I am also a physical therapist who works in a Fall Prevention Program (through Meals on Wheels, Diablo Region, Walnut Creek, CA.) One important factor is being able to stand up from a 17 in. seat height repeatedly, without using your arms (balance test: 30 second chair stand.) Many people lose their leg strength and endurance as they age. Also single limb balance (standing on one leg) for a goal of 10 secs. is important. In addition, the speed of your gait/walking (safely!) is linked to healthy aging and longevity. The slower your pace, the increased risk of falling...
2
For those of you living in a developing country or maybe even in the USA:
I have worked in Viet Nam for many years but my favorite project now is to keep the cane-walkers safe.
I am 75 and ride an ancient bicycle as my way to get around Ha Noi. I carry a baggie with several sizes of rubber cane tips, which I purchased in the States. Just about every day I stop because I see someone with a plain rattan cane. No rubber tip.
Recently, I biked past three elderly women (as old as I am), one with a tipless cane. I didn't stop because the three were in the midst of a fierce, loud argument. But then I thought--Oh well, they have the rest of their lives to argue.
I turned around and pulled out my baggie of cane tips.
By now, the three elders were glaring at me, the foreign intruder.
"Auntie," I said in Vietnamese, using an honorific to address the woman with the rattan cane, "you need to be out walking every day for exercise, but your cane is very dangerous." I made a slipping gesture for a cane and tilted as if I would fall. "The chance of falling is great. If you fall, you have a great chance of breaking a hip or a wrist, and then, and then..."
By that point, I'd retrieved the correct size of cane tip.
"Let me borrow your cane," I said.
I pushed the rubber tip onto the cane and gave it back to her.
"Ooooh!" the three women said in unison.
As I took off on my bicycle, I heard them laughing.
8
If one has to make a 'turn around' - DO IT SLOWLY. Turning too quickly CAN cause a moment of dizziness.
5
I took lessons on the falling technique (twist, avoid head impact, and don't use your arms) recommended by Brody. Although I did quite well (they said), I remain skeptical that I would think to use the technique if a sudden, unanticipated fall confronted me.
3
It's not really about thinking.It's like military training for something- training makes something repetitive, you have muscle memory. I was seriously thrown from a horse and didn't know that I knew how to tuck and roll, I just did it.
1
How will "a periodic kick in the pants...help keep us safe"? It sounds decidedly unsafe and potentially injurious to me.
4
As a senior Mainer living in the land of freeze and thaw and constant ice, I can tell you that Yaktraks don’t cut it. THey are like walking on slinkys, very destabilizing. Get serious traction—kahtoula microspikes (carbide tips, you can wear them into the grocery store), or similar product. Buy boots with rubber soles—not vibram, which hardens and becomes slippery in cold weather (rubber is why snow tires grip better). Do yoga to learn how to use your body and build leg strength, take balance classes. Use a ski pole when walking on icy sidewalks or driveways. Always keep a bucket of salty sand by the door and throw it down before the freeze (sno melt products just dissolve away)—wood ash is even better. Get rid of throw rugs indoors, never stand on counters. Take several trips rather than loading up. Play in the snow with your grandchildren—you will learn how to fall, and lucky you if you grew up skiing. Take your time, always.
10
"Your mom (or your dad) fell". It's the text, email. or voice message
dreaded by any adult child whose parent had heretofore been nicely settled in assisted living. And all too commonly received. I fell myself (age 60) and broke my arm when walking the dog. I had on thin-soled sneakers. Now, I don flexible hiking boots (with ankle support) on most outdoor walks. The brain senses, and corrects for, imbalance early, with these boots. I recommend!
4
Jane says that three times as many people die after falling (about 32,000 annually) then are killed by guns. In fact, about 35,000 are killed by guns each year, so roughly the same number are killed by guns as by falling.
4
I run up mountains in the winter, solo, with glare ice for long stretches, perhaps 100 feet. Micro spikes work fine, but then one must stop and put them on. Too much trouble. Instead, use dynamic balance rather that static - run over ice even on the down hill. Up hill is not a problem, but you can run uphill too. I may be an exception - I do plyometrics - intense jump training with a performance trainer and also boxing lessons. I am quicker, faster, and more agile than most 19 years olds - comparable to ELITE 19 year olds. There is no age, it has no meaning. But if you have to know, I voted against Richard Nixon and for Hubert Humphrey. I also back country ski in the Colorado Mountains, also solo, and go night club dancing with 20 years olds - and never, ever sit down.
1
In order to prevent falls, apart form these useful advises, we must not forget the importance our physical state and functionality. Aspects like balance, gait pattern, reaction capability against unexpected events or muscular strength are essential for avoiding falls. In that sense, technology, for instance, in providing new tools that allow GPs to assess in a few minutes, the risk of falling of seniors over 55.
To those who may be interested in these approaches, I recommend this web-site
www.fallskip.com
1
One factor not mentioned in the article is hearing loss. A meta-analysis of the association between hearing loss and falls indicated that the risk of falling is approx. 2.5 times higher in elderly patients with hearing loss than in those with good hearing. So hearing aids may also help to avoid falls.
2
Falls are common among the older population. In fact, around 25% of older Americans will fall this year, which can cause serious fractures and even brain injuries. Now that we know that falls are rampant among seniors, we should take the necessary steps to prevent the risk of this type of accident.
In addition to home modification, it’s also wise to consider getting long term care services like nursing homes, adult day care, assisted living facilities and home care. It’s easier to face your golden years with the help of these long term care settings. These will not restrict you from doing what you want, but it’s about creating a perfect setting for you to have a safer and more comfortable retirement. You can read more details about how elder care services can prevent the risk of accidents such as falling here: http://www.altcp.org/elder-care-services-reduce-accidents/.
High bed frames lead to falls from bed and the added height of mattresses takes many beds up to three feet from the floor. I am surprised this was not mentioned.
High beds amplify risk for those with osteoporosis. When my mother was in her late 80s, an advisors first recommendation was a new low bed frame. I have followed this advice myself and found it hard to locate a low frame.
2
Platform bed? (A staple at most Scandinavian design furniture stores.)
Sometimes they can be too low, but maybe fine-tune with a 'just right' mattress height?
3
Something else to mention is side-effects of medication. An example - medicine for high blood pressure can cause low blood pressure and dizziness.
4
I lost 20 lbs. and did not decrease blood pressure med. Result - a fall and a concussion. Now off the med.
The statement implying that the number of gun deaths annually is 10,000 is incorrect.
Including gun deaths due to accident and suicide, over 33,000 Americans die each year from firearms.
5
Bi-focal glasses can create distance confusion when walking.
5
If you find yourself needing a cane, please get and use a cane.
Get several and leave them around the house, as you would eyeglasses.
My mother, a proud Leo, refused to buy and use a cane even as she clearly aged and lost balance and stability. She would lurch from piece of furniture to piece of furniture around the house. When she left the house, which was not often due to her diminishing balance, she needed an arm to lean against and then would use a grocery cart as her cane/walker.
But buy and use a cane? NO WAY. Well, her death came rather quickly, just two weeks after she - yep, you got it - fell in her living room and could not get up. An alert system button around her neck brought help, but she went into the hospital and declined and died.
Since her death, I have on occasion found myself standing in the home health products - like canes and walkers - in not a few drugstores looking at the merchandise. Sometimes I cry. Sometimes, when I do see an elder out on errands using a cane or walker, I smile. And then I cry.
I wish my mom had let go of, set down that pride she held and bought and used a cane. Maybe she would still be with us? I like to think so.
For myself, if and when that time comes, I'll get a cane. Or 2. Or 5. Or the biggest, baddest walking stick - ala Margaret Mead - that I can find.
I'll keep moving and do it in style and no one and nothing will keep me home.
19
Get a grab stick--a 4 ft. rod with handle and trigger-grip; the other end of the rod has two rubber-tipped arms which move in to grab small items on higher shelves as you stay grounded on the floor. I have one in my kitchen, one in garage, use them a lot.
7
Take your time. Don't do two things at the same time and/or do not do things in haste. I don't know how many times I almost fell because I was in a hurry. I once fell down the basement stairs thinking about doing two things while doing a third: one concerned something upstairs and one concerning doing something on the main floor while I was carrying the laundry basket to go to the basement. Luckily I survived with only many bruises.
13
Use a bag to move your laundry around. Laundry baskets take at least one arm, maybe two; and don't do what I used to do, just grab the laundry in my arms. Then a friend gave me a large sturdy plastic bag that I use now, and I can use both arms to negotiate the cellar stairs. Every time I want to just grab the laundry, I think of what my friend would say if I fell!
6
i let the bag roll down the stairs and later gradually toss it up...
3
My mother and my recently deceased father in law (both born in 1928) have both fallen in non winter conditions while using both aluminum walkers and the fancy rolling walkers. They are not a panacea for avoiding falls. Just a reminder!
1
Bifocals! If you have a strong correction the reading focal has a greatly different depth perception than the walking. The result is that bifocals are a major cause of falls on stairs and inclined as the brain uses their reading focal’s depth perception as if the walking, upper lens.
If you can afford it, walk with a computer length bifocal. That extra foot or more focus’s depth perception is usually too little in difference for danger and if you have to read just hold it or read it from a short distance or arms extended or even remove your glasses.
4
I had a serious fall nine years ago, resulting in removal of most of the ankle joint and bone fusion because the plates and screws would not hold. Although I get along quite well, albeit with a slight limp, I am very cautious. A couple of special things I do:
1 )I keep a standard-type walker in my shower, just in case when washing my hair with my eyes closed I become unsteady. This is a good thing to do also for anyone who has recently had knee or hip surgery.
2) I use a small grocery cart that I bought on line to bring in the groceries from my car and had a small ramp installed in the doorway so it glides easily. I also use the cart inside the house to carry laundry back and forth and to take out the garbage to the garbage cans. Works perfectly!
3) I had engineered wood floors installed in most of my house. I figure if I do fall it will be much gentler than landing on tile floors, as most homes in Arizona where I live do.
11
Great article; thank you. Totally agree: worth having a set of Yaktrax - easily bought from Amazon - in a drawer for when needed (but take them off as soon as you reach your front door).
2
To prevent falls, ALWAYS use your walker or Rollator without regard to your thought that it makes you look OLD. Some of us are old! I am 84. Today at a Memorial service I could not rise from the armless pew when the rest of the 200 + people in attendane rose for parts of the ceremony. My husband lifted me to an upright stance when we were leaving. Don't feel embarassed. be very prowd that you can STAND and use your walker once you are upright. Keep on living no matter how hard it is to manuver over some surfaces with you walker. Keep on with your life. I am a newly published author as of 2016 when my biography of my Father, Raymond H Wallace was published by the Univesity of Connecticut Thomas Dodd Research center. Mary W.Bushnell
10
Tragically I am now sitting Shiva in mourning for my beloved mother Mina Bannett. She fell on September 25 while reaching over her head to put paper towels away in the pantry while preparing for Yom Kippur break the fast. No ladder, no stool or chair. Just looking up above her head. All of this advice is good and I am glad and wish to reiterate the advice regarding moving things off of higher shelves. Bottom line, If you have to look up to get it, you do not want it. Let someone else get it for you and have your shelves reorganized as Jane Brody suggests.
Also, If you do have a fall, please consider it a warning, see your doctor even if you are not hurt. have them check your blood pressure, review your medications, especially anxiety and anti depressant medications, and consider the use of a cane or walker. Don’t be too proud to avoid these aids.
If you hit your head, even a minor bump, consider a CT scan of the head. It is amazing how small a bump can lead to a subdural bleed which could be fatal or lead to dementia.
Take my word for it. We are in such sorrow now over my Mom’s tragic loss and if our story can make one of you avoid a fall and prevent your family from this horrible experience that would be a comfort.
12
You can buy winter boots with built-in studs that can also flip over to give regular tread. Because the studs are built-in, I always have them with me and they don't slip off like some of the slip on studs do. I still need to be sensible and realistic when walking in winter but at least I have a good "tool" to work with. And when used with caution and judiciousness, it increases my mobility.
5
I am a physical therapist who primarily treats the elderly at home. There are two crucial elements of falls that were not mentioned here. Have your medications reviewed annually by your internist. Polypharmacy is a leading cause of falls. Second, don't acquire an assistive device independently. Consumers who purchase and train themselves with devices are more likely to fall than those who have them prescribed by a physical therapist who trains them to use the right device properly.
