Ask the Doctor
Questions about kidney disease? Risk factors? Signs and symptoms? Are you concerned about yourself, a friend or family member? Ask Dr. Spry.
By Chris L. Wells, PhD, PT, CCS, ATC
Whether you are young or old, if you are recovering from an illness and feeling weak, you probably have a fear of falling. The fear of a fall alone increases your risk of falls. Falls can happen for a number of reasons. Perhaps you are busy or distracted and not paying attention to your environment. Or there can be a decrease in sensation in your feet and legs. Other possibilities are poor lighting or decrease in visual acuity, or use of multiple medications. What steps can you take to reduce your risk of falls?
Participating in a regular exercise program is one of the best ways to reduce your risk of falls. Muscle weakness and fatigue are major contributors to falls as they can cause a reduction in your ability to activate muscles during unexpected events, such as tripping over a household pet or an uneven sidewalk. A decrease in muscle flexibility can also increase your risk of falls. Your exercise program should include 30 minutes of aerobic exercise like walking, dancing, cycling, or swimming at a moderate intensity level five days a week. Moderate intensity is commonly described as exercising at a level that makes you short of breath, that challenges your ability to speak, but you still are able to talk. Stretching should be completed after exercising with the position being held for 30- 45 seconds and repeated 3 to 5 times. Finally strength training should be completed twice a week with a focus on legs, pelvis, shoulder, and trunk muscles.
You should also take steps to make your home and work environment safer. Inspect your surroundings, clearing away items you might possibly trip over. Remove things from the floor; pick up books, papers, clothes, and shoes from common walk areas and steps. Watch out for extension cords and electrical wires, and remove throw rugs. You should make sure there is proper lighting, particularly in hallways, steps and in the basement. Using frosted light bulbs will reduce glare. You should have hand rails installed in stairwells and in the shower areas. In your bathroom, place nonskid mats in and outside the bath and dry your legs and feet prior to stepping off the mats. Finally, place commonly used items in the lower shelves in cabinets to avoid having to climb onto a stool. If you need to use a stool, use a stool that has a hand rail and that has nonskid legs. If you live alone and have great concerns of falling, you may want to carry an electric call system that can activate help if you do fall. Carry your cell phone, or develop a system with your neighbors that would alert them if something is wrong, such as hanging a sign on your door in the morning and bringing it in at night.
Now you need to look at yourself beyond exercise and environment. When is the last time you had your vision checked? It is recommended that you should have your eyes checked at least every two years and more frequently if you have had a change in your health. You should wear supportive shoes that have nonskid soles, low heels and avoid deep treads on the sole.
If you take more than two medications on a daily basis, you should consult with your pharmacist, or a member of your medical team to make sure the drugs are not causing adverse effects such as dizziness, lightheadedness, decreased level of alertness, or altered heart rate or blood pressure. If you are over the age of 55, it is very helpful to have a gerontologist, who is a physician specializing in the aging process, examine you and your medication list. It is helpful if you can detect a pattern to your symptoms based on your medications. For example, if experience a sense of lightheadedness within an hour of taking your medication, or your symptoms began after a recent change in the dosage of a medication.
These are just some suggestions that may help reduce your risk of falls. It is advised to make a checklist from items listed in this article and add to the list based upon your individual circumstances. Then, have a friend or family member review your list and your environment to determine if it is complete and accurate. Do not delay in taking steps to reduce your risk of falls. If you already have a history of falls or have a fear of falling, see a physician or a physical therapist for a thorough evaluation to determine your risk and develop a personal plan.