Caring Currents

3 Key Steps to Protect Against Falls -- and Prevent a "Cascade" of Health Problems

Respecting the elderly
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As many of us in the role of caring for older family members have found out the hard way, a fall that leads to a broken hip or other fracture can set of a chain reaction of health problems that can leave a formerly strong and independent person weakened and frail. Thanks to the "cascade" effect, a fall can trigger a series of serious health problems, and often leads to death. The Centers for Disease Control reports that falls are the leading cause of injury deaths among older adults, as well as the most common cause of hospital admissions for trauma. So it's important to take steps to prevent falls, including these:

1. Prevent and Treat Osteoporosis. Making sure everyone's getting enough calcium and vitamin D is key here. Many older adults stop drinking milk, and don't realize that the lack of low fat dairy in their diets is sabotaging their intake of nutrients necessary for bone health. Vitamin D is particularly troublesome, since it's found primarily in fortified milk, and there are few other dietary sources. Many older folks stay inside more and get less sun exposure, so they end up with low vitamin D levels without knowing it. Find ways to sneak more calcium and other bone-building nutrients into your diet and see your doctor for a bone density test. Most experts recommend regular bone density tests after the age of 65, but if you're thin, eat a diet low in dairy, have a family history of osteoporosis, or have any other risk factors, ask for a bone density screening now.

2. Improve Strength and Balance with Exercise. Exercise classes designed with the safety, confidence, and special needs of older adults are springing up at community centers, gyms, senior centers, and elsewhere across the country. No matter where you live, it shouldn't be hard to find a gentle movement, dance, or yoga class designed with older bodies in mind. For example, the Arthritis Foundation offers a variety of classes through local chapters. Another option becoming more and more popular is Tai Chi, an ancient Chinese martial art, that's now offered through many health centers such as Kaiser Permanente facilities. Several studies have shown that Tai Chi improves balance and reduces the risk and the fear of falling among older adults. In one study, people between the ages of 70 and 92 who took Tai Chi three times a week for six months had a 55 percent lower risk of falling than a comparable group who didn't take classes.

3. Treat Balance Problems. When an older adult starts feeling dizzy and having balance problems, the culprit is often the inner ear. One recent study found that 35 percent of all older adults had balance problems caused by changes within the inner ear due to aging. And most of these are treatable. People who have BPPV (Benign paroxysmal positional vertigo), which accounts for about 20 percent of all cases of inner ear dizziness, swear by a new procedure called the Epley maneuver -- also called canalith repositioning procedure (CRP). BPPV is caused by a buildup of tiny calcium carbonate crystals in the inner ear, and the CRP effectively repositions the crystals.

Treatment for other types of inner ear dysfunction typically starts with specialized physical therapy called vestibular rehabilitation therapy. Working with a specialized therapist, you learn a series of exercises to retrain the brain to recognize and process signals from the inner ear.

There are also several medications that your doctor can prescribe, alone or in combination, to treat various types of inner ear problems. And as a last resort, there are also surgical options.

These aren't the only conditions that cause falling, of course. A number of other health issues, such as low blood pressure, can cause dizziness, balance problems, and weakness in older adults. Also, many medications have dizziness as a side effect, so it's important to be on the alert for medication side effects and errors. The bottom line: If you or someone you're caring for seems unstable or weak on their feet, don't hesitate to call the doctor and ask for a workup to determine what might be going on.