8
I live in Helsinki where winter ice and snow are frequently a problem. The place is very quick to plow off most of the snow but even cleaning up leaves slick areas. Most areas also spread sand to hold down the most slippery places but in the suburbs that application sometimes takes time. It is most dangerous , not on very cold days, but on days when the snow has melted a bit and refrozen overnight leaving a wet area over ice which can be very tricky. Ice on outside stairways is very dangerous and I prefer ramps if they are available but a slanted surface with ice is also dangerous. At 92 I have sow reaction times and cannot catch myself to re-balance in time to prevent a fall so when I feel myself going down I try to bend my legs to minimize the impact, I usually fall about three or four times each winter and most time extend my arms quickly enough to prevent my head from reaching the ground. I usually just get up again and keep going but about a month ago I landed on my chin when my foot caught on a curb as I was crossing the street. I needed three stitches to close the wound and it healed in a week or so.. My brother died a few years ago on a slippery fall indoors at the age of 85 when he struck his head. The big problem with older people is a slow reaction time . Luckily my bones seem in good shape and they don't break easily. Maybe drinking a lot of milk helps.
7
One important about using crampons/cleats on your shoes to walk on ice: take them off before walking in the house. A friend of mine is currently recovering from a broken elbow incurred when he tried to walk on a tile floor.
2
Marble floors, too. Yaktraks are great, but they are really hard to put on and remove. Hard to do unless there's a place to sit down.
2
Thanks for this important info. I’d like to also share that we need to conscientiously maintain the physical condition, strength and proper weight, to get back up after a fall . For some of us it would be hard enough to get up off the floor without an injury, not to mention if we had pain or an actual fracture.
There are resources that deal with getting up off the ground. For today, we can start with standing up from the chair, with or without using your arms, and see if we can do a few rep’s and what it feels like. That’s a starting point...
2
Above all, SLOW DOWN. Falls seem to happen much more frequently when we are hurrying and distracted. Walking can and should be a form of meditation, in which we focus on our body, and its movements through our environment.
Two years ago I took what seemed to be a very minor fall at first, but I broke all 5 fingers on one hand as I reached out to cushion the fall. After a long and painful series of surgeries, I never, ever hurry as I move through the world.
Interestingly, that fact alone has improved my life in numerous ways. I notice and enjoy my physical environment far more than before my fall. I stop to look at interesting details along the way, and I now love the luxurious feeling of never being rushed. I stay in the moment far more, and this not only enriches my perceptions, but keeps me safe as well. Getting old has many surprising benefits...this is one of them.
27
Why are ther so many falls in Arizona???
I would think it's due to the average age of the state. Older adults fall a lot more often than other age groups.
4
Because Arizona has no real winter it needs more falls.
8
Many places in AZ do get real winters. It’s all about altitude.
My right knee is still unstable due to falling on it 5 years ago when I tripped while getting on a DC Metro escalator on the way to work. For the last 18 months or so, I've taken to wearing a pair of light neoprene slippers with a patterned rubber sole when taking a shower. I am able to climb in and out of my tub shower without feeling unsteady--and I'm able to stand while showering without feeling like my feet are slipping out from under me while in the shower.
I bought these neoprene slippers on The Grommet, a "start-up" product website. These slippers I have are still available on the Grommet website. I never take a shower without using these slippers, and I take them with me when I travel. I've gotten (and will get a second series) platelet-rich plasma injections in both my knees so I can heal the small meniscal tear in my right knee resulting from the fall, and moderate some minor osteoarthritis in my left knee.
2
"Always use a handrail when going up and down stairs. Consider installing a railing on stoops that lack them."
Consider also the strength of it's attachment to the wall - if it's a banister on drywall, how are the attachments made, and is it attached to studs rather than just a decorative item? If you grab it after starting a fall, the weight it will suddenly bear could break it loose and add to your injury.
7
Pets, such as dogs and cats of any size, can get underfoot and cause a fall as well.
8
....and watch out for their toys! I have two cats who leave toys all over. I have often thought of how ignominious a fall would be were I to trip over a felt mouse.
5
I have been going to strength training for several years (I am in my 60's) and it has saved me twice from falling badly. Case in point - I stepped off a curb and stumbled flying forward. I would landed on my face if my arms hadn't shot out to break my fall. I disagree with the author that in such a scenario I could injure my arms. Because of my strength training my arms were able to shoot out (muscles were strong enough to, most elderly who do not exercise lack muscle strength so they tend to just fall flat like a domino)and break my fall. In another instance I didn't see a small step between two rooms - I tripped over it and went forward but my arms went flailing forward and my legs supported me as I ran forward. I thank my trainer because he emphasized the importance of building muscles - walking is fine but that is NOT enough. The author could have used her article to emphasize the importance of working out regularly.
6
Falling correctly helped me, a few years ago. An uneven sidewalk outside a hospital tripped me. I put my purse in fornt of my face and fell on my ample belly. I was sore for a few days but nothing worse.
1
Advice from a Certified Yoga Therapist.
One more thing about walking on snow and ice- yes to leaning forward, taking small steps, and wearing secure footwear-- but what about the feet inside those shoes? When you're cold your tend to bunch up your toes to stay warm. This makes for a tense and narrow foot pad. Spreading your toes wide will give you a larger and stronger base.
6
Growing up in Michigan, my father taught me to walk "pigeon toed" to keep from falling on icy sidewalks. (Toes pointed in towards the other foot.)
IT WORKS!
2
Being present, paying attention... and Yak-Traks are my mantras to prevent falls.
CAUTION: Do not wear Yak Traks indoors, ie after a beautiful winter walk on the Rail Trail, I stopped at the grocery store and skidded into the produce department on the linoleum floor!
3
Yaktrax are fine outdoors, but come inside and they are hazardous on smooth surfaces like vinyl flooring. Spikes work well though they can catch on carpets. It is hard to find a traction device that works well on all surfaces. Here in the Adirondacks the worst surface is glare ice covered with a thin layer of new snow.
1
I find worse then that is hard clear ice with a thin layer of water on top...
The Dutch are getting classes in falling ... we here have kids without health insurance.
17
Thanks so much. This was such a helpful article. How about a series “Taking control of your Aging”? Jinny
4
I tried bifocals for a couple of weeks - and at the end of week 2, leaving the subway station, it suddenly looked like the stairs dropped off dramatically on the side - I almost wiped out from very high up. For me, it turned out to make the most sense to have 2 pair of glasses.
Don't fall into the trap thinking a new eyeglass prescription makes everything instantly better and safer - be extra careful when your prescription changes (or you're new to wearing glasses!) That goes for new medication too!
15
I have to share that much of the advice regarding how to fall right is incorrect. As a man who has studied judo for nearly 40 years I can attest to this. I spent the first two months of training learning mostly about falling correctly, over and over again, before doing any actual defensive fighting. My recommendation would be to take a good judo class that will teach you how to fall correctly to prevent serious injuries.
5
Additional advice:
(1) Get a cane, and use it when you go to the mailbox to retrieve your mail.
(2) If there is snow or ice on the ground, walk on the lawn when you go to the mailbox; you are less likely to slip and fall, and if you fall it won't hurt as much.
(3) Put a second railing in your staircase. It is extremely helpful if your leg joints hurt (arthritis) because you can use your arms to relieve the pressure on your legs.
7
I have a little nerve damage so stairs are tricky. the FIRST modification we made to our Queen Anne house when we moved in 25 years ago was a railing opposite the banister! Saved me many times. I also always watch my feet!
2
I use a clean sponge mop to clean the shower tiles. To do this, I stand outside of the bath tub and spray a cleaning spray over the shower tiles, and then wait a few minutes before sponging. The tiles were brand new a few months ago, but the grout gets dark between the tiles every few months. (Must be pollution, even though my windows are closed. )
I use another clean sponge mop to reach into the inside back of the microwave to clean splashes, which is otherwise too high for me to reach.
I am now very, very careful. I had a nasty fall 26 years ago when I was 40, which was a slip in the store -- it was a crash actually -- and it resulted in a surgically untreated skull fracture. The hospital believed a slip was only a slip and did not see the need for an MRI. I developed massive bleeding and swelling, and spent most of my time asleep. For several years, until the swelling subsided.
4
After taking a shower, I wipe myself first, then I use the towel* to wipe the tiles; that way, they never need any special cleaning.
*Note: Instead of bath towels, I use large hand towels, a clean one every time.
7
Oh, another thing: don't "pivot or swivel" as my orthopedic surgeon recommended, as we get older. To that I have added, don't jump out of bed and start racing around! Those of us who have been very active all our lives, find it difficult to adjust to a slower lifestyle. But it beats breaking the other hip :)
9
Best wishes for a complete recovery of your broken hip!
4
I always tell my mother to "walk like a duck" on uneven or potentially slippery (here, in Pittsburgh, we call it "slippy") ground. It may look ungainly, but a flat-footed gait is a steadier gait.
That said, it is also important to pay attention to side effects of your medications, particularly one that you've recently begun taking. A friend who was recently prescribed a statin noticed that caused a minor change in his depth perception and overall steadiness—effects that aren't not commonly associated with statins, but important nonetheless.
4
Good advice, hold the handrail ! I broke my foot and now have a walking cast. Common sense is sometimes not so common :-)
5
"Nearly three times as many people die after falling (some 32,000 a year) than are killed by guns in the United States." This is only true if firearm-related suicides are excluded from the data. Total firearm related deaths—homicides, suicides, unintentional—exceed deaths from falls.
9
I am 87 years old and I am not prone to fall because, to me, the MOST IMPORTANT thing you can do is TO CONCENTRATE ON WHAT YOU ARE DOING. DON'T PUT YOUR MIND SOMEWHERE ELSE to think what project you have and what you are going to do. PLACE YOUR MIND IN WHAT YOU ARE DOING AND LOOK AROUND TO MAKE SURE THE SIDEWALK OR ANYWHERE YOU ARE IS SAFE. Don't place your thoughts away from what you are doing. If you see something that you like STOP, LOOK and then and only then keep walking. Think of a surgeon trying to operate.....HE/SHE WILL NEVER PUT THEIR MINDS ON A DIFFERENT SUBJECT BUT WHAT THEY ARE DOING AT THAT MOMENT.....OTHERWISE YOU WILL END UP WITHOUT YOUR LIVER, KIDNEY, HEART AND GOD KNOWS WHAT ELSE. Have a good and safe day !!!
42
Absolutely!
6
The best way to prevent falls is to never get out of bed. Unfortunately, this
has a downside. Life is cruel.
11
As a recovering couch potato holding a minor in Physics, this article is spot on. There are plenty of tips like these people can use to safeguard and improve their lives.
4
Always leave a light on in the hall right outside your bedroom so you won't get dizzy or mixed up if you have to get up in the middle of the night. Sit up first, take a breath, look at the light, then stand up. I trained myself to do this automatically every time and when I'm sick or on a medication it has saved me from falls and from bumping into things.
16
In September I tripped on a downed flexible dilineator on the street at Water Street as I started to cross the street. I usually keep an eye on those things, but it was almost flat on the ground and I was down on the ground before I saw it. Hurt both legs, particularly one knee that is still not healed after almost 4 months. I have had no trouble with walking since then, but I am not healed.
5
Another severed risk factor for falls - baths that double as showers. Often they do not have flat bottoms, so it is impossible to stand with your feet slightly apart to maintain balance, especially if you are trying to control the shower with soap in your eyes. Such places should have support rails - it should be mandatory for hotels and other places where elderly people (or anyone, including children) are likely to stay or visit.
I once had a tumble in a well-known hotel in London that had one of these baths, and nothing but the shower curtain to hang on to. I just missed hitting my head on the toilet pedestal. I complained to management, and visited again last year, six years on - nothing had changed!
6
Be compulsive about holding on to the grab bars when getting off the bus and *don't let go until both feet are on the street."
When you are going up or down the stairs to/from the subway (or in any other situation): concentrate on holding on to the hand rail and don't be trying to fish out your metrocard, take your gloves on or off, etc. Just concentrate on holding on and looking ahead.
