Falls are a major public health concern for many seniors especially those living alone. Every second of every day, an older adult (age 65-plus) suffers a fall in the United States making falls the leading cause of injury and death as a result of an injury in this age group. One out of four older adults fall each year in the United States leading to about 36 million falls each year – resulting in more than 32,000 deaths. More than 95 percent of all hip fractures are caused by falling. The risk of falls begins in the mid-60s and increases in the 80s and 90s.
Falls put seniors at risk of serious injury including hip fractures and head injury. Fortunately, most falls result in only minor scrapes and bruises, if that. But they can be frightening, and even if there’s little physical harm, people sometimes develop a strong fear of falling that can change their entire life and behavior. Between five percent and 10 percent of falls among older people do result in a major physical injury such as broken bones, serious cuts, and bad bangs to the head. Everything from slippery throw rugs, poor lighting, side effects from multiple medications has been identified as risk factors for falling. Foot problems and pain were also mentioned as risk factors for falls.
The aging foot and falls
The feet, like the rest of the body, feel the effects of aging. Muscles thin out. There is neuropathy and loss of sensation. Blood is more likely to pool in veins, which causes feet and ankles to swell or the flow to the feet is severely decreased. The shape of the foot can change also leaving the foot pads under the heel and the ball of the foot much thinner or with painful calluses. Arthritis and foot deformity are common cause for foot pain seen in about 30 percent of elderly people. All these foot changes along with effects of medications, medical conditions and even poor eyesight can make seniors unsteady on their feet and increase their risk of falling. Researchers found that foot pain was a bigger factor in indoor falls than in outdoor falls because of slow gait and poor balance.
Preventing falls
Here are some simple fall-prevention measures for seniors at risk for falling.
• Tell your doctor right away if you have fallen, if you’re afraid you might fall, or if you feel unsteady on your feet.
• Review all of your medicines with your doctor or pharmacist and discuss any side effects like feeling dizzy, light-headed or sleepy.
• Have your eyes checked annually and update your glasses, as needed.
• Have your feet checked annually and discuss proper footwear with your podiatrist.
• Make your home safe by getting rid of trip hazards such as throw rugs and keep your floors clutter free. When needed install grab bars in the bathroom, handrails and extra lights.
• Ask for help with self-care and home chores if needed.
The foot-care program that helped prevent falls consisted of foot exercises, wearing orthotics, and footwear advice which resulted in a 36 percent decrease in the number of falls over a year’s time.
Here is how it was done
Choose your shoes wisely – and wear them: Many people are not wearing the correct size or style of shoes which can contribute to falls. The Harvard researchers found no difference in the type of shoes worn and falls. They did however find that people who wore shoes indoors were less likely to suffer a serious injury from a fall than those who wore slippers, socks or went barefoot. Shoes definitely helped with balance and support which will prevent falls. Older people must be especially careful and wear comfortable well-fitting shoes to accommodate any foot deformity and prevent foot injury and pain. Most running or walking shoes/sneakers will fit the bill. They are wide, roomy, light weight and stretchy enough to keep older feet comfortable, stable, and supported. A recent trend is more people are buying shoes online, so going to a shoe store and getting their feet measured is becoming a thing of the past which may contribute to this challenge. Even if you are buying shoes online measure your feet according to the online guide at the shoe store or go to the shoe store or podiatrist office to have your feet measured before buying shoes online.
Maintain a healthy weight: Weight gain and higher BMI (body mass index) tends to put more stress on the feet. People who are overweight or obese tend to have more foot pain and other foot problems. Maintaining a healthy weight or losing weight can help take some pressure off your feet, spare you some foot pain, and possibly reduce your chances of falling.
Try over the counter orthotics first: Orthotics have been shown to prevent some falls by stabilizing the feet, redistributing foot pressure, and providing additional tactile/feeling input to the foot. Orthotics can be expensive, so try over the counter orthotics first and you can get custom made orthotics if needed. You can get good quality insoles that provide structure from your podiatrist office.
Give your feet a workout: Exercises for the feet and ankles can help offset the muscle loss and stiffness that may set in with age. Researchers (Menz, et al) found home exercises were the main reason the foot-care program helped prevent falls. Three of the exercises used in the study are here, try them along with tai chi, yoga or other exercises to increase range of motion and improve your balance.
Three exercises to strengthen your feet and prevent falls
• Place a large rubber or elastic band around the end of your big toes and gently pull your feet away from each other with your heels on the ground. It increases the range of motion in the big toe joint, but does not correct the bunion.
• Place a resistance band — a large stretchy band used for exercises — around the leg of a table. Put your forefoot in the band and rotate your ankle to stretch the band out, away from the table leg. This exercise strengthens the ankle muscles.
• Pick up small stones or marbles with your toes. This exercise strengthens the muscles in the toes and helps with the tendency for toes to curl in old age.
Taking care of your feet could improve your foot functioning and prevent falls and serious injury. If you are at risk for falls, you need to have your feet checked by a podiatrist today, it will save your feet and your life.
• For more information, email us at foothealth242@gmail.com or visit www.apma.org. To see a podiatrist, telephone 325-2996 for an appointment, visit Bahamas Foot Centre on Rosetta Street, or call 394-5824 for an appointment; or visit Bahamas Surgical Associates Centre on Hilltop Medical Centre off 4th Terrace Collins Avenue. In Grand Bahama, call Lucayan Medical Centre at 373-7400 for an appointment.
