Addressing Falls In Our Senior Population
Dr. Dhira Khosla
“My balance is terrible.”
“I feel unsteady when I close my eyes in the shower.”
“When I fall down I have a hard time getting up without help.”
“I fall a lot but I haven’t been seriously injured.”
These are just some of the many statements I hear when patients present with balance difficulty. As a person ages, balance tends to worsen and falls begin to occur. A single fall may or may not result in a serious injury. But once an elderly patient falls, he or she is at a much higher risk for more falls in the future. Falls which do result in serious injury, such as hip fracture, place the patient at significant risk of complications from that injury.
These injuries can lead to prolonged hospitalizations as well as decline in activity level after they have recovered from the acute injury. In many cases, after such devastating falls, patients need to be moved from their home into a nursing home environment. All too often, patients receive treatment for the fall-related injuries, but not enough attention is paid to whether there are underlying causes for the fall. Because repeated falls can lead to such dramatic and often permanent changes in a person’s quality of life, it can be very beneficial to gain a better understanding of potential root causes of poor balance.
There are many factors that can lead to impaired balance, and often patients suffer from more than one issue. Some of the common neurological reasons for poor balance and frequent falls in the elderly are peripheral neuropathy affecting the feet, movement disorders such as Parkinson’s disease, and weakness and spasticity of the limbs due to stroke. Visual impairment and vertigo resulting from strokes or tumors can also lead to falls. Dizziness from inner ear dysfunction and inability to maintain blood pressure control can greatly impair balance as well.
Balance related issues in the older population tend to go under-reported or under-diagnosed. People tell themselves “It was only a minor fall, I didn’t get injured” or “I don’t want to walk around with a cane so I’ll just be more careful.” Unfortunately, all too often, physicians find there isn’t enough time during visits to discuss a patient’s gait. Set aside time with your physician for a detailed discussion if you or a loved one suffers from poor balance and repeated falls. If there is an underlying cause for the falls and it is identified in a timely manner, it could help avoid significant complications and disability.
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