7
Being over 65 but still having a very active life of hiking, hunting, and fishing helps a lot. Walking over uneven ground, standing on a rocking boat, going across lake ice and up and down hill makes one much more agile. Building our new home made me prepare for the future. ADA compliant, low slip floor tile, a walk in shower and a lot of design features. Now I volunteer to help others of my age retrofit their homes.
14
I broke a hip - a wrist three times - and twisted ankles again and again. That was in my 60s...now in my 70s, it doesn't happen anymore.
Why? Because in the past my prescription (very slight) eye glasses distorted my perception of curbs and uneven pavement...and I'd trip and sometimes fall badly.
Once I switched to glasses giving a 100% sharp view of the ground below and the way ahead, the tripping stopped.
It amazed me that physios gave much the same advice as here but never, ever questioned my sight.
All that's written is of course good sound advice...but clear vision of the ground and the way ahead is a must.
32
Never sit in a roller chair on a slick (wood, tile, etc.) surface. Mine threw me into a window and broke my shoulder. I now have a plate instead of a bone.
9
I have bad arthritis in both knees and am wobbly as a weeble. I think a lot of the "mindfulness" stuff the WELL thing loves so much is hooey, but I do try to focus when crossing a room, even counting the steps. I have fallen once--was sweeping and planted my feet and reached WAY out to get some grunge and just kept going forward and forward. And I could not get up (knees). My daughter was home, thank goodness. I also highly recommend grab bars--I
love my grab bars in the bathroom--I want to marry them! As for no-stick soles--those trip me!
5
if you want to know more about how to prevent falls go to this site from the CDC. https://www.cdc.gov/homeandrecreationalsafety/falls/index.html
There is a wealth of information for the lay person and health care providers. If you are over 65, your health care provider should assess for your fall risk. The CDC site provides detailed information about their fall and injury reduction program STEADI. You can also look on line and find specific programs to help you improve strength and balance, and to complete a home risk assessment. One such program is a Matter of Balance. Many Senior Centers offer these programs.
K. Lamb RN, Gerontological Clinical Specialist
10
Thank you so much for that link to the CDC site. I have now bookmarked it. It takes great patience to type out long URLs like that, and I, for one, am grateful to you for doing so.
1
Balance is controlled by three physiological components. Vision, inner ear semi-circular canals and receptors in muscle/tendon/joints. These mechanisms work on a “use it or loose it” basis.
Our sedentary way of life, in developed countries, decreases the need for use of these mechanisms, allowing them to fade, resulting in poor balance in the elderly.
Personal observation of people and communities in developing countries show superior balance ability.
So, in early and mid life, when we spend most of the day not on our feet we are loosing the mechanisms that control balance. Also, again, at an early age, when we ride escalators and walk up and down stairways holding on to rails paradoxically, we are not stimulating our balance mechanisms, leading to poor balance at a later age.
Any activity/exercise that requires balance will maintain these mechanisms and prolong the day till we need the excellent suggestions in this article.
7
I spearhead a Falls Prevention Project at The MetroHealth System in Cleveland, Ohio. We are all at risk of falling. I strongly recommend to look into a Matter of Balance workshop in your area for your loved ones. For us Young caretakers I recommend consider becoming a certified matter of balance trainer. It helps to become more familiarized with ways to reduce the risks of falling. This was an excellent article. Thank you New York Times. Seniors deserve to age in place.
7
Never barefoot? Not even indoors at home? I’m not buying it. We didn’t evolve for shoes. We aren’t at our most stable in shoes. And unless you are wearing topsiders, bare feet are better traction on wet floors than shoes.
9
I have recovered from two falls. The first one happened when I was going for a walk on our trails with the dogs- the dogs were roughhousing with each other and slammed into me from behind, knocking me over and twisting my foot so that I fractured my ankle. Lesson learned- make sure the dogs are in front of me when we go for a walk.
The second fall happened walking out of a restaurant onto a dark walkway, where a bright spotlight blocked my vision of an uneven spot in the sidewalk. I fell and broke my wrist. Lesson- make sure you can see what you are walking on at night. I now use the "flashlight" feature on my phone to illuminate a dark sidewalk.
15
You are so right about falling in bathrooms in particular. I fainted in my bathroom when I was in my mid-50s, resulting not only in head injuries that produced a last scar on my forehead, but also a concussion. The cause of the fainting was that I did wait a few extra seconds after sitting up in bed before walking to the bathroom. ALWAYS give yourself a few seconds to make sure that you don't faint when rising from a prone position.
That said, throw rugs are a hazard in any part of the house. I put rug grippers under those that did not come with a rubberized backing. I keep them to a minimum other than mats in front of exterior doors.
If vision is poor, consider marking steps with fluorescent paint or strips. Use bright lights wherever you walk.
If your balance is less than perfect, let someone else climb on step stools. Hire a handy person for these chores. Use long-wanded dusting tools for cleaning high ceilings and ceiling fans.
There are many more hints but these alone will go far to prevent falls inside the house.
6
These suggestions are helpful if one is a "healthy elderly person" but my parents are in their early 80s and both have failing vision. They actually MUCH prefer semidarkness over bright lightbulbs. So their home is minefield of tripping hazards. Hence, seeing where they are walking or holding onto a counter or nearby bar is not possible because they cannot see 4 feet in front of them. One parent has fallen once and nearly died from a blood clot from that fall. My point is that the article is mostly talking about preventatives for "healthy elderly" which is fine but useless for the elderly who are already precarious.
My experience with healthcare workers is that they quickly size up elderly into these two simple categories because they know that the ones who have already badly fallen once are likely not to be around two years later. Falling at that age statistically can literally be a life-ender.
10
Spouses and children taking care of loved ones are also at risk of falling. Caregiving often requires physical demands that jeopardize the caregiver's own health, strength, and energy level, making them susceptible to injury. Home modifications such as portable ramps, roll-in showers, widened doorways and assistive devices (e.g., raised toilet seats, reachers, walkers) can provide immediate relief and reduce the stress of caregiving. The presence of home modifications is associated with decreased rates of caregiver injury. Our Fall Prevention Center of Excellence at USC has a myriad of materials that are helpful in identifying environmental strategies: www.stopfalls.org
14
This is so true and rarely mentioned. I truly do not know how some people handle being sole caregivers.
7
I recently tripped on some kitty litter. Fell. And broke my kneecap. I am a reasonably fit, 60-year-old with great walking shoes.....never thought that would happen to me.....kitty litter, not icy sidewalks, watch out!
11
I fell when I carried 14 lbs. of cat litter, plus several other things, up my back porch stairs in the dark (several cautions there!) I didn't break anything when I fell, but nevertheless it took me 9 months fully to recover from my injuries. One of the nurses asked why I didn't order my cat litter from the Internet. I hadn't known that was a possibility, but now the cat litter arrives at on my front porch, far from the steps, and I just pull it in.
Speaking of cat litter, don't use the clumping kind for traction on ice. You will slide.
2
I apparently am an expert in falling, as I have had a number of falls over the course of my life, and only broke a bone (my arm) once at age six. After a scary fall down stairs in 2015, I now use the handrail every time I go up and down stairs and am very careful not to walk on icy, snowy surfaces, and am extra careful in the bathroom. Also, I avoid escalators and take the elevator instead.
6
I'm 67. The best way to prevent falls is physical fitness. And a healthy diet full of Vitamin D, K and magnesium. Nix the calcium.
However, in a fit of rage, I climbed up on a 6 foot ladder to do something about a light shining all night in my window. And I had on heels! I did not property secure the ladder and was barely to the top when I realized I was going down onto hard dirt. Had a minute to think. I tucked and rolled onto my bottom (which doesn't have much fat). I got up and walked away. Lucky I guess. Plus strong muscles to cushion my bones, and a lifetime of good nutrition that all my friends laughed at me for.
Meanwhile, the rest of them are using canes.
7
Not much fat on your bottom, lifetime good nutrition, wearing high heels at 67. Thank you for reporting on your amazing physical condition and praiseworthy self-discipline, but there's no empathy here for "the rest of them" who are "using canes." We should imagine what life is like for the disabled, not disdain them for their plight.
17
Maybe the vitamins helped..or you got lucky....glad you're OK.
1
Have your eyes examined by an ophthalmologist. Cataracts can develop slowly, making us less aware that our vision is changing, or quickly. It's also important to detect macular degeneration early on.
22
YES!!!!!!!!! and see my comment elsewhere re vision and falls
5
The Cornell University campus here in Upstate, NY, has signs posted all over campus where icy sidewalks are legion--"Walk like a penguin". This forces you to use a wider stance and walk "flat footed." It is far safer than mincing, forward steps when you encounter icy terrain.
I walk 2-3 miles daily, and bring a hiking pole with me whenever I suspect icy patches on my walks. It helps with balance and improves the rhythm of your walk. I've had mine for 13 years and it's worth every penny of the investment for both regular walking and hiking.
8
"walking like a penguin" only sorta helps but for humans it is actually better to walk slightly forward -- because our center of gravity is quite different from fat short stubby penguins. It takes some practice but you walk with your weight slightly forward as your legs move forward. What this does is shift your center of gravity closer to a constant center. I had lots of chances to practice on NYC sheer ice streets and it definitely works.
4
"Walk like a penguin"!
An acquaintance of mine once told another friend, who had fallen badly, "Walk like a Lipizanner."
It seems to me that the best thing to do is to pick your feet up -- yes, like a Lipizanner. Scuffling along just leads to tripping on small cracks and pitching headlong. The other thing that seems important is to keep both feet pointing forward, not outwards like a duck; those who have a foot that turns to the side are literally in no position for a save.
Of course, on ice, it's the soles of your shoes that count most.
Fear of falling is indeed life-changing.
4
An ice-and-snow climbing technique helps tremendously, especially when you are descending a slippery surface. Bend knees, get nose over toes, splay feet a bit, let rump protrude behind, take short steps. It’s called pied en canard - “duck foot.”
If it’s too slick to be handled with this, resort to the Minnesota shuffle: knees bent, feet apart and in constant contact.
And yes, a walking stick, especially a spiked one, helps tremendously. So do Stabil-Icers if you’re going to be walking in the most dangerous places of all: parking lots.
3
Thanks for sharing this information. I have read many articles that discuss about these slip and fall cases in these past few weeks. I think it's important for anyone to take some preventive actions, so that they won't be slipped on those slippery roads. I have also read an article that might be interesting at https://www.lemberglaw.com/slips-and-falls-personal-injury-attorneys-ct-... that talks about legal side of slip and fall case. Hope it helps everyone.
I’m terrified of falling, esp. with each increasing year. But the approach is not rocket science. Here is what I always keep in mind…
Most accidents happen in or near the home, when you guard is more down. Remember that as you reach to get that heavy glass bowl from the upper shelf, etc.
If there is any snow, or remnants of snow/ice, or you even SUSPECT there may be some you cannot see, walk much more carefully.
Check your pride at the door. If a cane or walker would be helpful, use it!
While I am nimble and confident going up and down stairs, even the most alert, healthy young person could have a freak stumble up or down a step. I hold the railing on all staircases, no matter what. I never just ‘assume’ that going up/down the stairs will be without incident.
As for step stools, it’s very important to have one in the home that has a handbar (for support) at chest level. See example in link below. Usually you are reaching UP when on a stepstool, so if you lose your balance, a handbar that is way down at knee level ain’t gonna help you catch your fall. ;-)
https://www.amazon.co.uk/Abru-22032-Step-Handrail-Stool/dp/B01F7HV7ZC
Yoga, tai chi, wobble boards, Alexander Technique, etc. These all help you be aware of your body, alignment, and they help you with balance.
6
"I hold the railing on all staircases, no matter what."
In reality this is not what happens with daily use of stairs in a home. Many times one is going up or down with something in hand. So the risk is always there because you might have at most one hand free, if that. A good normal example is a clothes basket. What do you do then? I agree that one must be careful but the truth is that one doesnt always have both hands free at all times.
1
Laundry upstairs, washer & dryer downstairs.
Fun & safer: THROW your laundry downstairs, maybe the laundry basket too, Walk down the stairs & pick up the laundry.
3
Exactly what i do with my laundry in a mesh bag. just throw it down the stairs. no more laundry buckets for me.
