Need to Know
Fear of Falling – Once a person has fallen, the fear of falling again may worry them daily. This fear often causes a person to move about less often, which causes greater problems in their gait or the way they walk. Many older adults may not report a fall because the injury was minimal, or they may think their fall was due to “getting older”.. Always be alert for signs that the person you care for is fearful of falling. These signs include:
- Concern or worry during walking
- Sweating or shaking while walking
- Clutching persons or objects while walking
- Reluctance to change position or walk
- Becoming wobbly or less mobile after a fall
Who is at Risk for Falling?
Know if the person you care for has any of these conditions that place them at risk for falling:
- Reduced Vision – when a person has reduced vision, is sensitive to glare, or has poor depth perception (difficulty judging distance of near and far objects), he may have trouble seeing a walking pathway, obstacles in the way or the edges of stairs.
- Becoming Dizzy when Standing – Postural hypotension is a drop in blood pressure that occurs when a person stands. When this happens, persons can become very dizzy quickly, lose their balance, and fall to the ground. Postural hypotension is more common in persons who do not drink enough fluids and become dehydrated. This is a problem in older adults who do not always sense being thirsty.
- Urine and Bladder Problems - The frequent urge to pass urine will cause a person to wake up at night to go to the bathroom. This urge to pass urine can cause people to rush to the bathroom or leak urine that they can slip in. If the person awakens and the bedroom or bath is dark and there is not a clear pathway to reach the bathroom, there is the risk of falling.
- Gait Problems - A person’s gait, or how one walks, can affect their risk for tripping, losing balance, and falling. For example, Parkinson’s patients are at a high risk for falls because of their shuffling gait. As the person shuffles across a room it is easy to trip over uneven door thresholds or clutter in their walking path. Another example is a person with a painful foot, who may partially limp or have trouble bearing weight on a foot. Other people who commonly have gait problems are those with stroke, partial paralysis, cerebral palsy, and osteoarthritis.
- Loss of Sensation – When a person loses the ability to feel in the feet and legs, this is called paresthesia. With a loss of feeling it is easy to stumble, trip and fall. This may occur in people with diabetes, serious vitamin B12 deficiency, and after taking chemotherapy for cancer.
- Using Canes, Crutches or Walkers - Assist devices such as a cane, crutch or walker, help people who are less mobile walk more safely. The devices offer more support and stability when rising from a chair and walking. However, if a device is not used correctly a person can fall. For example, when using a cane a person must always stand straight, and not bend over. If a person uses a walker, leaning over the walker or walking too far behind it can lead to a fall. See our lessons on Correct Use of Canes and Correct Use of Walkers.
- Medicines - Some medicines cause side effects causing a person to become dizzy, weak, confused or sick to their stomach. These effects can also happen if a person takes several medicines for their condition or they take more medicines than they actually need. People should check with their doctor, nurse, or pharmacist about a drug’s potential to cause risk for falls.
Who Most Often Has an Injury from a Fall?
- People with Osteoporosis - Osteoporosis is a disease of the bones that leads to low bone mass and a loss of bone tissue. The disease leaves bones very brittle, increasing the risk for broken bones (fractures), even if a person does not fall. Bone fractures typically affect the wrist, arms, hip, and spine.
- People with Bleeding Disorders - Normally, when there is an injury to blood vessels in the skin and tissues, the blood clots quickly to prevent serious bleeding. Blood contains cells called platelets and clotting factors. However, there are diseases, conditions and medicines that affect the number or action of platelets and clotting factors, thus causing people to bleed more easily and for a longer time. These include:
- Severe liver disease
- Certain cancers like leukemia and lymphoma
- Inherited conditions like Hemophilia
- Medicine side effects from chemotherapy drugs and drugs containing excess amounts of aspirin.
- Medicines that act on clotting factors such as heparin, warfarin (Coumadin) and low-molecular weight heparin (Lovenox)
- Radiation therapy can reduce platelet counts temporarily