Good Morning Dr. Paul Goldfinger. Here are today’s top stories. Friday, September 23, 2016.
The CBS News (9/22) website reports that “falls are the number one cause of fatal and nonfatal injuries among adults over 65,” researchers concluded in a report published in the CDC’s Morbidity and Mortality Weekly Report.
The report found that “in 2014, older Americans fell 29 million times, leading to seven million injuries” that sometimes landed people in the emergency department. Unfortunately, “more than 27,000 falls led to death.”
In a press statement, CDC Director Tom Frieden, MD, MPH, said, “Older adult falls are increasing and, sadly, often herald the end of independence.” Dr. Frieden went on to emphasize that falls can be prevented.
Below is the link to the excellent CBS News article on this subject.
Blogfinger medical commentary by Paul Goldfinger, MD, FACC:
These stats are impressive, and the article describes certain elements that we might not ordinarily think of. Once someone falls, there are a variety of variables that need to be evaluated in order to prevent more falls. For example, is the patient keeping his falls secret for fear of losing independence? Family members must think of this if, for example, bruises are seen or balance problems noticed.
Falls can be minor or terrifyingly dangerous. Falling down even a few steps can result in horrible injuries. And that damage can be made worse by coexisting factors such as chronic therapy with blood thinners, causing traumatic bleeding to be worse than expected.
Don’t forget the need to have an “I fell down and can’t get up” button around the patients neck. I had a patient who fell and got wedged between the toilet and the bathtub, and she could not reach a phone; luckily a friend came by to pick her up for her regular card game. And how about a cell phone to be worn in a holster all the time? There are exercises to improve balance, and make sure to check the lighting in the house.
Head injuries can be deceptive, and, if one occurs, an ER visit and then subsequent observation are essential.
Some of the prevention factors include safe footwear, regular eye exams, and getting rid of throw rugs.
If a senior gets in a car accident, don’t allow him/her to just go home and rest. Always take them to the hospital to be checked. And if they do go home make sure that someone provides oversight to look for emerging signs of trouble.
As we have pointed out in our BF articles, seniors are often on multiple medications, and those may be overdosed, mixed up,causing side effects, or interacting with each other. The end result might be a fall, due to dizziness or a drop in blood pressure. There are other medical issues, such as cardiac rhythm disturbances, that could cause falling, so if someone falls, have them checked even if there is no obvious injury and be sure to have his medication list reviewed—-bring all the meds with you.
We have also reported on drug dependency in seniors, and that might be a factor.
For some seniors, they tend to rush around, and that can cause quick turns and loss of balance. My mother was like that, so I stuck a big sign on her fridge: “Slow Down.” Of course, she gave it back to me by saying, “You talk too fast and not loud enough.” She used to say, “Stop mumbling.” At least she didn’t put any signs on our fridge.
The psycho-social issues resulting from falling are very important as well. Patients sometimes lie about what happened in order to avoid unpleasant consequences such as neurologic findings which could result in loss of a driving license and thus loss of freedom. A neurologist might pick up a problem with peripheral vision which could result in a car accident.
Families of elderly patients must be vigilant.