City folk walk a lot and quickly, can't get to far at 5mph. But that's too fast as we age. For safety, need to slow down, be aware, don't hurry.
Also why those 10mph Dutch bikers are safer, not trying to go 25mph as cyclists here (and less likely tor crash commuting than racing cars...)
1
Do Pilates.
4
Or Tai chi or yoga, or hike in the woods off the trail or walk on the beach. Move! The thing is to keep using your body, to keep moving!
2
Lol, this article is very timely. I just badly sprained my ankle in an icy driveway. Haven't been able to walk in a week. huge inconvenience if you work and/or have kids and/or go to uni. really, watch your step! better safe than sorry
5
Dear Jane Brody,
I am a Rehab Doc (PM&R) in Temple and Waco Texas, Baylor Scott & White, who has cared for many people with serious injuries sustained in falls
For those who have lived long enough to have gotten to a stage of life where they are safer walking with a walker than without, it has been my clinical observation that many falls occur when the person is NOT USING THEIR WALKER. This clinical observation is supported by a recently published paper by Clare Luz PhD, et al. : "Do Canes or Walkers Make Any Difference? NonUse and Fall Injuries," The Gerontologist, vol. 57, no. 2, pp. 211-218, 2017.
January 10, 2018
When folks get to a time in life that a walker is needed, then have spent their whole life before that NOT using a walker. Therefore there is need for a reminder for use of the walker as a person comes to stand.
I am working on a reminding device that can be attached to any walker, that provides real time cuing for use of the walker, as a person stands from a chair or bed. Along with my engineering colleague Scott Koziol PhD, at Baylor University in Waco, I will soon have a high functioning but inexpensive device that will be suitable for human studies that will hopefully demonstrate the utility of real time reminding to affect behavior and increase walker use.
Paul A. Friedman MD
5
My experience with the elderly is that once they are using a walker they are using it all of the time. You see this in nursing homes, assisted living. It is rare for any of them using a walker to try to get around without them. Canes on the other hand -- whole other story. Folks who should be using them regularly leave them in one place, sit down, and then cannot get back to their cane without standing and walking to it. Big risk there. That's a big problem.
3
I had false pride about the walker for yrs. Now I use it when going out--say to a doctor. It really goes bring the center of gravity forward and stabilize it. You feel more secure. I would love to get another dog--but wonder if it would trip me.
Some physical therapists and neurologists say that a cane is better than a walker. While a walker might feel safer, it does nothing for the leg muscles or for balance, and so its use can be counterproductive. While one doesn't want an older person to fall, it's imperative that muscles not be allowed to weaken.
1
i fall right smack down a couple of says ago ouch did not thnk i could get up but i did
3
I think the main reason I read these columns is for the excellent advice found in the Comments.
27
Absolutely!! I just uttered those words to my daughter...
I fell twice this past winter on ice. I love walking and found one common thread in my community: those people who tend to their yards in the summer, always clean their sidewalks in the winter. Next winter, I plan to run a few copies of a note that I will stuff into mail boxes with a gentle reminder to clean the snow and to spread some de-icer on the walks.
My daughter gave me fabulous walking sticks from MEC for Christmas, and they still didn't prevent me from falling.. it happens so fast.
I was running with a friend last January ('17) and fell on the raggedy streets of Brooklyn. It happened so fast I did not have time to break the fall. I spent the greater part of the year in physical therapy, praying it would be enough to keep me from surgery, something a surgeon suggested after an MRI revealed I had a medial meniscus tear. I also joined a gym - something my gut also needed - and worked religiously on the elliptical and stationery bike. It seems to be working! After months of wearing a most annoying brace, I now can walk with relative ease and hope to resume running later in the year. Be careful you runners!
9
I realized I needed to work on balance and general strength and started a lifting program. After a few months I noticed gains in balance and core strength, and so when my foot hit "wrong" on the wonky landing off my porch and I went down, I felt like I was able to handle the fall and suffered contusions and abrasions and some knee and ankle strains that hurt like the dickens, and not a broken hip or shoulder. I'm 66 and it brought home to me that one bad fall could do me in. Kind of sobering, since my internal sense of self doesn't feel "vulnerable" at all.
16
There is a great course at the JCC in Manhattan called FALL STOP, MOVE STRONG which increases strength and balance in older adults. It has made a tremendous difference in my awareness and maneuvering through the obstacles of indoor and outdoor life.
3
Good article but it contains the following error: "Nearly three times as many people die after falling (some 32,000 a year) than are killed by guns in the United States." That's true only because suicides are not included in the number. The number of all deaths from guns in 2013 was over 33,000.
6
Suicides should never be included in the gun statistics. Similarly, jumping off a tall structure shouldn’t be counted as death from fall.
4
You speak in alternative facts. Suicide by shooting oneself with a gun isn't a shooting or gun death?
3
to further complicate matters, it is not always clear if a death is a suicide or accidental, especially with the elderly. An accidental Rx overdose, or not? A gun shot? A jump, or a fall, or god forbid pushed? Unless there is a suicide note left, or witness, the EMT's, Dr's, etc can only hazard a guess if it was suicide or accident or something worse. Hence, federal and state suicide statistics are always a bit suspect.
2
An article about falls and no mention of 60, 70, 80 year olds on ladders??? No more cleaning gutters once you turn 50
11
Best advice I ever got for going down stairs: use the “trailing hand” technique. Rather thank clutching the railing with your hand in front of you, keep your hand behind you, holding the rail from the underside if possible.
A forward-facing grip can’t always stop your forward momentum if you fall; a trailing hand grip breaks the momentum.
http://www.dailymotion.com/video/x9l2ra
15
Weak ankles definitely play a role. Increasing the strength of your ankles does take some time, but it works. Before you get out of bed, either pull your knees to your chest and wrap your arms around your knees or put a pillow under your lower legs. Then trace the alphabet with your feet. Exaggerate the movement so your ankles get the full range of motion in every direction. Upper case, lowercase, doesn't really matter. Do it daily and in 4-6 weeks your ankles will be stronger, but do it every day to maintain that strength.
13
You don't consider suicides when you count gun deaths? Are suicides by gun not deaths?
8
Yes, that statement made no sense. Whether shot by self or another person, it's a gun death.
7
Last year I was staying with a relative and as the bedroom was very cold I wore socks to bed.
I got up about 5 AM and the bedroom was pitch black. I was disoriented and totally lost my balance.
The bedroom had a hardwood floor with no rugs. My fall was similar to falling on ice. My feet flew out from under me: I suffered a compound wrist fracture and banged the back of my skull on an electric radiator needing 9 staples to close the gash. I am ok now but am more aware of “fall potential” activities. I am 71 and very active, doing 20 minutes of yoga daily and lifting weights.
Also in the past year, a 53 year old cousin died after falling down a flight of stairs. She suffered a massive brain injury and died 2 days after the fall.
10
"Nearly three times as many people die after falling (some 32,000 a year) than are killed by guns in the United States."
That statistic is irritating at best. A violent gun death does not compare at all with an accidental death by falling. Jane Brody is trying to sensationalize this piece. We get it; falls are bad and to be avoided, but don't conflate the two.
8
Why is there no comparison? The deceased will be as missed either way. Death is death.
2
I knew three men, two in their late 70s and one in his 80s, who suffered brain injuries in one case fatal, from falling. The other two aren't the same. If I fall, I will break my fall with my hands contrary to the advice in this column.
4
This this article doesn't mention something that needs to be mentioned more often. Use a cane or a walker or a rollator. Many people refuse to use these because of vanity. They don't want to look old. But if it helps keep you from falling, and helps keep you independent, you should give them a shot.
22
Also a shopping cart.
4
You don't have to buy expensive 'chains' for your shoes. Just glue some sandpaper on the soles. It will generally last for awhile.
Hint: Know the number of stairs between first and second floor of your house. When you're carrying a full basket of laundry downstairs, and can't really see in front of you, COUNT THE STEPS. If you miss one you'll probably take a dive = broken hip, or worse!
JimF from Sewell
12
Very good advice. I ALWAYS count the steps. I live in a split entry and am up and down the stairs like a yo-yo daily. (great exercise!). 7 steps and then 6 ........
2
I do that too. Also - I placed an astroturf of mat at the bottom of the cellar stairs as an textural reminder that that is indeed the bottom ( it has helped in electric outages, too).
5
The only fall I avidly look forward to is that of the Trump presidency.
133
President Trump is standing between you and the fall of the USA, Jay. And thank God that he is.
1
"President Trump is standing between you and the fall of the USA, Jay."
Good heavens, StandingO. Is that a joke?
5
Jane, if you would like a lesson in how to fall correctly, I invite you to join me my padded martial arts studio in Alameda. I am a certified trainer, a yoga instructor, and the Senior Safety Officer for the Alameda Fire Dept. Its the least I could do for you after all the years of great articles you have produced.
7
No mention many seniors are full of drugs B/P meds are the worst when rising causing dizziness . Now the medical profession is proposing driving down BP levels even lower, that means more drugs or more mg dosage.
9
To protect myself and my unborn baby son due in the icy month of December, I came up with the idea to carriy Kosher salt in a bag and sprinkled it (like rosebuds as I would describe it!) on any icy path I encountered!
Decades have past since my son's birth, but I still carry salt to keep safe on icy days, and recommend it to my coworkers due in the winter months!
It works!
10
Absolutely. As soon as weather gets crisp, I put containers of salt or ice melt in the passenger well and back seat floor. If necessary, I can salt my way to safe, dry land.
Another practice is to admit vulnerability & stay home if retired. Whenever snow or ice are predicted, I check dog & cat food supplies & head to the store for several days of fresh greens. Then the car & I go home, the car goes in the garage & I don't leave the house till everything melts.
22
One of the best parts of my recent retirement- watching the snow come down and know that I don't have to get on the highway to go to work at night.
My mother-in-law started falling in her 90s (which she kept hidden from us for a long time). Even after we knew about it, however, she refused to use a cane or walker because she never hurt herself (until she did). For some reason her falls would start with her feeling like her legs were just "crumbling." As a result, she would fall straight down rather than forward or backward. At least it kept her from getting hurt for quite awhile. When she finally did fall backward (fortunately in her carpeted home) and broke her pelvis, it was a simple fracture that healed on its own. But she used a walker after that!
2
I appreciate the intentions and reminders overall in this article, but I wouldn't try to learn to fall a certain way without getting hands-on guidance from a physical therapist. I twisted to my side instinctively during a sudden fall a few years ago and broke my shoulder. I now take many of the recommended precautions and am planning to start a conditioning program this year, as I have noticed that I am losing some muscle strength in my legs.
7
Recent article I read re. the benefits of yoga in maintaining muscle strength and balance in the older (that’s me, I’m 63) population. I have been going to a gentle yoga class about three days per week for the past six months. I love it, I’m more flexible, I sleep better and my core muscles and back muscles are getting stronger.
5
This is great. And a couple more here. Never, ever think you know your own house so well that you don't need to turn on a light to go to the bathroom in the middle of the night. Don't be shy on the street. Reach for a stranger's arm when getting off a bus or train if you are insecure - people are great.
18
Nightlights. Your friend.
4
Yes, I have a few nightlights - bathroom, kitchen, guest room - plus a couple of motion-sensor lights.
2
When walking indoors, always wear shoes or slippers with nonskid soles — not barefoot (unless you want a broken toe), and never just socks unless they have nonslip grips on the soles.
This does not apply to walking on carpets== avoid friction when walking on carpets and pick up your feet.
4
My relationship to the space around me, my balance, and my ability to protect myself has radically changed for the better since I became a student of traditional Yang-style 108 long-form Tai Chi. Daily practice has improved my health and balance. I recommend it to people of all ages.
14
I suggest googling something like "falls prevention" with the name of your local county or city. There are classes and tips available in many places.
Regular participation in exercise classes also builds strength, agility, and balance to help prevent falls.
3
Even in broad daylight when my stairway is easily seen, I make a point of turning on the overhead light before I start downstairs. It's a ritual I indulge to make me slow down, look, and think about what I'm doing. In my late 70s I can't take any chances.
11
I'm 70 y.o. I feel much more secure walking barefooted, and always do at home, even with the sometimes unwanted accompanying cold feet. I would walk barefooted outdoors if it was possible.
