What are some ways to prevent falls

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Because falls account for 95% of bone fractures, it's important to find ways to prevent them. When people fall in their homes, others may wonder how that can happen in a familiar environment. But you can fall anywhere, including your own home where you may have walked the same floors for half of your life. You may have medical conditions that contribute to a loss of balance. You may be rushing to answer the phone or get to the bathroom. Or you may trip on that piece of carpet you've been meaning to tack down for a long time. (Table 17 lists ways of preventing falls.) There are things you can do now to help you take control and prevent falls. It's not just the new lamp with a long cord that can trip you. If you

Table 17 Preventing Falls

I Outdoor Environment

Home Interior

Personal Issues

Remove snow and ice; sand walkways and driveways for better traction

Do not use scatter or throw type of rugs

Avoid excessive alcohol

Install railings near steps

Tack down loose carpet

Wear rubber-soled, low-heeled shoes (do not wear backless slip-on shoes or slippers)

Clear clutter from outdoor steps and entryways

Clear clutter from stairs and rooms

Do not rush from room to room (e.g., to answer the phone)

Install good lighting

Move electrical cords and wires out of walking path

Use cane or walker as needed; don't be afraid to ask for assistance when needed

If possible, install garage door openers

Install good lighting in every room

Use great care when using a step stool

Keep extra cane or walker in car

Keep a flashlight next to your bed

Get appropriate eyeglasses to correct poor vision

Keep flashlight in the car in case walkways are not well lit

Use nightlights

Be aware of your surroundings, e.g., watch for raised thresholds between doorways

Pay attention to "Caution—Wet Floors" signs and floors that look wet without a sign

Keep a step stool available to reach things. It should have wide steps and, if possible, a high handrail

When visiting outside your own home, walk slowly and carefully, watching for obstacles

Do not walk across uneven surfaces such as gravel driveways

Install grab bars next to the toilet and in the bathtub/shower

Use caution when crossing the street

Stay off grassy slopes as they can be particularly slippery, especially when wet

Consider installing a raised toilet seat

Watch for uneven surfaces, ice, and loose sand

100 Q & A ABOUT OSTEOPOROSIS AND OSTEOPENIA Table 17 Preventing Falls (cont.)

Outdoor Environment

Home Interior

Personal Issues

Get help for yard work or snow removal as needed

Use a rubber mat that is suc-tioned to the bathtub or install non-skid surface in tub and shower

Do not walk at night without good lighting

When linoleum and tile floors are washed at home, do not walk on them until they are dry

Develop strength, flexibility, and balance through

Install a bedside phone to call for help in case you feel too unsteady to get out of bed

Be aware of your risk factors

• Medications that cause dizziness or sedation

• Medications that cause diuresis (leading to frequent trips to the bathroom)

• Illnesses affecting balance such as stroke, Parkinson's, Alzheimer's, postural hypotension, urinary incontinence, flu

• Conditions affecting your feet (e.g., neuropathy of diabetes)

• Depression

Keep a shower chair available to avoid having to sit in the bathtub

When getting out of bed, rise in stages, sitting first, and getting up slowly

Do not wear extra long robes, nightgowns, skirts, or pants

Take one step at a time on stairs are placed on a new medication or you develop a new symptom such as fever or dehydration, you are more likely to fall. So, it's particularly important to be aware of any change in your personal circumstances as well as any changes in your environment.

The more risk factors you have for falling, the more likely you will fall. Risk factors for falling include:

• poor balance or poor vision

• Alzheimer's disease or any condition that impairs thinking or memory, including depression

• weakness or numbness in the feet or legs

• medications such as those used to treat depression, psychosis, and high blood pressure

• medical conditions such as arthritis, Vitamin D deficiency, stroke, Parkinson's, infection, dehydration, fever, sudden blood pressure or pulse changes

While you may not have any control over some of your medical conditions or the medications used to treat them, you do have some control over exercise. Increasing your strength, balance, and coordination can reduce your risk of falling. Tai chi has been shown to reduce the risk of falling in frail older people, reduce the rate of bone loss, and also reduce the number of fractures, possibly due to fewer falls from improved balance. Don't underestimate the importance of the improved balance, coordination, and flexibility that results from exercise.

If you or a family member has many risk factors for falling, you may want to invest in a medical alarm to alert medical and rescue personnel if you or a family member falls. Bed rails are available for non-hospital beds. Getting up in a dark room may make falls more likely. Be sure to have a well-lit path to the bathroom. If you don't want to wake your partner with extra light, keep a small flashlight next to the bed.

If you are on a number of different medications, it's important to make sure that you are taking the correct dosage at the appropriate time every day. Using a pillminder allows you to stock each compartment with your daily allotment of pills. That makes it less likely that you will take too much of any of your medications, some of which might lower your blood pressure and make you drowsy or dizzy, causing you to fall. You should also avoid the use of alcohol and discuss any over-the-counter medications with your clinician prior to taking them.

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