Ask the Pharmacist: Falls in the Elderly
By: Stefanie Black, Pharmacist at Thrifty Foods Pharmacy
As nicer weather is upon us, the sunnier and longer days may lead many of us to head outdoors for a walk, a hike or even to putter in the now blossoming garden. Even on rainy days, we are more inclined to tackle projects around our homes and spring cleaning errands. As simple, (sometimes) enjoyable and routine as many of these tasks may seem, it's important to remember each comes with increased risk - particularly as we get older.
Falls are the leading cause of injury in the elderly and may result in fractures and hospitalizations. Falls are not a “normal” part of aging and may be due in part to medications. If you have had a fall in the past year, feel unsteady when standing or walking or have any worries about falling, you may want to ask your pharmacist for a medication review. We can assess which medications may be contributing and work with prescribers to stop, switch or lower doses to minimize risk.
Several medications that can increase fall risk (particularly if on multiple medications), may include opioids, antipsychotics, antidepressants, benzodiazepines, and other sedatives such as sleeping medications. This is not a comprehensive list which is why it’s good to talk with the pharmacist or doctor if you have any concerns about your medications.
One of the reasons some seniors fall is due to low blood pressure so it is a good idea to monitor your blood pressure especially if you take medications for it. Another reason for falls is hypoglycemia (low blood sugar) so if you are taking medications for diabetes that can lower blood sugar, it is important to monitor your blood sugar.
Fall risk is high with previous falls, weakness, gait and balance impairment or use of sedating medications. Some other factors that can increase risk are visual impairment, age over 80 years old, female sex, low weight, urinary incontinence, cognitive impairment, arthritis, and undertreated pain.
Some ways to reduce fall risk are getting regular exercise such as walking, water workouts, or Tai Chi that include balance, gait, and strength training, rising slowly to standing, wearing sturdy, properly fitting shoes with non-skid soles, and avoiding wearing multifocal lenses while walking, especially on stairs. Vitamin D may help to reduce fall risk by improving muscle strength and balance.
Some ways to improve safety in your home to prevent falls are installing grab bars in the bathroom, ensuring stairways have hand rails on both sides, having adequate lighting especially if you need to get up at night, removing tripping hazards (throw rugs, loose floorboards), arranging furniture to create a clear walking path, carrying an alert device or cell phone to contact help in case of a fall, and putting a bell on your pet’s collar so that it’s harder for them to get underfoot without you noticing.
Often people are fearful of talking to their doctor or pharmacist about previous falls or fall risks because they don’t want to lose independence. But with some modifications to lifestyle, home layout, and medications, we can lower risks and help keep your independence. Asking for that little bit of help may mean the difference between a healthy summer or one spent recovering from injury.