Maybe I'm an exception ( or wrong, but I don't think so ), but all my life I always felt more secure when on a ladder, being barefoot, too.
10
Yes!
1
Learning to fall is one piece of the puzzle, but practicing balance is a necessary part of self training practice. Balancing on each foot, arms at one's side, and arms crossed for 60 seconds daily can help address vertical balance issues. Standing near a wall helps make the practice safer. But practicing balance in other relationships to gravity is essential too. Hatha yoga practice addresses this need very well.
7
I fell getting out of the bath last March. My health (heart & liver) is pretty close to the cliff edge and man, that fall nearly pushed me clean over and then some - I landed on the delicate, swollen, liver. My muscles just aren’t strong enough to get up from lying down or sitting with legs stretched out now, especially in the narrow space of a bath.
Non of the alternatives work, the walls aren’t suitable for supports, walk-in baths just look flood-prone and shallow, so a remodelling of the bathroom with a better, walk-in, shower will have to do - I’d rather do without the expense or losing the bath (I loved a hot, relaxing bath), but it’s just not feasible these days. Oh well, I suppose it’s just a little thing in the grand scheme of things.
1
Hi Matt
I have the same problem at 75. I can’t get out of the tub anymore and loved a warm bath. I got a great shower chair from Amazon which fits in the bathtub. I have a hand held shower so I can safely sit and bathe and wash my hair. It is nice and warm and almost as good as a bath. I had grab bars installed all around the tub for support. I think the chair was around $44 and well worth it.
Good luck and stay safe.
9
On icy and slippery surfaces, use non-slip shoes/boots, take small steps as many have suggested. Keep hands free to navigate balance, and don't reach out far. The idea is to keep the center of gravity close to the body so you're not hyperextended and off balance. Inside the home, make sure that area rugs are flat and not wrinkled. Watch your steps, even inside, in case you might trip over an electrical cord. Be extra careful in the bath/shower. A fall there on ceramic surfaces can do you in. It's all about being aware and vigilant, anticipating that falling on hard surfaces can be deadly.
2
"Watch your steps, even inside, in case you might trip over an electrical cord."
When I read a similar statement in the article, I was puzzled.
In a million years I wouldn't string an electrical cord or an extension cord across a room. Cords carrying electricity should be safely lined against walls. Period. Doing otherwise is courting a fire.
(And for that matter, rocker switches on multiple-plug gadgets should be turned to the "off" position when you're not using an electronic component or television set, and so on. Anything that uses a remote-control device, particularly, is always on even when it's off. Why waste the electricity anyway?)
2
Very timely article. I am an orthopaedic surgeon and am treating injuries resulting from falls. As a child growing up in India - I did not see any elderly fall. Elderly did not live alone. They also acted their age - used a cane when appropriate for example. There was an additional factor - a broken bone if properly treated meant financial ruin (and still does in India). In US these are reversed. Many elderly live alone. Thanks to medicare, a broken hip is not the financial ruin, it is in other countries. Culturally, many US people are resistant to accepting a decline in their function which leads to poor decisions and falls.
12
Practicing balance/equilibrium exercises on a regular basis BEFORE you become frail/unsteady can make a great deal of difference. Prepare for old age while you're still young (early 60's) may go along way to decreasing falls as you age. Talk to your doctor or physical therapist.
6
Try to stay aware, particularly in the dark, of your pet's location. It's particularly heartbreaking for both pet and parent when it's the cause of a fall.
7
This reminds me that I read somewhere that one should stand on one foot while brushing one's teeth to improve balance. Maybe now I'll make that a New Year's resolution!
4
Don't walk with your hands in your pockets.
On a separate point, I appreciate the advice to roll as you fall. I once got tripped as I was rushing along a busy Manhattan sidewalk and went flying headlong into the traffic lane. Somehow my high school gymnastics training instinctively made me do a "back shoulder roll" which enabled me to get to my feet and out of harm's way just as the light changed. I had some bruises, but without rolling that fall could have been a life-ending event.
4
Watch out for ice under a thin layer of snow.
Make sure shoes (with any type of sole) have plenty of tread (like a tire) to avoid hydroplaning.
1
I'm 82, and a few years ago a trainer I was working out with gave me some information I wish all seniors had. He related how, in the course of our evolution, hands and feet were used for grasping. Then he showed me that it was hard to shove him to the side if he curled his toes (in his shoes) as if in a grabbing action. Over the years, when I felt I might fall, I repeated that action and regained my balance. The trick is remembering to do it, which, of course, brings up another common problem many seniors have.
6
What about falls which are related to hearing loss? In the US I believe many people go without hearing aids due to the high cost and lack of insurance coverage to correct hearing problems. Falls caused by factors related to hearing loss should also be considered.
4
Stop doing multiple tasks while in motion, especially while going up or down stairs. Ex. Do not hold coffee cup, last night's water glass, your e-reader and your car keys while climbing. It may have been OK at 30, but not above 65.
13
A good step to start with is simply taking falls seriously. Our society tends to regard falls by the elderly as a joke, something for a stand-up comedy routine. This makes seniors embarrassed to ask for help or take precautions. It also leads to dangerous situations in public where seniors are casually shoved or knocked out of the way, because it's not hip or cool to wait for a moment.
6
I had a woman say to me, "You have your nerve making people watch you try to walk." I figure her time will come.
6
Two additional hazards in the city are people sitting on the stairs in the subway stations, so the infirm cannot hold on to the railings, and people on the cell phone crashing a baby stroller hard into the person in front.
4
If you or a loved one suffered a fall and are homebound, you are entitled to a Homecare PT visit for a fall risk/safety assessment. Ask your MD for a referral. Usually the visits are 100% covered by Medicare. It does help and I ask for it frequently for patients. Falls lead to many issues from decreased mobility. The 'hazards of immobility' were one of the first things I learned as a nursing student in the late 70's. And it has never changed.
You can also call your local hospital outpatient Physical Therapy department and ask them about balance training.
21
There are less expensive, more effective means than seeing a physical therapist to prevent falls. PT’s are paid more for when they see you after you’re hurt so that is where their incentive lies. If you are involved in a regular exercise program, your personal trainer can help you just as well for a lot cheaper.
1
At the age of 78, my father used a narrow highchair to get up on the kitchen counter -- with his old, slick slippers -- to change an overhead lightbulb, something he'd done many times before. It was 11pm and he had visiting family in the house. When he tried to step back onto the chair, it slid out from under him and he landed with a thud on the floor -- he broke his back. Unfortunately, he did everything wrong, and this otherwise smart and cautious man couldn't believe what had happened to him -- he lived with great pain for the next eight years. When they took him off Coumadin to give him yet another hydrocortisone shot for the pain, he got a blood clot and suffered a fatal stroke. If only he had not taken that risk!
25
Sit down on the kitchen counter, and then lower yourself to the floor. Even if the highchair doesn't slide, you probably cannot see where it is, and may tip it over by stepping on it off-center.
2
Stay off kitchen counters...
2
Also, don't walk with your hands in your pockets. Your balance will be better, and if you do fall, you might avoid hitting your head if your arms and hands are free.
34
Pick up your feet! Give up your high heels even your not-so-high heels.
Curled up on the couch with a blanket, the phone rings. Do not spring up and trip over the blanket.
22
Blankets!! Been there, done that. Fell right into the baseboard. Callers can leave a message if you can't get to your phone in time. Or keep the phone with you.
There is an error in the amount of gun deaths listed in the article. There are 32,000 gun deaths per year so falls, according the text, would be thre times that.
6
Thank you Jane for this very useful information.
7
A cane or hiking pole on slippery slushy sidewalks is immensely helpful.
9
Practice getting up from the floor! In addition to trying to prevent falls, also make sure that you can get up from the floor using either leg. You can practice this at home in front of a chair. First get down on the floor, slowly, on either your right or left leg. Then get up again using the same leg. You should be able to get up without leaning on anything, but you may need to work up to this; you can lean on the chair at first if you need to, but if you fall outside there may not be anything close to lean on.
Once you've gotten down and up on one leg, do it on the other leg. Ideally, you should be able to get down and up on both your right and left legs without leaning on anything.
38
Ah, yes, getting up off the floor. As I turned 70 I realized I could no longer do that without agony... and at 70-1/2 I realized I could not get off the floor on my own. Stuck down there staring under the couch at dust bunnies and lost cat toys!
Until that moment I'd never seen myself as one of the old ladies in the ads about "I've fallen and can't get up!"
Total Knee Replacement #1, four weeks ago, has made me able to rise and shine once again, and I'm eagerly awaiting TKR #2!
17
Easier still, come onto all fours, get your legs under you and rise up safely.
3
After suffering a couple of falls that happened so fast I had no time to react, I started doing exercises to improve hand-eye coordination: playing jacks, juggling 2 balls, bouncing a ball on a tennis racquet, etc. These simple activities greatly improved my ability to react. Also, since I started getting in my 10k steps a day, I feel much more sure-footed.
28
When I travel, I have gotten in the habot of bringing a nightlight and a rubber bath mat with me.
Although a number of hotels have them, the majority do not.
25
Is everyone aware that iPhones have a built-in flashlight feature? Great at night, for reading menus and shopping in dark stores.
11
I travel a lot with my mom who has mobility issues. When booking a room, I always ask for a room that has a shower for her. The sides of tubs can be quite high, If the hotel doesn't have a room, I'll find a hotel that does. I'll pay the extra bucks for a lot of peace of mind.
6
Motion activated LED night lights are great for those nocturnal excursions. Most people have enough strategically located outlets that they can light the entire path to the destination (usually the bathroom), and that destination can be lit enough to allow safe 'hurrying'. Older eyes also take a while to recover from the blast of overhead lights in the middle of the night...
I can walk throughout my home at night and see the floor at all times.
3
If you need a cane, have an instructor teach you how to use it and practice.
7
What, no "walking around the house without wearing a properly fitted helmet is simply stupid"? There are more head injuries from falling at home than from a bike, and helmets would surely help. Yet you reserve your scolding only for cyclists? https://www.nytimes.com/2017/10/23/well/buckle-up-a-helmet-to-save-a-lif...
1
Yes yes, you can do all this when you are outside but what happens when the obnoxious jerk, or unsupervised child, or biker on the sidewalk cretin, or the just oblivious on their phone person runs or smashes or does a full body slam right into you? That's what I run into in the rude place I live.
13
I was kneecapped by someone else’s dog 14 years ago. Even after extensive PT, rehab and surgery, my knee has never been the same. But I don’t regret that I owned a dog or that I took him to an off leash dog park, where my accident happened. We have to live.
6
@eve, Push back hard so they take the fall, not you. It's self preservation.
2
I learned to fall 40 years ago from an Olympic judo coach while taking aikido in Connecticut. I am now in my 70s. My body still know how to fall, and the old lessons still work. I have been launched off horses more than once unto the hard road, and fallen on cement, all without getting hurt!
Falling forward, one should land on one's forearms, not ones hands. To do that, keep your hands in line with your forearms. If I am worried I might fall, I put both forearms up in front of me and resist the urge to land on my hands, even if it means I have to fall a little farther before hitting the ground.
New gadgets in the home are useful if you do fall: Google Home or Amazon Echo: you can dial a friend or relative with just your voice, even if you have fallen on the other side of the room. I also use the Samsung Gear watch so I can dial for help outside. My problem is not getting hurt while falling, but my knees kill me when I try to get up!
10
Thank you, Mary. A good use for Echo!
2
Tripping on a crack in the sidewalk in a small Maine town last year (well, I wasn't looking), I flew several yards forward, as if I were flying, and did a beautiful belly flop, hitting chest, stomach, hips, and arms all at once. Not a scratch. Not a broken bone. And no aches. Gosh, was I lucky.
(Lucky, too, that I thought to keep my head up and not land on my face.)
But I have to say, for one moment as I was sailing through the air, I felt very young, the way I felt when I used to launch myself into a swimming pool.
What about a helmet? You recommended using one for bike riding. Why not for falls like these?
One of the best things one of any age can purchase and use during icy-slippery conditions are "Yak-Tracks." They are inexpensive and available at Costco and elsewhere, and they fit easily over your shoes and aid in giving traction. They are indispensable when hiking in winter conditions as well.
