that a fall is unlikely to happen to them. Not true! Falls are actually the leading cause of fatal and nonfatal injuries among older adults. More than one out of four persons (14 million) who are age sixty-five and older will fall each year. Over 3 million will be treated in the Emergency Room, and 28,000 will die.
One out of every five falls results in an injury, such as a broken bone or head injury. For instance, every year 300,000 older adults are hospitalized for a hip fracture, and 95% of these are caused by a fall. Three-quarters of those are women. Close to 50% of those older adults who were living independently before the fall are no longer able to do so afterwards.
Falls are also a leading cause of traumatic brain injury (TBI) in older adults due to brain bleeds. TBI can permanently damage mental abilities. Brain injuries have been linked to a higher risk of developing (or worsening) dementia. They are also associated with emotional instability.
Many people falsely believe it’s normal to fall when you are old. Also not true!
If your family member has any of these problems, they have a higher chance of falling:
Taking more than four medications. The more medications a person takes, the greater likelihood of a fall. This is especially true if any of the drugs are known to also cause dizziness or drowsiness. Talk with the doctor or pharmacist about medication options that do not have these side effects. The pharmacist may also have tips about when to take them. For instance, taking a pill at night may be better so your relative will sleep through the dizzy period. It’s also wise to have as simple a medication regimen as possible. This reduces the chance that your family member will accidentally take too many pills, or the wrong ones. You might also ask about geriatric doses. (Older adults metabolize medicines more slowly. As a result, they can easily “overdose” even when they strictly follow the doctor’s recommendations. A lower dosage may well deliver the benefits of the medicine without the hazardous side effects.)
Trouble with vision or hearing. Many falls result from stumbling over an object that wasn’t seen. Or because the person didn’t hear a hazard in time to react. Have your relative get yearly vision checks. Hearing should be checked once every three years.
Alcohol use. Alcohol affects balance. In fact, 10 percent of all ER visits for a fall involve alcohol. And drinking among older adults occurs more often than people think. It tends to start after a loss. For example, after the death of a spouse or after friends move away. Older adults who did not drink before may turn to alcohol in their loneliness. Boredom from retirement is another common cause. And alcohol combined with prescription medications makes the chances of falling even greater. In addition, the metabolism of older adults is slower than that of younger adults. This means alcohol stays in the bloodstream longer. The National Institute on Alcohol Abuse and Alcoholism recommends that men over age 65 have no more than two drinks per day. Women no more than one.
Depression and isolation. Seniors who are isolated have a greater chance of turning to alcohol. Depression can contribute to isolation. It can also lead to drinking. Fortunately, depression is a treatable condition. If you suspect your loved one is depressed, talk with the doctor. There are many treatment options.
Incontinence. It is not uncommon for a fall to occur because a person is rushing to get to the bathroom. Your relative may not pay as much attention to the floor and end up tripping. They may clip corners and lose balance. There are medical and nonmedical approaches to address incontinence. Don’t let the hazards of urgency create a fall risk.
Dizziness when standing. This is the result of a drop in blood pressure. It is always best to talk with the doctor to rule out a medical cause. Some nonmedical situations contribute to this type of dizziness. These situations respond well to simple changes in habits. For instance, drinking more fluids may help with dehydration, which can contribute to low blood pressure upon standing. Sitting up in bed for five minutes before standing in the morning can help get the blood flowing well. Even better, sit in bed and do some arm and leg exercises. It can also help to eat five or six small meals during the day rather than one or two big ones. A large meal causes blood to stay in the area of the stomach for a longer time, contributing to low blood pressure. Last, a person who gets dizzy when standing should also avoid hot showers and hot rooms. Heat tends to lower blood pressure. (Plus, a fall in the bathroom is especially dangerous with all the hard surfaces!)
Numbness in the feet. When we lose sensation in our feet, it is difficult to keep our balance. Our brains don’t get the balance-related feedback of how our weight is distributed. We also may not notice if there is a pebble underfoot or that the ground beneath is unstable or uneven. Because people with diabetes often lose sensation in their feet, they need to be especially careful about falls.
Previous falls and a fear of falling. If a person has fallen before, there is a greater chance they will fall again. But the fear of falling is equally disabling. Many older adults who have fallen become afraid of falling. As a result, they limit their activity unnecessarily. When they do less physically, they lose their strength, flexibility, and sense of balance. Ironically, this becomes a downward spiral. Less activity leads to less ability to prevent or catch a fall. Even after a fall, it is a wise idea to remain physically active. Talk to the doctor about an appropriate, low-key exercise program that will strength muscles and increase flexibility and balance. AND confidence!
