Consequences of falling

One in three adults age 65 and older falls each year, but less than half talk to their health care providers about it.

Among older adults (those 65 or older), falls are the leading cause of injury or death. They are also the most common cause of nonfatal injuries and hos- pital admissions for trau- ma. In 2010, 2.3 million nonfatal fall injuries among older adults were treated in emergency rooms and more than 662,000 of these patients were hos- pitalized.

In 2010, the direct medical costs of falls, adjusted for inflation, was $30.0 billion.

Up to 30 percent of people who fall suffer moderate to severe injuries such as lacerations, hip fractures or head traumas. These injuries can make it hard to get around or live independently, and increase the risk of early death.

Falls are the most common cause of traumatic brain injuries, or TBI. In 2000, TBI accounted for 46 percent of fatal falls among older adults.

Many people who fall, even if they are not injured, develop a fear of falling. This fear may cause them to limit their activities, which leads to reduced mobility and loss of physical fitness, and in turn increases their actual risk of falling.

Source: Centers for Disease Control and Prevention

Duncan Munro, 72, of James Island, has fallen twice, stumbling in a parking lot and hitting his head on a BMW in one fall and tripping over his dog in his house in the other.

Likewise, 79-year-old West Ashley resident Betty Ochoa has tumbled twice, first after someone brushed by her while disembarking on a cruise and the second after tripping on a rug in her home. She has gotten rid of the rug.

And Linda Mohr, 71, of James Island has had two major falls, one in the shower that took her 30 minutes to get up from and another in the basement as she was trying to take out the trash. The latter left her face black and blue and required a visit to the emergency room.

They are among the dozens of seniors who, unlike many, have taken proactive steps to help prevent future falls, including taking the “Matter of Balance” class at the Lowcountry Senior Center on James Island and removing risks from physical environment.

Growing concern?

When baby boomers started turning 65 in 2011, they kicked off a trend that should focus national attention on preventing falls. The numbers are staggering, no pun intended.

The Census Bureau estimates the number of seniors age 65 and older in the United States will double in the next 40 years, from 40.2 million in 2010 to 88.5 million in 2050.

And according to the S.C. Office of Research and Statistics, the Centers for Disease Control and Prevention and World Health Organization, falls are the leading cause of injury death among people age 65 and older, in the Palmetto State, the United States, and the world.

It’s not only disconcerting but expensive for a health care system that has been the subject of fierce debate the last four years.

In 2010, the CDC says 2.3 million nonfatal fall injuries among older adults were treated in emergency rooms and more than 662,000 of them required hospitalization. The direct cost of falls was $30 billion.

In South Carolina, the state statistics office says 36,000 falls by adults age 55 and older resulted in visits to the emergency room and 8,900 in hospitalizations. The tab: about $404 million.

Prevention is key

That’s a lot of money for a health problem that is much easier to prevent than cancer or car accidents.

Unfortunately, seniors who have fallen often react by avoiding movement, which often leads to a cascade of other health problems, according to Dr. Bright McConnell, an age management physician with FitMed Partners on Daniel Island.

“As people age, they lose strength, have slower reaction times and often have poor balance. This can often lead to falls and injuries,” says McConnell. “When a patient falls, they lose confidence, which is natural reaction. However, this fear can actually be detrimental and lead to more injuries in the future.”

Like many health care providers, McConnell recommends exercise for senior citizens to help prevent spills.

“Exercising will actually help prevent falls. For example, strength training will help decrease the loss of bone density while getting stronger through working the muscles. Yoga and t’ai chi will help improve balance, which requires good muscle strength and joint mobility,” says McConnell.

“There are various benefits of being active for a senior citizen. Exercise can help with disease prevention, keep weight in check, encourage a healthy heart and prevent falls.”

Those who have been sedentary, he adds, need to start slowly, get some guidance, and possibly get a balance assessment.

FitMed Partners has a Biodex balance assessment machine, a training device that allow clinicians to measure neuromuscular control and pinpoint weaknesses.

Assessment first?

Theodore Darby, 78, of Mount Pleasant took the Biodex test last week at FitMed Partners, just months after he started an exercise program at the Senior Services Center in Mount Pleasant.

“I decided I better start doing something,” says Darby. “I am glad I am exercising. It makes me feel better. I was getting lazy. ... This is the first time I have done an exercise routine in my life. I like having a set routine. It is helping me mentally and physically.”

Darby has many of the issues that make him more vulnerable to falling, including a pacemaker, bad knee, neuropathy from previous cancer and arthritis.

“I feel my neuropathy and arthritis affect my balance a bit,” he says, noting that imbalances are particularly noticeable when he gets up too fast after sitting.

The BioDex test, he discovered, was harder than he thought it would be and helped him realize a common problem for seniors: delayed reaction to falling.

“When it moved, it took me a minute to figure out how to counteract the fall.”

Local options

Health and wellness centers in the Lowcountry are responding to the need.

In addition to its “Matter of Balance” classes, the Lowcountry Senior Center is piloting a new, evidenced-based program, “FallProof Balance,” with a $4,800 grant from the Boeing Employee Community Fund.

Aleshia Parrish, who teaches Matter of Balance and FallProof and has worked with training seniors for 20 years, thinks the approach of preventing falls is gaining traction and it starts with exercise.

“There are so many wonderful benefits to having a regular exercise program and fall prevention is just one of them. It is more about improving balance and mobility than training one’s body not to fall.”

Increasingly, many of the yoga studios are tailoring classes for seniors who need more focus on leg and hip strength, flexibility and balance.

In February, local yoga instructor Gail Corvette started a class, “Grace: Strong in Silver,” at The Yoga House of Charleston in West Ashley after working with increasing numbers of people with arthritis and post-trauma balance issues.

“The regular yoga classes weren’t teaching people to stretch the joint to the max and strengthen the muscles around the joint,” says Corvette, saying she was inspired by Desiree Rumbaugh and her “Wisdom Warriors” groups.

“I’ve been tailoring a basic class for their (senior) needs, but we don’t just lie around and do gentle stuff. Every class has a challenge,” says Corvette.

Her class is filled with seniors and older adults who either have health issues compromising balance, from Parkinson’s disease and people coming out of chemotherapy to just grandmothers, such as 70-year-old Helen Cochran, who want to keep up with the grandkids.

“I have eight wonderful grandchildren and want to be able to get on the floor with them and get back up,” says Cochran, a regular in Corvette’s Grace class.

But she admits to some initial misgivings.

“I didn’t think I would last. My concept of yoga was totally different. I thought it was all these hard bodies doing weird poses, but Gail makes it so simple to do. All the poses aren’t easy, but she’s made it where I can do it.”

“I’ve gotten all kinds of benefits from it. I don’t have the hip problems any more. My arthritis is better and I feel like I have better balance.”

Reach David Quick at 937-5516 or dquick@postand courier.com.