Tuesday, November 26, 2013

Don’t Let a Fall Spoil Thanksgiving

Eighty-something-year-old “Mrs. Johnson,” homemade pie in hand, stepped through her granddaughter’s front doorway for a Thanksgiving visit, tripped on the threshold, and fell flat on the floor. The family encircled her with a gasp, as she lay on her back, eyes closed.

“GOOD NIGHT NURSE!” she suddenly exclaimed, opening her eyes and looking to see if the pie survived the fall.

She was fortunate; she was unhurt. But every hour in America, 6,000 older adults per day are treated in emergency departments for nonfatal fall injuries, according to the Centers for Disease Control and Prevention (CDC).

With Thanksgiving approaching, doctors caution patients that a simple holiday visit away from the familiarity of home could result in a fall and hospital visit.

“When I’m on call for Christmas or Thanksgiving, and I see many elderly folks come in with hip fractures,” said C. Bruce Malone, MD, an Austin orthopedic surgeon. “Often, they fall on the front steps or the entry to the front door — somewhere they don’t have a normal habit of passing. And it produces a fractured hip and a real problem.”

While it’s easy to imagine the reasons this might happen — unfamiliar flooring or rugs, the commotion of a family gathering, children running around, even pets underfoot — Dr. Malone says falls typically point to an underlying health issue.

“I constantly see people who break their hip, and the families tell me, ‘Mama was okay until she broke her hip.’ But in essence, mama broke her hip because she wasn’t okay,” explained Dr. Malone, a past-president of the Texas Medical Association. “Her health is likely starting to fade and that ultimately caused her to fall and break her hip. The broken hip is a symptom of what’s going on in their central nervous system or their heart.”

Those underlying issues can vary: Syncope, or dizziness, possibly caused by a heart issue or perhaps a mini-stroke; degenerating eyesight; or reduced function in the person’s knees, hips, or legs.

He and the CDC recommend that patients:
  • Exercise (carefully) regularly. Dr. Malone suggests even regular exercise on a small stationary bike in one’s home is beneficial. “I really encourage my patients to do some kind of exercise. It’s that old adage, ‘Use it or lose it,’ ” he said.
  • Visit a physician if the patient experiences any unexplained dizziness or disorientation.
  • Review their medicines with a physician or pharmacist to see if any of them cause avoidable dizziness or drowsiness.
  • Visit an ophthalmologist at least once per year to have their eyesight checked.
  • Give the senior’s home a checkup: Remove tripping hazards like loose rugs, add grab bars in the bathroom, add railings on both sides of stairways, and improve household lighting.
  • Get out of bed slowly. “I tell them, ‘Sit there for a minute or so to let your blood pressure stabilize before you get up and walk, and be careful of what’s around your bed.’ We have people trip over their own pets,” he said.
  • Use a walking aid like a cane or walker if it helps. People’s vanity often prevents them from using these, even when they really should, he said. “They want to put up a front, they don’t want to look ‘old,’ when they really are old, then they lose their balance and something bad happens.”
  • Openly discuss health concerns with the doctor, especially as the CDC says one out of three adults aged 65 and older falls each year, but less than half talk to their doctor about it. Remember, that fall might indicate a bigger problem.

And it’s probably a good idea to ensure the house is free of potential hazards if grandma or grandpa are coming to visit this Thanksgiving or Christmas. While "Mrs. Johnson" survived her fall (the pie did not, by the way) it's best to avoid the risk of injury.

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