BScN, RN, GNC(C) President,
Eldercare Home Health Inc.

Unfortunately, there’s no easy answer to the question “Why do seniors fall?”

The answer is often very individualized and very complex.

That said, there are more “common” causes for falls – but be aware, this list is by no means exhaustive.

First there are the true accidents

Missing a stair on the way down the staircase, tripping over a toy left by a child in a hallway, slipping on a slick wet floor in a grocery store…these are all scenarios that we have seen in cases where seniors have fallen. Although the cases that we have seen have resulted in serious injuries, like fractures, these kinds of “accidents” have been the exceptions.

Most of the falls that we see are related to impaired mobility, sensory changes, balance disturbances, medication influences, blood pressure fluctuations, dehydration, confusion, agitation, disorientation etc.

There’s enough material available to write volumes on each of these causative factors, but in the interest of being useful, each day for the next number of days, I’ll touch only on some important highlights.

You might receive guidance to wear “appropriate footwear”. What does that actually mean?

Proper footwear may include shoes or slippers with non-skid soles, that are closed back, that have either no heel or a low (1″) heel. I have noticed that most styles of slippers, worn by Clients, do not have support around the heel and often do not have non-skid soles. (Socks should also be non-skid).

While we’re in the region of the foot in our discussions, other foot related issues include foot and nail care that allow for comfort and fit in the shoe. A podiatrist or foot care nurse might be needed to assist with this. For those with longstanding diabetes, neuropathy may be a contributing factor to falls. A person with neuropathy in the feet cannot feel their foot in their shoe or striking the ground. Swollen extremities caused by poor circulaton, edema, heart failure, infection are problematic because sensation in the foot and leg may be impaired. Also the added weight of edema in the legs, makes it difficult to move the legs normally and easily during walking. Any kind of pain will interfere with a person’s gait-and this may be due to arthritis, osteoporosis, fracture, intermittent claudication, knee pain, side effects of medication, poor circulation etc.

Some solutions may include; regular exercises, analgesics, pressure stockings, orthotics, weight loss, leg massage, proper footcare, diabetic control, reduction of edema, etc.

Helpful people may include a physiotherapist, a chiropodist, a footcare nurse, a doctor or specialty footwear professional.

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