Tufts University Health & Nutrition Newsletter.
Your Guide To Living Healthier Longer.
February 1998, Volume 15, Number 12.

According to one study from Atlanta's Emory University, Tai Chi - a smooth, graceful form of exercise focusing on balance and body awareness - is even more effective than a high-tech, computerized balance training machine in reducing falls.

TO AVOID A NURSING HOME, AVOID FALLING

It's no surprise that old age, living alone, a lack of social support, and poor health often send people to nursing homes. But in many cases, so does a single fall, according to new research from Yale University Medical School.

In a study of more than 1100 people in their 70s and older, those who were seriously injured in a fall were 10 times more likely to enter a nursing home than others of the same age and general health. Even those who fell and weren't badly hurt were three to five times more likely to end up in nursing homes. That's because falls can be psychologically as well as physically disabling. Consider that difficulty getting up after a fall and the loss of self-confidence that can result are often enough to tip the scales in favor of a decision to seek care in a "safer" place. Furthermore, even when a fall doesn't cause injury, it can be a sign of a problem that necessitates nursing home care - for instance, severe arthritis.

Broken hips represent about a third of serious fall-related injuries, according to the Yale study. Other injuries from falls associated with the decision to enter a nursing home include dislocated joints, head injuries, and fractures of the pelvis, ribs, legs, feet, arms, or hands.

Unfortunately, such injuries occur relatively frequently. Each year about a third of people over age 65 - and half of all people over age 80 - experience a fall and about 10 percent of them are seriously hurt.

Of course, a fall in itself does not inevitably result in nursing home placement. But the Yale study does suggest that preventing falls may reduce the number of admissions to nursing homes - and thus stave off the loss of independence, lack of privacy, and high costs that often follow. Here are several ways to reduce the risk of falling:

If you are taking prescription drugs, ask your doctor about side effects that could leave you vulnerable to falls. Medications like sedatives can make you drowsy or dizzy. Fortunately, in some cases the dose can be reduced without causing any harm. Even just knowing that a drug can impair balance may help someone tread more carefully.

Ask your doctor to check for postural hypotension - a condition in which blood pressure drops as you stand up after lying down. Sudden drops in blood pressure upon changing position can lead to dizziness or disorientation. In some people, low blood pressure can occur after a meal, when the blood is diverted from the arteries to the digestive tract.

Make sure you can see as clearly as possible by using bright light bulbs in your home and getting your vision checked regularly.

Minimize at-home hazards by clearing the floors of clutter.Tack down throw rugs, and keep loose extension cords out of the way. In addition, use nonskid mats in the bathtub and attach grab bars on walls near the shower and toilet.

Take special precautions in the winter: walk on the grass if the sidewalk looks slippery, and stay on plastic carpet runners when inside buildings with wet floors (or those made of slick marble or tile).

Indoors and out, wear low-heeled shoes or boots with good traction.

Try forms of exercise that focus specifically on balance (you may need the help of a physical therapist or trained instructor). According to one study from Atlanta's Emory University, Tai Chi - a smooth, graceful form of exercise focusing on balance and body awareness - is even more effective than a high-tech, computerized balance training machine in reducing falls. Your local health club, Y, or senior citizen center may offer classes in Tai Chi.

"Deeply versed, passionate and informed, Mr. Rones is a committed and caring teacher of the Asian Mind-Body arts including Qigong, Tai Chi, and Yoga." Ted Kaptchuk, Harvard Medical School, Author of The Web That Has No Weaver