Dangers of falls
April 4, 2024
To the Class of 1964:
After the sad and sudden death of Joe Lieberman due to complications from a fall (see Joe’s In Memoriam page), there has been a flurry of classmate email correspondence regarding the prevalence and dangers of falls among us. Joe’s death is a cautionary tale, as was classmate Dennis Upper’s death 5½ years ago when he fell down a flight of 13 stairs and died the next day (see his In Memoriam page). Because I’m an EMT on an ambulance squad, I was urged by some of you to communicate some thoughts on the subject.
As an EMT dealing with medical emergencies of all kinds, I’m well sensitized to the dangers of falls, which are the most frequent cause of ambulance dispatches in my town by more than a factor of two over the next most frequent emergencies (motor vehicle crashes, breathing difficulties). More than a third of seniors in our age bracket report a fall in the last year, and half of those seniors report multiple falls. These statistics are undoubtedly lower bounds on the problem, because such incidents are generally underreported. In short, falls are not just something that happens to other people, and are nothing to take lightly.
Some of my dispatches turn out to be simply lift assists for patients who have fallen and can’t get up. But at our age, falls can have very serious consequences, due to osteoporosis and other frailties, with risks exacerbated if you are on a blood thinner, as many of us are for atrial fibrillation. Head trauma can lead to subdural hematoma (internal bleeding), the deadliest of head injuries. Hip fracture from a fall is common and often devastating, with 50% of geriatric patients with a hip fracture dying within six months.
What can you do to keep from falling? Most precautions are quite obvious, once you stop to think about it.
- Develop a healthy fear of falling, even if you’ve never fallen. It only has to happen once, as Joe’s and Dennis’ stories attest.
- Install and use grab bars in your shower and bath.
- Install and use railings on your staircases, preferably on both sides. And install free-standing handrails for your outside steps.
- Be obsessively careful when climbing or descending stairs, watching each step (literally), particularly when going downstairs. Don’t ever carry anything with two hands. Keep one hand free and grip the railing.
- Stay off ladders and stepstools unless you can brace yourself. Let someone else clean the gutters.
- Stay well clear of icy surfaces.
- Consider investing in a medical alert device and wear it all the time, even in the shower. This is particularly important if you live alone. An Apple watch or smartphone may serve much the same purpose, allowing you to call for help, but you’re unlikely to take those devices into the shower with you.
- Exercise for half an hour most days of the week, for strength and balance. And don’t sit in one position for long periods. Stretch and walk around at least once an hour.
- If you have balance issues, use a cane.
My experience is that most 9-1-1 fall victims can’t tell you why they fell, which means they weren’t paying close attention to where they put their feet. And if they don’t know why they stumbled, it’s difficult to prevent a recurrence.
Be careful out there. And I’ll see you in New Haven next month! (Register here for the reunion.)
Best wishes,
