Tips for Preventing Falls and Broken Hips in Elderly Parents


Mom fell often - as in at least once a week. She lived alone in her apartment for several years after Dad needed nursing home care. One reason Mom could remain alone was that I arrived bright and early every day at her home to help her shower, get her breakfast ready and do some light washing and straightening up. I'd later come over to pick her up and drive her to visit Dad.

Another reason she could remain alone was that she wore a personal alarm. I'd become aware of those in the early ‘90s when a neighbor needed a way to alert me if he got into trouble. I've found personal alarms to be an invaluable aid to anyone living alone who may have the need to summon help. If anyone's alarm got a work out, it was Mom's.

Mom had severe osteoarthritis and she'd had two hip replacements, the last one occurring fairly late in her life. Her knees rubbed bone on bone and had collapsed inward. They needed replacement as well, but she was too frail for the surgery. Though she faithfully used her wheeled walker for balance, she still fell regularly.

I've joked (actually, it's thinly veiled seriousness) with care agency people, and our city leaders, that every city needs one person available day and night to just sit and wait for a call to pick someone up off the floor. Caregivers have a dreadful time with this problem and often they don't know who to call for help.

Mom outweighed me and when she fell she was dead weight on the floor. Also, with her hip replacements and barely workable knees, it would be easy to hurt her if I lifted her incorrectly. My solution was to call 911. I'd tell the dispatcher that we didn't need lights and police cars. It's just a fall. The firefighters would arrive, assess Mom and help her get up. She'd cheerfully thank them and we'd send them on their way. It got increasingly embarrassing as the same men seemed to be on duty with each call. Eventually, one man not too kindly implied that we were misusing the service.

I understood. But what is a caregiver to do? There were only a couple of more falls after that embarrassing time before the final at-home fall where Mom told me, the morning after, that she was afraid and she wanted to move to Rosewood to be with Dad. I jumped at this chance to get her to safety and got her through the red tape in time to have her in a room at the nursing home by evening – before she changed her mind.

Falls Can Cause Serious Injury and Death for Elderly Parents

Falls can be devastating to seniors and the elderly. A friend of mine in his early 60s, fainted as a result of a blood pressure medication and ended up with whiplash that still causes him severe pain and problems. Though I'm no spring chicken, I still feel that I don't quite qualify as an "elder." Last winter, I took flight on some ice and ended up in a situation where only the strength of my bones and good fortune kept me from breaking a hip or knee. A younger colleague of mine was out walking his dog that same winter. He slipped on a patch of ice and fell, breaking his wrist. There's no doubt about it, falls cause a lot of pain and often permanent injury.

Younger people, however, generally heal faster than their elders and are less likely to die from a trauma like a broken hip. I believe the only reason my tiny-boned mother didn't break any bones was that she'd had a hysterectomy in her 30s and had been on estrogen ever since, which helps to prevent bone loss. There's really no other explanation.

Aside from broken bones, serious contusions and traumatic brain injury may also result from a fall. Bruising may seem like a normal bodily response to an accident, but particularly deep contusions may actually be deep tissue injuries which can progress rapidly into a high-stage ulcer.

The neighbor I mentioned earlier used his personal alarm for the last time to summon me to his side after he'd fallen and broken his hip. Joe was in his 80s and ended up passing away six weeks later.

Fall Prevention

First, no matter what you do to protect your elder from falls, there are no guarantees. I removed all of my neighbor's scatter rugs, much to his disgust, and cleaned up clutter from his floors daily. For my mother-in-law, when she was in her home and prone to dizzy spells, we'd put in rails along her walls so she could have something to grab wherever she was. My mother's bathroom was outfitted with all of the "anti-fall" gear available. Yes, we were on top of things, but they all still took tumbles.

Preventing falls is important and the steps we took likely prevented quite a few incidents, but not everything is under our control. Many elders need medications for various ailments, and a side effect of many medications, including some blood pressure medications, is dizziness. Then, there are blood sugar changes in diabetics. Dizziness can result from a rapid drop in blood pressure or blood sugar. Inner ear problems are also a major cause of dizziness.

Another issue is bone strength. Some studies suggest that many hips are not broken from a fall. Instead a spontaneous hip fracture can actually cause a fall.

No matter what we do, we won't prevent every fall. I don't believe in curtailing the activities of an elder to the point where he or she must reside on the sofa just to be safe. None of us wants to take a tumble, and surely it is worse for the aged. But living life without any risk is, in my mind, a route to a long, slow death.

I like to see elders do what they can to stay active. People of any age, but particularly those over 60, should work on their balance, as balance becomes less reliable as we age. Physical therapists can prescribe exercises for this. Watch for inner ear infections which can cause dizziness, as can a urinary tract infection or any low-grade infection. Make homes as safe as possible. Encourage the use of walkers when needed. Keep an eye out for obvious obstacles around an elder's home.

Do what you can to prevent a fall, short of curtailing their will to live. And, if possible, recruit a nice, strong friend who will agree to be on call for "pick up duty." Short of an official position offered by every city in the nation, that may be the best we can do.

Carol Bradley Bursack

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Over the span of two decades, author, columnist, consultant and speaker Carol Bradley Bursack cared for a neighbor and six elderly family members. Her experiences inspired her to pen, "Minding Our Elders: Caregivers Share Their Personal Stories," a portable support group book for caregivers.

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It would be really helpful in such a situation if you got a doctor to order an occupational therapist in there to teach Mom how to successfully get up off the floor by herself. Usually it involves the person who fell: doing a self assessment, moving over to the sofa or low chair, pulling the cushion off, sliding onto the cushion, hoisting onto the cushion-less low sofa, onto the sofa proper, and then getting up. Or similar process. Or train Mama yourself. Get on the floor and develop a practical process. If it takes Mama 30 minutes to get back up, that's still OK because she can do it for herself. She may miss the attention of the handsome, muscular firefighters however. ;-)
My mother is "tied" to her walker---she had hip replacement last year & while it was considered a "success" she wound up needing a walker, instead of just a cane. She will routinely putter about her apt with no aid--altho there are grab bars all over the place, so we've made the place as safe as it can be. I did remove all scatter rugs (is that a generational thing? I don't have any in my home) and took the dust ruffle off her bed as she'd step on it and slide off the bed. We found out thru trial and error what was a hazard to her and eliminated them one by one. Yes, she is a smaller person, but lifting her was a 2-3 man issue. The panic alarm did nothing but add to our communal grief--it went off if it smacked on her walker (she likes people to know she's wearing one) and so the EMT's were regular visitors. She has not fallen in a long time, so I think the re-balance of her meds, along with the removal of a lot of obstacles has helped. We had a super light winter this year and so the fear of her slipping on ice just didn't exist. Her dr said she's one "bad" fall away from death..literally. She's 85 and cantankerous some days, sweet others. Her own mother ticked along until age 95, living alone--until she had a very bad fall and broke both wrists. Within 3 months, she'd passed away, and to that point she'd been totally independent.
The article is fine but doesn't answer a question I have: how should the caregiver hold the person who is about to fall? What's the best way to pick up a person who has fallen but not injured him or herself?