DEAR DOCTOR K:
I have osteoporosis, so my bones are going to break more easily. My doctor told me I should therefore try to avoid falls, but he didn’t say how. Any ideas?
A tumble can send a person with osteoporosis down the road to disability. Many factors can increase your risk for falls. Some have to do with your physical condition; others come from the environment. There is much you can do to reduce both types of risks.
I’ve put some questions for you to ask yourself, below. They can help you get a general sense of your risk of falling.
What is your risk for falling?
|Question||Points for a “yes” answer|
|Have you fallen in the past year?||2|
|Do you use a cane or walker to get around safely?||2|
|Do you sometimes feel unsteady when you are walking?||1|
|Do you steady yourself by holding on to furniture?||1|
|Do you often have to rush to the toilet?||1|
|Do you have difficulty stepping onto the curb?||1|
|Are you worried about falling?||1|
|Do you need to push yourself out of a chair?||1|
|Have you lost some feeling in your feet?||1|
|Do you take medication that makes you feel lightheaded?||1|
|Do you often feel sad or depressed?||1|
If your score is 4 or higher, discuss your risk with your doctor.
|Source: Centers for Disease Control and Prevention; Rubenstein LZ, et al. “Validating an evidence-based, self-rated fall risk questionnaire (FRQ) for older adults,” Journal of Safety Research (Dec. 2011), Vol. 42, No. 6, pp. 493–9.|
If your risk is high, consider strength and balance training. Focus on exercises that use the muscle groups required for the things you do in real life — getting out of a chair, climbing stairs or reaching a high shelf, for example.
Activities like yoga and tai chi improve balance and coordination as well as core strength. There is some evidence that they may help to prevent falls. Many of the movements done in these activities — lunging, stepping, turning and reaching — are similar to the movements we need to remain independent.
You can also take steps to decrease the impact of health-related issues on your risk of falls:
- PAIN. Chronic pain can hamper your mobility, throw you off balance, or make it difficult to maintain your balance. Talk to your doctor about pain medications that won’t increase your risk of falls.
- POOR VISION. It’s easy to trip or lose your balance when you can’t make out the edge of a stair or recognize an object in your path. Have an annual vision exam, and discuss your concerns about falling with your eye doctor.
- FOOT PROBLEMS. Your feet are central in preserving your balance. See a foot specialist if you have foot pain. Wear comfortable, supportive shoes. Avoid high heels. And if you have neuropathy, use a walking stick.
- MEDICATION SIDE EFFECTS. Many drugs increase the risk of falling. Review all of your medications with your doctor. If any of them tend to impair your attention or balance, there may be alternative treatments that are less likely to do so.
- Finally, most falls occur in the home. The following measures can minimize your risk:
- IMPROVE LIGHTING. Make sure all areas of your home are well illuminated. Use nightlights to mark hallways and the bathroom.
- PROVIDE HANDHOLDS. Install grab bars in the bathroom, by the bath and shower. They can help you keep from falling when you are standing on a slippery surface.
- REMOVE OBSTACLES AND HAZARDS. Clear away clutter from the floors. Keep cords and cables near the walls where you can’t trip on them. Secure area rugs and use grip mats for traction in the bathtub.
The average home is full of hazards. And as we age, we often develop physical problems. You can work on both fronts. You can improve your physical limitations, and you can remove and replace many of the hazards.