Falls and Fractures

Soon to be 90, the former U.S. president, Ronald Reagan, falls at home and breaks a hip. A middle-aged physician falls in his back yard and breaks his arm. A young nurse falls in the hospital parking lot and breaks an ankle. A teenager falls on the ski hill and breaks a wrist. A child trips and falls down and cracks his skull.

All this happens within a few days. You wonder who is going to be next? Is anybody immune to falls and injuries? No! Falls account for 75 percent of all injury-related in-hospital deaths. And our seniors are at high risk.

One-third of Canadians admitted to hospital with an injury are aged 65 or older. Approximately, 60 percent of persons who die from falls are 65 years old or older, and falls account for 87 percent of all fractures in older adults.

You may say, “Enough of statistics, Doc! What’s your point?”

The point is that 90 percent of injuries are predictable and preventable. And we can do a lot to prevent our seniors getting hurt.

It is not unusual to see one of our local seniors walking on a wintry slippery road to catch a bus or go shopping. The next thing you hear is that grandpa fell on icy roads and broke a hip.

I know some businesses do provide delivery services to our seniors for a fee. Are all businesses doing the same? Are seniors aware of these services and taking advantage of it?

This is just one example of how seniors are at risk of hurting themselves. Studies have shown there are many reasons why seniors fall and break their bones. And it is not always on icy roads. And there is a lot we can do to prevent this happening.

Hip fracture is the most frequent serious consequence of falling among seniors. Osteoporosis is one of the main reasons. Can we prevent osteoporosis?

Prevention of osteoporosis should start in childhood with an adequate intake of calcium, says an article in the New England Journal of Medicine. Hormone replacement therapy (25 percent reduction in hip fractures), calcium and vitamin D supplements in later life (23 percent reduction in hip fractures), active weight-bearing exercises (40-50 percent reduction in hip fractures), and combining these programs with balance training reduces osteoporosis and the risk of hip fractures, says the article.

Multimodal programs and interventions have shown success in preventing fall among the seniors. Home visit by a nurse and a physical therapist can assess and treat postural drop in blood pressure, discontinue sedatives and other medications which impair balance and walking, eliminate or modify hazards in the home, encourage exercise programs and gait training, and plan behavioural modification. These actions can reduce the risk of falling by 31 percent.

One thing we cannot control is the weather and slippery road conditions. Here the prevention is to stay home and seek help from family, friends and neighbours.

Nobody is immune to falls and fractures. But our seniors are the most vulnerable. Let us help them stay healthy and well. And they have to learn to ask for help. If you don’t ask then you don’t get it!

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