Oct. 28, 2006
 
HEALTH: Why There’s Many a Slip When Fall Rolls Around
 
By Lee Bowman
Scripps Howard News Service
 
Falling leaves and the first snowflakes herald an unfortunate season mostly marked by hospital emergency rooms -- fracture season for the elderly.
 
Falls happen to seniors all the time -- an estimated 30,000 people age 65 and over are injured in a fall each week in the United States. But numerous studies here and in other countries consistently show that more falls, and more limb and hip fractures, occur during the winter than during the rest of the year.
 
The surprise about that is that snow and ice appear to play only a relatively minor role in the increase. A six-year study by Spanish researchers in Barcelona found the same winter spike, even though it doesn't snow or even rain a lot there during the mild but cooler winters.
 
A number of researchers believe that a combination of colder weather and shorter, darker days contributes to falls among the elderly in several ways.
 
One factor is that seniors become less active and get less sunlight and vitamin D in the fall and winter, leaving them less steady and with weaker bones. It's also possible that cold itself affects circulation and blood pressure and impairs brain communication with muscles. And there's evidence that darker days combine with poor indoor lighting to increase the danger of missing a step or stumbling over an ottoman.
 
In fact, at least a third of all falls among the elderly in the United States involve environmental hazards, like poor lighting, unsecured rugs or lack of secure handrails on stairs. And 54 percent of all fall-related deaths among the elderly occur in the home, with another 20 percent taking place in residential institutions.
 
More than 24 percent of seniors who suffer a hip fracture die within a year of the fall, and another 50 percent never return to their former level of mobility and independence.
 
"A fall can change everything for a senior citizen," said Tish Thomas, director of the Adult Day Connection at the University of Missouri-Columbia, an adult day health-care program. "Not only are falls potentially life-threatening, but oftentimes a bad fall can mean a move to a nursing home."
 
The Day Connection program and Missouri students recently set up an intervention called Safer Steps, in which students toured the homes of day-care participants and inventoried fall-preventing safety features -- or the lack of them.
 
Educating the elderly and those who help them in fall prevention is crucial. A recent survey done for the nonprofit Home Safety Council found that many caregivers don't know the simple procedures that can help avoid a fall in the home.
 
Nearly two-thirds didn't realize that non-slip or secured rugs and handrails on both sides of a staircase are important protection, and about half didn't know that lighting at both the top and bottom of stairs is crucial. Nearly a third weren't familiar with the need for grab bars in the shower.
 
Even many who knew what changes could be made to home architecture to improve safety said they were reluctant to propose them because they were worried about a negative reaction from their friend or other loved one.
 
"Talking with mature adults about how to make their homes safer is a sensitive subject, but it's worth having the conversation," said Meri-K Appy, president of the council. "Simple home modifications and a few behavior changes can make it possible for people to live safely and independently in the homes they love."
 
The council urges that all families conduct a home-safety walk-through to find and fix potential hazards.
 
Along with having good lighting and solid railings, make a home safer by reducing clutter in heavily traveled areas and on stairs, securing wires and cords away from walking areas and making sure that any furniture with high trip potential, such as footstools and coffee tables, is out of harm's way. There are numerous organizations offering advice on preventing falls. Below are Web connections for some of them.
 
National Safety Council: www.nsc.org
 
National Council on Aging: www.ncoa.org
 
Home Modification Resource Center: www.homemods.org
 
National Institute on Aging: www.nia.nih.gov
 
Home Safety Council: www.homesafetycouncil.org/family
 
Contact Lee Bowman at BowmanL@SHNS.com. Distributed by Scripps Howard News Service, http://www.shns.com