10
After 15 years walking dogs off leash and off trail, I prefer Kahtoolas to yak traks.
1
The online version of this article is sponsored by Wirecutter, which has a review of "nonslip traction devices" even though the article makes no mention of them during the slickest time of the year. I swear by Yak-Tracks and I'm pretty sure they're about as good as competing products. The important thing to remember about them is that they're only good if they're used. It's easy to get complacent and risk short trips up the driveway without bothering to put them on. The solution? An old pair of shoes by the door that always has them on and is therefor always ready to go!
4
Every year I read a similar article from Ms. Brody. I am always upset by her repackaging of the same cookie cutter approach. I am a physical therapist who specializes in falls prevention in the elderly. Falls occur due to
multiple reasons in the elderly including but not limited to diminished strength, diminished flexibility, diminished sensation, diminished vision, poor motor control, deconditioning, and most importantly, lack of balance skills. As a persons balance becomes worse they move less to decrease falls risk, but this leads to further erosion of balance skills and worsening of falls risk. The treatment depends on what the fall is due to. BUT THERE IS TREATMENT. Cookie cutter columns such as this lead to the mistaken assumption that that there are a few simple things to do rather than seeking out a practitioner with appropriate training In evidence based interventions. If you have balance issues, I urge you to see a PT with specific training in balance and fall prevention.
Herb Karpatkin , PT,DSc
Assistant Professor
Hunter College Physical Therapy Program
97
Agree that Ms. Brody can be repetitive, especially for those of us who have read her columns over the years! But we notice that you give no advice! Additionally, it doesn't escape us that you obviously have a vested (Money!) in folks going to see a PT, beforehand!!!
2
My grandmother’s non-skid bath mat slid out from under my foot upon entering the shower, resulting in me clutching at the curtain, taking down the shower rod, and clanging hard into the tiles. Turns out the same thing had happened to my sister on her visit, so be careful with those mats!
15
Another safety tip: if you must have small rugs, recoat the nonskid surface regularly with liquid rug latex. A small bottle, available widely online, will thoroughly cover the back of two average size bathroom rugs. I did this recently with two of mine and they don’t move at all with the fresh coat of latex.
8
Bath mats are not slip-proof though they give the sense that they might be. I too have learned through first hand experience, especially if you step on them at an angle when entering the shower, and the whole thing slides.
When I was in 4th grade I sprained my ankle and thereafter kept spraining it. After the 2nd time of twisting it I just started to fall when the twisting would even begin and fifty years later I still just fall straight down. Knowing the dangers of falling from an early age I visualize being in a motorcycle wreck and how to get out of one unhurt. I've been successful twice.
Now that I'm past 65 I know I'm not young anymore, don't have the strength or reflexes of my 19 year old self, and add to that, the fact that an older brother died due to a fall, and I play around with ideas as to what to do should I have another fall. I now wear bicycle and motorcycle helmets which I never have done before, have bars and slip mats in the tub, and preach the "expect the unexpected" to my wife who is usually immersed in the nature around her as she rides her bike. She has broken both her ankles in separate accidents involving leaves and sliding.
My father taught me to always "expect the unexpected" when teaching me to drive when I was fifteen. He'd say, "that car down the road coming towards us; the driver is elderly and he just had a heart attack. What are you going to do; where are you going to go? right, left, stop, speedup? Quick, what will you do?" It's helped me more than once having him whisper that into my ear as I start to slip into a moment of distraction.
As an aside-how many people have fire escapes where they aren't mandatory? Choice-Death by fire or a rope ladder?
7
What a wonderful lesson your father taught 15-year-old you. Thank you for sharing it.
5
"I now ask a tall customer (or store clerk) to help retrieve a grocery item on the top shelf,"
Consider whether asking a short customer to pick something up off the floor for you sounds like a good idea the next time you're inclined to do this.
Why assume just because someone is tall they can easily lift their arms above their shoulders or feel like being enlisted - often without option - to fetch things for you.
It's a rude, unsolicited comment about a person's physical traits and an unwelcome assumption that you have the right to a stranger's services just because.
Try finding that clerk - it's their job to help.
6
Chill out May, it is not rude. People have asked me to help reach something and I am 70, not easily insulted. Glad to help!
6
Just 3 days ago I was asked to reach up to the top shelf at the grocery store to get something for a much shorter woman (I am on the tall side)!
It was my pleasure to help her get those 2-liter bottles of Fresca.
I am thrilled to be healthy and fit enough to give assistance. If someone asked me to bend down and pick something up for them, I'd do it happily.
I'm used to being asked; I don't mind one bit.
7
Ouch. I'm tall-ish. I don't mind at all when people ask me to hand them something from the top shelf. And it happens all the time.
I'm sure there are plenty of us taller people around. Unlike trying to find a clerk, who, due to precarious employment, aren't even on shift.
3
1. Ladders are forbidden.
2, Get rid of small carpets, the kind used in halls.
3. Put a grab bar in your shower, just outside your shower, and next to your toilet.
4. Watch out for water splashes next to your refrigerator, the place where you fill drinking glasses.
5. Next time you paint your front or back steps, sprinkle some sand on the paint while it is still wet.
6. Make sure no kitchen grease lands on the floor by your stove. Don't delay; clean it up NOW.
I am 90; my wife less so, but not much. She suffered lateral fractures involving her pelvis when she tried to transfer from her walker into her wheel chair...when the brakes were not set. THINK.
40
I recommend a grab bar opposite the toilet for a pull forward and up. If your bathroom configuration allows.
2
Studies have shown that visual impairment due to cataracts are an important factor in falling in the elderly. Post cataract surgery decreased the incidence of falling.
19
I am not sure about the recommendation to take small steps on slippery surfaces.
That way one tends to keep both legs close together and the body is supported by a very small surface. I am more for taking a wide stance with the toes pointed outward, a bit more like rollerblading.
3
I practice standing on one foot. after I first started have noticed great improvement in balance. but what can help if youre the type who stands on the edge of the bathtub or a lower shelf to reach a higher one? youre lucky youre still around!
10
First, put that phone in your pocket on stairs or outside. You will need that arm and it won't be available in a fall. Second, learning to fall works, ask any older skater, gymnast etc., but the skill isn't going to be learnable once you're too old to practice real falls. Doubt that visualization helps much. Third, your hands are needed, and vastly better to injure than your head or hip. Just don't stiff arm the ground! Fourth, backward falls, as on ice, are both very fast and dangerous. Muscle memory to turn sideways is your only good chance, at least until your wearable air bag becomes available! Fifth, and personal experience here, a walking stick, ski pole or anything with a wrist strap can rip muscles, tendons in even a mild fall. Downhill skiers learned this half a century ago, but the news didn't travel. I lost a tricep last year when I had a standing still X-C fall but my ski pole didn't let go.
5
Ms. Brody, please write an article about positional vertigo! I woke up with it one morning and was SO lucky I knew what it was.(My sister had had an episode.) Otherwise, it would have been terrifying rather than just frightening! Please consider doing so. Thank you.
9
Look up the term "Epley Maneuver" and follow the instructions. The problem is within your ears' tiny mechanism for balance.
3
a light on the bexroom and bathroom is a must. older people stay balanced with their eyes
1
Add to the list of things that can trip you in your home: pets. A dog jumping around or a cat rubbing against your legs will send you right over. Love my kitties, but there is a good chance that they will get me killed one day.
PS. Anybody know where I can take one of those "learn to fall" classes?
20
My cat is blind and hovers practically on my feet as I prepare her meals. She sees only a sliver at the bottom of her eyes. A few near-misses and now I look down at my feet before I walk to place her food dish.
2
Most states have a senior citizens kind of clearing house. If you can find it, ask them they may have suggestions. Also, almost all states have lists of "senior citizen centers" where people play cards, get together, etc. Call one or more of those and they may have resources, maybe your "Y" could help also.
2
sjs, try youtube.com
Search for how to fall
2
I've worked out a couple of handy solutions for walking on ice: Pull a pair of socks over your shoes. Alternatively, unroll a couple kitchen mesh scrubbies and pull them over your shoes and secure them. I get about a mile out of them.
3
Some falls are actually the result of minor fainting spells in the elderly. If the fall is unexplainable please see your doctor. My mother in her nineties was very active and walked without a cane or walker. She had several falls that she attributed to “tripping” or slippery shoes. It turns out her heart was stopping and she was in need of a pacemaker. Unfortunately that was only determined while she was in an ambulance after a bad fall in the bathroom where her head hit the tile and she suffered a traumatic brain injury. She recovered but required a stay in the hospital and then a nursing care facility until she healed. Best to have unexplainable falls checked out.
23
Wearing nonskid shoes is great but watch out on carpeting! My office redid the floors and the first day the nice new carpet was in, my snow boots caught and I fell, hitting a solid oak desk and fracturing my left humerus.
10
I also trip on carpet. The fronts of my shoes catch.
2
I know how to fall, but don't want to. After having to stay in the house for 24 hours because of ice, I just bought some Icebug boots online. I thank you, and so does my dog, who is missing her walks.
7
Are the recommendations that are made evidence based? The only one that seems to be is the recommendation to maintain physical strength and balance, which is supported by a study of Canadians.
7
Common sense! As PT who hears about falls after they happen, it is usually standing on a chair, tripping over a pet or extension cord, bad footwear,etc
2
I’m 67 and try to do most of what is suggested in the piece but I also still skateboard, surf and ski.
It’s good to do activities you’ve always done where you have to keep your balance.
6
Wiping up even small spills is good advice. A spot of water on the bathroom floor, not more than the size of a quarter, sent me flying. I landed on the side of the tub, cracking two ribs.
11
to prevent falling one must exercise one's balance and reflexes daily. there is a very simple way to do this. whenever you are standing still -- waiting in line at the grocery store or post office, or at a cross walk -- stand on one foot and balance. switch feet. do this everyday. make it a part of your daily routine. I stand on one foot while baking or cooking, etc. I also play hacky sack, solo. two or three times a week to keep my reflexes sharp. I'm 60 and have been doing this onefootbalance for about ten years and after a while you will notice that your reflexes become very sharp., so this will be my preventative routine for the foreseeable future.
53
FALLS Are one of the greatest causes of injury and death in the US. Especially among seniors. As a Senior Boomer, I can tell you that if you think falls are something that happen to somebody else, think again. We try to keep things from cluttering the floors of the house, to dry slippery surfaces and to plan carefully when reaching for something that's in some place high. Still, there are minor trips and falls. We're far more cautious about going out in inclement weather than before, gauge the weight of packages we have to shlep in from the car. And try to do stretching along with some exercises. It's difficult for those seniors who become forgetful to plan for safety. So family, friends and community can help. Whoever said old age were the golden years was way off base.
11
I've known three young and healthy people who have broken bones from falls on ice. I strongly recommend to everyone who walks in snowy or icy conditions to get boots with outsoles designed for ice, like Vibram's Arctic Grip. My wife and I both have boots with Arctic Grip soles and they are so much better than regular rubber treads on ice. They also can be worn while driving and indoors, unlike traction devices. In icy conditions Yaktrax and Stabilicers are better but much more inconvenient for brief trips outside.
7
I might suggest that businesses ask an old lady to take a walk around their premises, including out to the parking lot. At night.
I recently took a pretty hard fall at a commercial business, on the sidewalk leading out to the parking lot. It had completely inadequate lighting, and the sidewalk was uneven. The next time time I was there, I told the owner's son, and he listened carefully.
19
Great suggestion -- virtually all businesses should be willing to participate with you in things like what you suggest. As a lawyer, we call these cases "slip and fall" and they are the bane of virtually every business/
Personally I am always straightening carpet by the entrance or picking up things lying on the floor. Great suggestions and sorry for you fall,
8
I try to stifle my impuse to sprint up stairs eagerly... focus, slow down and plod... this is because of the many times I have caught my toe going up... also focus on holding, really holding, a rail going up and down...
All this after a visit East when four - four! - of my friends had suffered grievous injuries in innocuous falls, although I suspect alcohol was involved in at least one... another area that merits precaution...
14
Collagen, the structural protein whose absence causes wrinkling of the skin as we age, is, I believe, one of the culprits in the increase of falls by older people. Pay attention, be aware and don't take stupid chances for sure, but those ligaments and tendons don't work the way they once did because collagen, the queen of flexibility, is decreasing in them.