Which of these risk factors does your loved one have?
Studies of older adults who went to the Emergency Room as a result of a fall indicate that 79% of falls occur at home. The most common locations are the bedroom, bathroom, and stairs. In that light, here are some general suggestions for changes around the house that can reduce the risk of falling:
Remove clutter from narrow walkways, especially halls and stairways.
Remove throw rugs. They often have curled corners or rumpled ridges that can cause someone to trip. Or they can slip on the hard surface beneath. One option is to use double-sided tape. This helps keep corners flat and the rug “glued down” to the floor.
Use nonskid mats in the bathroom. Add nonskid strips to the floor of the shower or tub.
Install grab bars in the bathroom, especially at the toilet and beside the shower or tub.
Put a bath bench in the shower so the person you care for can sit if they feel dizzy.
Avoid the use of ladders or a step stool. Store items that are used frequently in cupboards or shelves that are low and easy to reach.
Improve lighting in hallways, stairs, and bathroom. Improved visibility increases the chance your family member will see an obstacle and avoid a tumble. Consider motion-activated lights or at least, nightlights. (A sleepy senior waking up and urgently needing the bathroom is a common scenario for falls.)
Repair broken or unstable steps or stairs. An uneven or unexpected surface on the stairs can easily cause someone to stumble and fall. Additionally, consider nonskid strips as well as painting the edge of each stair for greater visibility.
Install handrails at all stairways. Catching oneself from a fall is as important as not falling to begin with.
Single-story living. Ideally the bathroom, bedroom, living room, and kitchen all are on one floor so there are no stairs required to go through daily life tasks.
Fall risk assessment If you are concerned about a family member’s risk for falling, ask the doctor to perform a “fall risk assessment.” It will determine whether they are at mild, moderate, or high risk. From there, the doctor can recommend a variety of approaches. They may include exercise, a medication review, or further examination. They might also suggest working with a physical therapist to strengthen muscles or an occupational therapist to learn how to effectively use a cane or walker.
A fall risk assessment has two parts:
Screening. This is simply a set of questions such as “Have you fallen before?” “Are you worried about falling?”
Assessment tools. These are activities that allow the doctor to get a sense of your loved one’s strength, balance, and gait. (Gait is a description of how stable a person is when walking).
There’s nothing to prepare for with an assessment like this. The results will simply point to the most appropriate steps to reduce the likelihood of a fall.
Vision screening
Poor vision contributes to falls. If your loved one cannot see well, they may not see obstacles that could lead them to trip, slip, and fall. Clutter on the ground, the edge of a stair, a slippery patch of water or ice can all lead to an accident. A yearly vision exam and keeping prescriptions updated can substantially reduce the chance of falling.
Hearing tests Scientists aren’t completely sure why, but the data across many studies show that a person with even just a mild hearing loss has a three times greater risk of falling than does a person with no hearing loss. It could be that problems with hearing may affect balance, since the ear governs both hearing and balance. Another theory relating to “cognitive load” is that portions of the brain dedicated to balance get “borrowed” as the brain puts extra resources toward trying to increase hearing and comprehension. Last, it may be that an individual with hearing loss is missing audio cues that might alert them to a trip and fall hazard. Hearing tests can help determine if your loved one has a greater risk of falls. There’s some thought that hearing aids can help compensate and reduce the risk.
When it comes to fall prevention, nothing underscores the “use it or lose it” maxim more than exercise. It’s not that the person you care for has to run marathons. Or even do any running at all. In the case of fall prevention, the issues are primarily balance and strength.
Losing one’s balance is the very definition of a fall. Balance relies on many systems that together, provide information to the brain. The inner ear registers head position and motion. Muscles, joints, and tendons give the brain information about action and location, as well as about gravity. The eyes help orient us in space. Standing on one foot with the eyes closed, for instance, will force your brain, muscles, and ears to work together to fine tune your inner sense of staying upright versus leaning over.
As we age, we do not retain our muscle mass and strength as easily as before. (Involuntary muscle loss starts in our thirties! Without consciously working on our muscles, by our seventies we may have lost up to 50% of our muscle mass.) Lower body strength exercises are recommended because people with greater strength in their legs are less likely to fall. If they do fall, they are less likely to sustain injuries such as a hip fracture.
Work with a physical therapist. The doctor can write a referral and Medicare will pay for it. Physical therapists are medically trained professionals who specialize in helping people move better. They work with exercises that can be done, even at home, to improve strength and balance. No special equipment is needed. They will also teach safety precautions so the person you care for won’t fall while doing the exercises.
