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What to Do if You Fall in Your Home: Have a fall plan in place in case fall prevention tactics aren't enough.

In last month's issue we reported on recent research from the Centers for Disease Control and Prevention (Morbidity and Mortality Weekly Report, May 11) pointing to a significant increase in the number of older adults dying from falls over the last decade. Falls are also a leading cause of nonfatal injuries in seniors. There are things you can do to lower your risk of falling--for example, you should remove tripping hazards such as throw rugs, install grab bars in your bathroom, and ensure your home is adequately lit. However, despite these precautions you or a loved one still may fall--so what should you do if this happens? Mount Sinai social worker Sheila Barton recommends that you have a "fall plan" in place.

Falling "Safely" Knowing how to fall in a way that might help protect you from serious injury is a handy skill. "Since you're more likely to injure yourself if your body is tense and stiff, try to 'relax' into the fall, keeping your arms and legs bent," Barton advises. "Protect your head--turn your face to the side if you're falling fowards, or tuck your chin into your chest if you're falling backwards. Also try to ensure that you fall onto parts of your body that are well padded by muscle and fat, such as your buttocks or thighs. This may help prevent broken bones." Barton notes that many senior centers and YMCAs offer classes on how to fall, and recommends you register for one if you can.

Summoning Help It's a good precaution to have a phone in every room. Another thing you may want to consider is signing up for a medical alert system (see From the Editor for more details on how these services work). If you'd rather not set up a medical alert system, purchase a clip attachment so that you can wear your cellphone on your belt or waistband.

Checking for Injuries and Getting Up

Try not to panic if you fall. "Take some deep breaths and stay calm," Barton says. "Take it slow as you see if you can move your limbs, flex your feet and hands, and turn your head. If you feel any pain, stop and wait a moment before trying again."

If you aren't injured and can get up, roll onto your side, bend your top leg, and slowly push up onto your hands and knees. Then crawl to a sturdy chair and use it to support yourself as you stand. Once upright, slowly turn and sit down. Barton recommends you don't wait for an emergency to learn how to get up from a fall in your home. "Practice often, in different rooms and using different objects for support," she says. "But don't practice getting up unless there is somebody there with you to help if needed."

What if You Can't Get Up? If you're unable to bear your weight, or can see that you have broken a bone, call for help. If you don't have a medical alert system and your phone isn't within reach, try to slide yourself towards the phone, taking your time. "If the phone is too far away, slide towards an object you may be able to use to make a noise by banging it on the floor, wall or door," Barton advises.

While you're prone, try to move and flex your limbs to maintain your circulation while you wait for help. "It's also vital to stay warm if you are going to have to wait for assistance," Barton adds. "Plan ahead for this by keeping decorative throws on your furniture--in an emergency, you can hook them off and use them as blankets and to support your head. They can also be useful to staunch any bleeding if you cut your head when you fell." If you fell on a hard floor but there is a carpeted surface nearby, try to slide yourself over and onto this, as it will be warmer. "It's also important to try to move away from any areas where there is a draft," Barton adds.

Tell Your Doctor Even if you don't injure yourself in a fall, it's important to tell your doctor that you fell. "Even if you think you are generally in good health, a fall can signal that you have an underlying illness you are unaware of," Barton explains. "Your doctor also will want to review your medications in case you are taking a drug that might have contributed to your fall because it affects balance. It's possible that you may be able to reduce the dose of the drug or switch to another option that is less likely to affect your balance."

Blood tests can reveal if you have low vitamin D levels (a risk factor for falls), and your doctor also may refer you to a physical therapist who can suggest exercises to strengthen your muscles and/or fit you for a mobility assistance device (such as a walker) if necessary. "If you wear glasses and have not had your vision checked recently, schedule an appointment with your eye doctor in case an outdated prescription or underlying eye condition was a factor in your fall," Barton adds.

Get a Home Safety Assessment Even if you've taken precautions to fall-proof your home it's possible you may have missed something, so it's worth getting an expert evaluation. Community fall prevention programs provide this service (contact your local Area Agency on Aging for details).


If you fall and can't get up:

* Call out for help if you think you can be heard.

* If you have an emergency call device or telephone at hand, use it. If you don't, try to slide yourself towards a telephone or a place where you will be heard.

* Make noise with your cane or another object, to attract attention.

* Wait for help in the most comfortable position for you. If you can, place a pillow under your head and cover yourself with a piece of clothing or a blanket to stay warm.

* Try to move your joints every few minutes, to ease circulation and prevent stiffness.

Caption: Each year, about 3 million older adults visit the Emergency Department due to fall injuries.
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Title Annotation:INDEPENDENCE
Publication:Focus on Healthy Aging
Date:Sep 1, 2018
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