2
I'm a life-long jogger, and around age 50 I started having a few incidents where I fell and hit my face on the pavement. This really unnerved me, not only from the pain and injury but also because when I was younger I tended to fall better when I did fall, and not get injured. I not only didn't want to hurt myself this way, I didn't want to become afraid of jogging. What I did - which maybe didn't make a lot of sense - was do some resistance training, reasoning that maybe with better upper body strength I could catch myself better and not smash my face. I think the best part was that it made me feel like I was doing something about it, and of course a bit of upper body strength never hurts. Anyway for whatever reason, I stopped the face-plants and am still going strong at 66, so maybe it helped after all.
9
After a very hard fall on an icy driveway several years ago, I found cleats & spikes at LL Bean for about $20. I have 2 sets that permanently stay on 2 pairs of boots by my door. This morning they were a godsend, as my driveway way covered in ice when I went out to walk my dog. Taking short baby steps on ice also keeps me on solid footing.
Being aware of one's surroundings & possible hazards is essential to one's safety.
16
"Nearly three times as many people die after falling (some 32,000 a year) than are killed by guns in the United States. " I don't understand the numbers here, about 32,000+ die every year in the US from guns, so is this a typo?
20
This is just wrong. I am not anti-gun but I hate incorrect statistics reporting. The New York Times reported in November on the CDC report of 2016 deaths from guns, which I'm sure is going to be higher for 2017 given the number of mass shootings, and they said this exactly "More than 33,000 people die in firearm-related deaths in the United States every year, according to an annual average compiled from C.D.C. data." Weird they would say three times more die from falling and give that number at 32,000 a year. Maybe they weren't comparing the same years! Anyone can make stats lie but this is just bad. Good catch James. Otherwise I likely would have just read it in amazement about falls being so deadly.
2
Nothing to do with falling...why are the vast majority of health stories illustrated with pictures of white people? It's really tiresome.
63
The pictures mirror editorial content and outlook. Think institutional racism unconscious bias.
7
That's an interesting point and one that I haven't thought about. Would you feel the same way if the vast majority were illustrated with pictures of black people?
1
I learned falling in Aikido and similar martial arts. The other day I tripped on something almost invisible (at night) while to a bus. I fell, rolled and stood. Of course the 20 year olds waiting at the stop were half panicked, concerned, etc., etc. I assured them that all was OK.
A few years ago, I took my son to his Judo class with him seated in front of me on the bike. We crossed (on the bike, not walking) in the cross walk when a young driver decided that for her, the red light was an optional suggestion only. She slowed but did not stop, bumped us, crushing the front wheel, and sending my (then) 7 yr old son flying. He hit the ground in a perfect Judo roll and stood up, uninjured.
There are ways to fall; it is not hard to learn (but is harder with age). It should be taught in every gym class. It is also good aerobic exercise.
39
Exactly...at what age does it become dangerous to actually practice falling rather than just visualizing? I have to believe visualizing is a very weak alternative.
6
I had a similar experience, years after I had stopped practicing aikido. I started to slip while walking down a wet incline and knew I couldn't stop the fall. I twisted as I fell and landed on my back with my arms and legs spread out to absorb the impact. I got up slightly damp but unhurt.
I tried to get my gym interested in starting a class on how to fall safely for seniors and soon-to-be-seniors. It never got anywhere, but I'm pleased to see this idea is being taught elsewhere.
7
Thank you for a great article. I have treated many people over the years for injuries sustained by falling, and most were preventable by the excellent advice you have presented!
8
Icebugs have the cleats already embedded in them, and they're much more effective than Yaktrax and other versions that you have to snap on over your regular shoes. They make many styles, including a front-zip version that's easy to get your foot into (unlike many boots) and makes them easy to put on and remove. We don't generally wear them indoors, but they don't mark our hardwood floors.
8
Good article.
To focus on maintaining physical strength, I would add that it's particularly important to work on your core. I once tripped on a brick-lined pathway (Philly is filled with them), but was able to prevent a fall by relying on my core to keep me upright.
7
I am over 70 and I am more
prone to falls now but I always considered myself a little clumsy. I used to trail run and still ski and hike. So I have been falling my whole life. Based on this experience, I take issue with not using one's hands to help break a fall. Landing on a shoulder can cause serious injury. I think the best advice is to go with the flow of a fall and protect your head and face while falling. Doing so will most likely involve using your hands and arms to help break your fall.
11
Thank you, Jane Brody, for this especially important advice. I have been reading your columns for a long time, and even once heard you speak in person in the Detroit area. Please continue to write and give lessons on health and well being. I appreciate your good words. Carol, 75.
9
A fall after a certain age is almost always catastrophic, life-altering. Have a stick handy, always -- one in the car, one in the house, one in the garage. My son gave me one years ago, when I was a lot more steady on my feet than I am now. It's designed like a ski pole, with a strap so you won't lose it and a point on the end so it's steady in snow or fallen leaves or soft earth. I've since aquired a couple more, and use them all the time, out here past where the sidewalk ends. And yak-tracks. Get 'em. Use 'em. Multiple pairs, one in the car, one in the house, one in the garage.
4
The stick is a good idea. I use a cane when the weather is bad and the surfaces are slippery. I don't really need it, but it does give support. And people do tend to slow down for someone with a cane.
8
I have had to not use my cane while on public transit. It made it much more dangerous because of the rude people who are running or pushing etc. My cane became yet another unsteady thing that could be knocked and then a fall was guaranteed.
2
I checked these walking sticks out on several web sites, especially Amazon, and there were many, many models [many of them collapsable to be able to put in a purse or knapsack and most importantly almost all of them were 1/2 or more less than a regular cane.
2
Last winter I fell on ice while walking across a parking lot. I broke a small bone in my right wrist and it still hurts when I work it too much. This winter I am one of those people you see driving around and around the parking lots looking for a spot right next to the door.
4
Minor point here. A quick Google search showed that 33,000 Americans died of gun related violence in 2016. So about the same as the the 32,000 who die from falls.
Reviewing fall prevention training online, a physical therapist modeled falling in a graceful twirl, spiraling down to a soft landing. I have tried that on my mat, and if I were that coordinated I would not be falling in the first place!
7
I learned to fall when I was in a hospital for 4 months with some weird problem which among other things caused me to lose 66 pounds and become incredibly weak. In spite of the hospital's protections and admonitions I managed to fall at least 3 times.
I don't know why but apparently I had taught myself to fall the right way -- like your PT person. The best I can recreate it is to as you start to fall, go as limp as possible, try and let your knees collapse, and let your body do what it seems to do naturally -- that kind of twirl as you go down. You only use your hands when you are a few inches from the ground, to try and let your head down easily. all movement is as not stiff as possible.
Regarding the aikido/judo roll -- as much as I loved, loved, loved aikido -- in my 20's and in great physical condition I pulled my shoulder doing a roll, didn't get physical therapy for it, and believe it helped lead to humungus TMJ problems down the line. I still support kids learning how to roll, but I doubt most older people could do it successfully.
2
My mother died as a result of a fall. She was donating a table to her local Jewish community center and carried it in by herself. She had to go through an in-progress exercise class to get to the donation area, was bumped into by an exerciser, fell, hit her head, got up, delivered her donation and went home.
It turned out that she had bleeding in her brain and after a few weeks ended up having surgery. Twice. She died the morning after she was released from the hospital from an embolism. She was 74. Active. Engaged. Healthy. Exercised daily. Ate well. Was living well.
I learned how many people die in just this fashion. Now, at almost 62, I am conscious about my shifting balance. I do yoga with my eyes closed to train my brain to "feel" what upright means.
36
Joanne, I'm so sorry this happened to your Mom -
your comment & suggestion " I am conscious about my shifting balance. I do yoga with my eyes closed to train my brain to "feel" what upright means."
is great for anyone esp. those of us over 60-
however, one should always practice with a chair or next to a wall if you are closing your eyes while balancing (on one leg for example)
! it is never too late to practice Tai Chi, Yoga, Qigong, etc. for balance, stability and flexibility as we age. Practice with awareness + mindful breathing- Thank you for reminding us! Stay peaceful & healthy !
7
I had a horrible relationship with my mother...so a release of sorts when she died so unexpectedly.
My home is not large enough for me to practice yoga without being near a wall or a chair : ). Hence, I do it everywhere and anywhere I feel compelled to stretch and do Sun Salutations.
My mantra for LIFE is BIBO (breathe in, breathe out) and SMILE and practice both every minute of every day. I also believe in KISS -- Keep It Simply Simple. d
Hence, one life long yoga practice is perfect.
4
I know two people who had bone breaking falls from people bumping into them. I sprained my ankle when someone grabbed my arm as I was walking past them. It's so important to watch out for the movement of other people, they can be a real hazard. People tell me that using a cane tends to caution other people to give you space.
I notice that, when I use a cane, people treat me differently, more carefully.
5
Remove hair conditioner from your shower!!. It leaves a greasy coating that is super hazardous. After several near slips in my 20s it took a sudden slip and three broken ribs after slamming down on the side of the tub before I got the conditioner out of the shower. Luckily I didn't fall backwards .
27
Get the bathtub/shower mat recommended here. They stick to the tub but have a nubby irregular surface that gives you a non slippery surface.
1
I always use conditioner and notice that it leaves a slippery coat on my non slip bathtub mat.
I now hose it off, adjusting the hand held shower nozzle to a hard stream and using the hottest water.
2
I switched to the leave-in hair conditioner partly for this reason.
Although I am active and healthy, two falls where I broke things has made me a bit fearful of falling when the ground is slippery. I fell on unseen ice on a 'spring is in the air' day 15 years ago breaking my radius. Then 3 years ago, I fell on a wet floor at work (early in the morning & custodian neglected to put out the 'wet floor' sign) - compression fracture of the spine, painful though I didn't go to the doc for a week (I have back pain always and just figured nothing was broken since I got up and went about my business). Neither fracture left lasting effects other than a sometimes achy wrist.
Still, I am more fearful than I'd like. I don't know how one overcomes that...
15
Hi Anne-Marie -- my best suggestion is practicing being conscious of your surroundings [and I don't mean that in a snarky way.] I'm 71 and not stable, although until recently I was. I noticed that in the last year or 2 I have [at first unconsciously] and now consciously noticing very closely potential trip and fall hazards from my instability, in my house and while outside.
Its a "learned behavior" and also if you know you are learning it, maybe your fear will ease up -- which is also helpful.
It also sounds like it might help you if you took one of those how to fall classes, mentioned in several messages and replies in this chain/ Good luck and keep breathing!
5
Muscle memory is powerful and effective.
We do fire drills monthly at my school so all of our muscles know how/where to get out. That way, if there's a real fire and everyone is freaking out, our bodies at least will remember the way to go.
If I were older/elderly, I really would practice falling in super-slow motion repeatedly (like daily) until my muscles learned what to do without me telling them. Can't hurt.
19
A good way to practice falling is to take up cross country skiing. It's fun to fall down in the snow.
11
....as long as someone is around to help you up! :-)
6
For my 92 year old father-in-law we purchased a "couch cane" that provided the perfect support for both rising and sitting from his chair. He had several falls from both trying to rise and pitching forward and sitting and missing the arm rest. The cane provided that essential middle pivot point for both the up and down actions. Now with the device, this has minimized the falls as he uses it to steady himself from chair to walker.
13
A fall or concern about the risk? First have your neurological status checked....reflexes, balance and so forth......and either get a blood B-12 level or, if over 65 or on anti-acids start prophylactic oral B-12.....Harrison's Internal Medicine suggests a dose of 1000mcg. per day. If your nervous system is deteriorating for lack of B-12 or folic acid ...all of the routine preventive measures can only help partially. Older folks progressively have less acid in their stomachs which is against normal B-12 absorption from food.
26
After I'd fallen three times in one year I went to see my doctor. She did a B-12 test and found I had Pernicious Anemia and my body wasn't absorbing vitamins from certain foods. I began taking B-12 shots and within weeks I felt normal again. I encourage anyone over the age of 60 to have their B-12 checked if they're feeling unsteady on their feet or experiencing brain fog. It's a neurological condition that will eventually kill you if not addressed.
6
In the bathtub/shower the use of hair conditioner can make for very slippery surfaces.