Take classes
Tai chi is a fluid motion, balance, and strengthening exercise that began as a “soft” martial art in China in the late 1600s. It can be described as movements performed in a slightly bent-knee position that involve continuously shifting the center of gravity from one leg to the other, with arms reaching out in various positions. These movements integrate posture, transference of weight, strength training, and trunk rotation. No special equipment is required. With appropriate supervision, tai chi is effective and safe even for very sedentary older adults and those who are at high risk of falls. In clinical trials it has been shown to reduce fall risk and to actually reduce the number of falls. Its effectiveness increases with the length of sessions and the frequency per week. There are different forms of tai chi. The “yang-style” has been demonstrated to offer the best outcomes.
Yoga is a form of exercise developed in India. Hatha yoga in particular consists of holding poses (asanas) and incorporating deep breathing while holding those poses. Studies have shown that it seems to help with balance, strength, and mobility. No studies have verified an actual reduction in falls. However, tests used in a fall risk assessment have shown that it seems to reduce the chance of falling. It also helps reduce the fear of falling.
To find classes, check with your local senior center or ask your doctor or physical therapist. Senior centers offer many exercise programs adapted for older adults. (Plus, once your relative goes to a class, they may find that they like the atmosphere. Senior centers have been modernizing. They aren’t the bingo and shuffleboard centers they used to be. The programming is much more active and engaging.)
Before starting a nonmedically supervised exercise program, it’s always wise to check with the doctor to see if there are any concerns. Most physicians will probably be delighted that your loved one is giving exercise a try!
Walking Exercise doesn’t get simpler than good old-fashioned walking. No special equipment is needed. It can be done indoors or outdoors. And it’s entirely at your loved one’s convenience. By its very nature, walking integrates all the body systems needed to maintain balance and stay upright. Some studies have shown that it is more effective at reducing falls and the risk for falls than are balance exercises alone.
For what it’s worth, walking doesn’t build up strength unless your relative is going up and down hills. Another disadvantage: There is a greater chance of falling while walking than while doing balance and strength exercises. As such, those who are notably frail or at high risk for falls might be better served focusing on balance and strength. But those who are generally healthy and stable can benefit. Ask the doctor or physical therapist about the best combination of activities for your relative.
It’s never too late to start moving and getting in better touch with the body. Even people in their nineties have been able to make improvements with very simple strength-building exercises. The key is to start slow and build gradually.
Caregiving Corner especially Ashlyn Hyde took excellent care of my mother for over 12 months. Ashlyn visited with mom once a week or whenever a need came up. My mother suffered from memory issues and mobility issues. Ashlyn and Caregiving Corner were always available to assist in additional care, doctor/hospital visits. When she was unable to live alone, Caregiving Corners were able to coordinate her move and downsize. There contacts made the relocation from Independent living to Assisted Living and then Memory care effortless, from my perspective. I live in California and mom was in Charlotte, Caregiving Corner served as an advocate for mom, always looking out for what was best for her and her condition. Finally when it came time for Hospice to enter, Ashlyn was able to recognize the need and recommend to me. I was probably in denial but trusted Ashlyn and feel mom's final days were much more comfortable and less confusing thanks to her efforts. I will always owe a debt of gratitude to Ashlyn for what she was able to provide for mom! Thanks again
I have had the pleasure of collaborating with Caregiving Corner as a Fractional COO since March 2023, and my experience has been nothing short of exceptional. From the moment I joined their team, it was evident that they prioritize their clients and care managers, fostering an environment of mutual respect and support.The company's commitment to streamlined processes and effective communication has been a game-changer. As a Fractional COO, I've had the opportunity to implement strategies that optimize operations and enhance overall efficiency. What truly sets Caregiving Corner apart is its unwavering dedication to the well-being of its clients. They prioritize open dialogue and maintain a strong sense of partnership, which has contributed significantly to the success of their education and partnerships in the community.In an industry where compassion and efficiency go hand in hand, Caregiving Conrer strikes the perfect balance.As a Fractional COO, I couldn't ask for a more fulfilling and rewarding partnership. If you're a caregiver looking for support, I wholeheartedly recommend Caregiving Corner. They are a true embodiment of integrity, compassion, and operational excellence.
Jennifer and Caregiving Corner are a trusted resource for senior care. Jennifer has a wealth of knowledge and will give you honest, unbiased advice in planning for the care of your loved one. Investing in her services is money well spent.
Jennifer and the Team at Caregiving Corner are patient, kind, courteous and generous with their time and their efforts. I would trust them implicitly with my family's best interest. Jennifer's willingness to provide support and guidance is second to none! Highly, highly recommend her services. Amazing advocate for her clients. She truly, truly cares and has their best interests at heart.