15
It also can coat your hands and limit your ability to steady yourself against a wall or bar,
1
. So true about the conditioner making things slippery. I have taken to putting my towel on the edge of the bathtub to provide a grip to help me get out
Shower chair and detachable, handheld shower head. That way you can sit down while applying and rinsing the conditioner, and then you won't fall. Shower chairs are a godsend for the mobility impaired.
Thank you, but I doubt if I can remember your advise on how to fall gracefully, when it happens. I am 70 and have a hard time remembering my family members first names.
15
It seems to me that if you fall forward to land on your side you are more likely to break your clavicle. I'd rather risk my wrists.
1
Without regard to breaking preference, in my experience - falling to the side results in fewer injuries.
5
Our biggest falling risk is our cat!
50
Put a bell on your cat, and a glow-in-the-dark or blinking-lights collar
10
Fall on your side instead? Maybe if you are 30. If you are 75, the chance that you will snap that hip and never recover your mobility is much greater, and the loss of mobility places people at a higher risk of life-changing (or life-threatening) sequelae than those from a broken wrist.
As an occupational therapist, I have treated older patients with both injuries. I know which ones got their old lives back and which did not.
Not falling at all is the best solution, and the risk of falling rises significantly after 80. There are plenty of things people can do to minimize their risks, and this article highlights many of them. What it doesn't do is separate the "well-elderly" from the "frail elderly". If you or your loved one is in the latter category, working your way down each strategy should be at the top of your to-do list. Right now.
39
Generally, in a fall to the side, the hands, arms and ribs hit the ground before the hips. Meaning that the hip has less impact to deal with.
1
I recommend a sedan chair or a palanquin, depending on income level.
88
The bearers might slip.
8
It may be fun to joke about falling (and the many people who recommend this obviously think it is), but as one in her eighties who has survived three falls (with luckily only one bad result, a broken leg), done because of doing something stupid, I just heartily recommend this article—and not being stupid.
Three winters ago, I slipped on a patch of ice hidden by newly fallen snow -- and broke my right wrist (and I'm right handed). And I was wearing boots with non-skid soles. Friends of mine who run outside all winter long recommended YakTrax -- so my husband went out and each bought a pair the day after my cast was put on ($20 and $30 per pair). We love them! Though they slip onto my boot soles fairly easily, I tend to leave them on one pair of boots, and I use them when clearing snow (which can be slippery) and when walking on icy sidewalks and drives. I can't drive in them, though, or walk inside with them. But they're easy to take off.
26
I fell on the ice and broke my right wrist 9 years ago. Soon thereafter I started wearing LLBean’s Stabilicers to walk my 20 minutes to work and back on snowy/icy winter sidewalks. It makes my walks a pleasure and I can even daydream as I walk. Just don’t wear them inside anywhere as you will likely slip on store tile. But they are easy to take off and on, and quite transportable.
9
Same thing happened to me - and we have found that MicroSpikes are much, much better than YaxTrax - which tend to roll instead of grip. But glad you love yours.
1
What does one do when one's senior parent refuses to stop climbing on the roof, and insists upon continuing unsafe practices such as placing a chair upon a bed and climbing on that to change a light bulb in a high ceiling? When one expresses concern and a desire for said parent to change said practices, said parent becomes angry. What should one do?
18
If you can afford to, preempt. Get the extra long-life lightbulbs and have a handyperson come change them on a schedule; could do that one yearly, and reuse that bulb if still good in an easier-to-reach fixture. You could give roof/gutter maintenance as a birthday or dad's day gift, perhaps; again, using a handyperson if you aren't one yourself. "Louise needs the work" or "I need to learn how to do this now, when you can coach me" are good excuses.
60
If possible [and its not easy] pay [if you can] for somebody you and parent both like or will tolerate to come in say.... 3 hours a week to do much of what parent is doing that's dangerous.
If no money to pay for this, check with your state elderly affairs office and/or local church organizations looking for the same kind of help.
Communicate using the "mom, I would feel really bad if you got hurt, will you let me help versus "mom --"DON"T do it that way its not safe.
Don't nag, people who are aging [like me at 71] can be very touchy about losing abilities.
Go to a store [walmart, hardware, whatever and check out very light weight, easy to open, easy to stand on bottom step, 2 step folding step ladders. You have to look around, I have arthritis and can't move around most of the step ladders made these days but after much searching [and having a friend's model as an example] I finally found one. [they're usually $20 roughly]
Again if money or time to look are issues try to find a church/senior citizen group of some sort -- somebody may have a spare or one they no longer need.
Above all -- good luck and hang in there. and -- I know you care.
4
I think we have to accept the choices our adult parents are making - they've lived a long enough life to be able to foresee consequences for actions, no?
1
The most useful things for our unsteady elder have been adding a potty chair next to the bed for nighttime (with easy change superabsorbent liner); adding a floor-to-ceiling grab bar pole when there was no wall for a regular grab bar; a wearable emergency button; house keys doled out to all the neighbors; daily exercise; a couple of gait belts to make it easier for helpers to help; and shorter bathrobes/nightgowns, so they never drag on the floor. If we had a better bathroom setup we'd add a sliding bench, which allows a person to sit down outside the bath/shower and slide on in instead of trying to step over.
Before we got to the point of needing a walker, we found a tall walking staff more helpful than a cane. And lots cooler, for those elders worried about "how will it look?"
We also had a physical therapist who taught the elder (and us coaches/helpers) to pick up the feet and walk heel first instead of shuffling; put out a hand for the seat of the chair when sitting down; and how to properly get up/down at least some stairs with a walker.
A lot of these things cost. I feel for those who can't afford them.
89
Preventive and helpful devices can often be found second hand at an inexpensive price. Try your local craigslist.org or yard sales.
2
Check with your local department of aging. Around here, they will send someone to do a safety audit of the home. make recommendations, and then install grab bars, railings, transfer seats, etc. using a sliding scale for payment based on income, from practically nothing to full cost of materials and a minimal labor charge. They also offer assistance, using the same sliding scale, for routine household maintenance such as cleaning gutters and installing and removing window air conditioners at the beginning and end of the season.
2
Shoes with reasonable tread prevent pain at any age. I fell on pine needles in a sloping driveway wearing slipper like shoes from an expensive store - I bruised the ligament that runs the length of th sole of the foot. Very painful and took months to heal. Check your shoes!
13
The best prevention is to remain active and more than an occasional class with a physical therapist, consider yoga or pilates twice weekly. Pilates has given me back balance and greatly diminished falls and is fun.
78
Tai Chi.
L&B&L
4
Be aware of secured items around you that you can grab, and avoid ice, wet leaves, and banana peels under your feet like grim death! Be careful in, and out there!!!
8
I am not elderly but I am very clumsy and I trip and fall while running or walking at least once a month. These are good tips.
23
We live in northern Minnesota, less than 20 miles from the Canada border (by crow). Icy surfaces are a reality from early November through April. As confirmed outdoor addicts, we’re out hiking and whatnot year round. Our go-to traction devices for footwear are Stabil-Icers, essentially studded snowtires for your feet. They are much superior to the (perhaps better-known) Yak Trax, as they don’t turn under your feet. Their more aggressive studs are superb on glare ice, even in that most dangerous environment: parking lots.
33
But don't make the mistake of walking into any lobby with a marble floor.
9
I agree about the Stabil-Icers! But also recommend that if your day will take you back inside after a walk or work outside with them on you need to have a pair handy of regular boots or shoes; the very feature that makes them so good on ice makes them treacherous on wood or any other hard indoor surface. I forgot this fact one day going to the supermarket and opted to take off my boots altogether in my stocking feet rather than to try to walk the aisles in the cleats.
7
I have those! They are great!
1
A very savvy physical therapist got me started working on my balance exercises a few years ago when he was treating me for knee problems - the best advice I ever got. Easy to practice standing anywhere anytime (except of course on icy sidewalks...)
A truly worthwhile article. Thanks much!
26
I've found that the practice of Tai Chi helps balance immensely. It's slow movements improves stability, flexibility and leg strength (important in rising from chairs) in addition to improving balance.
2
One of the best things older people can do is to throw out those awful clumpy white marshmallows they wear, thinking that the huge footprint will give them stability. What inevitably happens is that they trip on their own feet because one foot got caught on the large sole that sticks out. The toe boxes are usually big and upturned (kind of like a Dutch clog) and can cause tripping from that angle, too. A much better shoe would be something like a low profile walking shoe that allows the wearer to “feel” the ground at each step. Wearing those chunky white sneakers is like doing dishes with rubber gloves...you lose dexterity. Having their feet measured before buying new shoes can help a great deal. Many older people have bone loss and their feet have shrunk, yet they wear a size they’ve worn all of their life. When’s the last time your mom or dad had theirs measured? Fifty years ago? We finally got my MIL out of them, and into the proper size, and she doesn’t fall anymore. We’re trying to get my mother out of them, but she’s even more stubborn.
66
I am trying to figure out what sort of footwear you are describing. Marshmallows? Is this something they wear in winter?
1
It appears as we grow older we are more likely to need larger shoes, not smaller.
http://articles.latimes.com/2007/jan/01/health/la-he-agingfoot1jan01
Perhaps your mother in law was wearing shoes too large for her feet.
Let me suggest focusing on your core when you walk. I have prevented a few falls by standing as straight as possible, and keeping my head up. This puts my weight over my feet, and stabilizes me.
15
Except when my head is up I don't see the ground before me so trip on icy patches and uneven sidewalks. I agree that your suggested stance is better for your gait, but it is not better for seeing obstacles at your feet.
5
The teacher of my senior exercise classes reminds us: Keep your head up but look down with your eyes - good posture is important; so is seeing the dangers ahead.
1
A year ago (Jan 14th, 2017) I fell, breaking wrist bones. Not from slippery conditions -I wasn't focused on my feet -or where I was going (looking at the scenery). I wasn't using hiking poles, either (another safety tip). Sticky soles on good boots were ironically partly to blame, along with not picking up my feet. As your friends said, it happened in a flash. The good news: if my left hand had not ended up under my left face, I would have slammed my cheek and orbital bone solidly into the concrete, fracturing them and sustaining a concussion, instead of cuts, bruises and the wrist
Falling programs promise help. I'm going to push for local exercise programs to start one for seniors. The techniques remind me of judo practice - done years ago - but it is absolutely necessary to PRACTICE them so that they become second nature. Practicing them MAY also make bones a little stronger, IF it is true that small stresses, regularly applied, make bones stronger. Janet Rosen -Utah an aikido sensei- has videos online.
There are (I am sure) more deaths from falls than reported. When an uncle died, his falls in the prior year- the last time slamming his temple on a hard surface, causing a severe subdural hematoma, did not appear as a cause of death even tho' they were key factors.
For frail elders who survive broken bones and surgical repair- but can no longer walk - immobility causes bodies to breakdown faster and dependence increases. When they die, the falls are forgotten.
42
All good, and Aikido, Judo, or Jiu Jitsu training might help if you began in your 20s or 30s and kept up your basics. However, as we age, the reaction times become longer. Falls happen quickly, even to old Aikido black belts. The key is to perhaps realize that the older we get the less agile we become. What we could do 30 or 40 years ago playing with the kids is not possible now.
8
It's never too late to start a regular yoga or Tai chi/qigong practice. The benefits help in so many ways for fall prevention. Besides strength, flexibility balance & improved body mechanics ( erect posture , head up eyes focusing ahead ) you develop confidence, less fear & movements become more fluid & natural - no shuffling feet or stiffness. Group classes are fun social interactions also.
2
At least going up stairs, one can fall into the stairs. Going downstairs is the riskier direction - and don't be shy about going down sideways facing the rail.
And always have a sturdy walking stick available - one in the car, especially, in case you find yourself in or near an icy or slippery situation.
Also, if you are a slow mover, use a walking stick to show drivers and other moving people that you are not going to be rushed - too many people on devices today need extra visual clues.
84
Pride goeth before a fall! During recent rare snow and bitter cold spell here, I dug out the walker purchased after knee surgery and used it to check on neighbor's home in their absence, "walkeriing" in fresh snow rather than risking icy spots on pavement. Now I use walker to get mail if there is any chance of ice and to heck with pride until spring!
2