I'm writing to recommend Care Giving Corner for the best elder care management services I have come across. We were introduced to them for help with our parents' care by the Rev. Lisa Saunders at Christ Episcopal Church in Charlotte, who had known our family for 20 or 30 years. We had worked with a couple of the big national elder-care chains before, but their people seem so limited and their standard of care seemed very "average" at best.We work with Susan Ferone as our case worker/manager and Allyson Cooksy as our RN. They are conscientious, high-caliber, top-flight people. They're the kind of people we'd want to entertain with and be friends with, not just tolerate as hired help.They recently helped my parents identify and move to a retirement community that is a vast improvement over the retirement facility they had been in before. They connected us with services that helped with organizing, packing, moving, unpacking, setting up, and settling in. They even helped my mother find a decorator to help with some fabric choices and paint schemes to suit her new digs. That alone is half the battle - knowing who are the reliable, trustworthy service providers for various ancillary services.Allyson has helped my parents manage medical appointments, keep track of treatments and prescriptions, and devise daily structure that keeps things on track. She has helped identify and get services from therapists, etc. Allyson is amazing and a delight to be around.We live in a time when even those of us who are well-established and well-connected in our communities can feel bewildered by the experience of aging and everything that goes with it. Susan, Allyson, and their colleagues comprise an able and caring resource in an otherwise confusing and dysfunctional elder-care environment.
Jennifer and her team are top-notch and, without question, the best in the business. As an elder law attorney, I routinely refer my clients to Caregiving Corner because I know they will treat my clients like family. Thank you, Jennifer, for building such an incredible business that meets the needs of so many people!
Jennifer Szakaly is a registered guardian with high integrity and ethics. Jennifer goes above and beyond for her clients and she is not afraid to handle difficult cases and family dynamics to ensure her wards receive the best and most appropriate care. I cannot recommend her highly enough and I refer clients the Charlotte area to her very regularly. For any client in need of Aging Life Care Management or a Guardian, Jennifer and Caregiving Corner is the superior choice.
Caregiving Corner is an amazing resource for anyone who is navigating the experience of aging or caring for an aging family member. Jennifer and her team offer such a broad range of services - from helping families choose care facilities and make healthcare decisions to serving as a legal guardian for those who don't have family members (or whose family members are too unreliable). Their collective experience is invaluable, and most importantly, they have a genuine passion for working with older adults and their caregivers, and it shows. I enthusiastically recommend Caregiving Corner to everyone I know who is dealing with the often-challenging situation of caring for an aging loved one.
Since I started Transition With Care in 2009, a senior move management company, I have confidently referred my clients and families in need of care management services to Caregiving Corner. I have never received any negative feedback from my clients and consider Jennifer Szakaly and her team to be a shining example of how to help seniors and families navigate the complexities of caring for an aging loved one.
Our team at The Charlotte Assisted Living Community and Memory Care has had the pleasure of working with Jennifer and the Caregiving Corner Team for the last six months.During what can be some of the most trying and difficult times for their clients and loved ones, the Caregiving Corner team assists in navigating the journey to find a solution.Their compassion and dedication to their clients is above board. They offer a professional and sincere level of care to each family they are assisting. We look forward to our continued partnership.
I’m thankful for the guidance I’ve received from Jennifer Szakaly. She has helped me address current caregiving needs as well as understand options for what’s ahead. Her professionalism and experience is second to none.
I am an elder law attorney who has worked almost exclusively in the field of incompetency/guardianship for folks who no longer have the capacity to care for themselves. This is an extremely sensitive family matter, and the family of the incapacitated elder find themselves in a crisis and a world they do not understand. Caregiving Corner has been a savior to these families and lawyers in this field. Jennifer Szakaly, the founder and owner of Caregiving Corner, has assisted me in many cases, in Mecklenburg and surrounding counties, with evaluating, advocating for and acting as corporate guardian in these unfortunate situations. Caregiving Corner has a staff of professionals who assess the crisis, help find placement for the individual, and care for the individual and act in their best interests in all of their health matters. Jennifer is approved with the Clerks of Court who appoint her company. She is a Board member of affiliated organizations and non-profits. She is nationally certified as a corporate guardian, as well as holds degrees and other certifications in the field of geriatric care. I don't know anyone more qualified in this field or anyone more compassionate for the work she does for others.
Jennifer and her team take outstanding care of their clients and families! They are well-respected as professionals in this industry. Highly recommend Caregiving Corner!