Does an adult in your home often fall? You can stop this with a Fall Risk Assessment!

We've all heard and maybe even seen our grandparents fall while moving around. Sometimes we think, "Oh, that's just how it is when we get older, we need to be a little more careful." But you know, these falls are not something to think about so simply. Even just one fall can lead to something serious, like a broken bone (`(Fracture)`), and sometimes a head injury or brain damage. So it's very important to be a little careful about this, especially when thinking about our beloved elders.

So what is this Fall Risk Assessment?

Simply put, a fall risk assessment is a procedure where your doctor examines you to determine your risk of falling. Just as we service a car periodically and fix its faults, our body changes as we age, becoming aware of the new risks that come with them, and taking steps to address them. This can help you prevent falls.

Why is this (Fall Risk Assessment) so important?

You might be thinking, "Okay, so what good does it do me if I know it exists?" Consider these facts:

• You can reduce your risk of falling: When you know exactly what things can cause you to fall, it's easier to avoid them.
• You can find out what your specific risk factors are: Not everyone falls the same way. Once you understand what specifically affects you, you can take steps to address them.
• You can be independent, independent, and active for as long as you can: It's hard to do everyday tasks when you're constantly afraid of falling. After this assessment, you can overcome that fear and live happily.
• You can live a healthy, independent life: How sad it would be if you broke a limb due to a fall and were confined to bed? This is a help to avoid such situations.

Many people think that falling is normal and unavoidable as we age. But that's not the truth. Most falls can be prevented! It just takes a proper risk assessment and taking the necessary steps.

Who needs a Fall Risk Assessment?

It's generally a good idea for every adult age 65 or older to have at least a basic fall risk screening. When you see a doctor, they may ask you questions like these:

• "Do you feel a little unsteady, like you're off balance, either when you're standing or walking?"
• "Have you fallen at least once in the past year?"
• "Do you always feel afraid or anxious about falling?"

If you answer "yes" to any of these questions, your doctor will likely suggest that you undergo a ``comprehensive fall risk assessment``, which will look into this a little more deeply.

How often should this assessment be done?

According to guidelines from various health organizations, it's a good idea to have this fall risk assessment at least once a year . However, depending on other medical conditions you have, your age, and whether you've fallen before, your doctor may recommend that you have this test more often, for example, every six months.

What things increase my risk of falling?

There are many factors that can contribute to falls. Let's look at the main ones.

Physical and health reasons:

• Ageing: As we age, our muscles weaken, our eyesight gradually deteriorates, our hearing may also deteriorate, our reaction time decreases, and it becomes difficult to maintain our balance. All of these factors increase the risk of falling.
• Balance problems: Some people feel unsteady even when standing upright. They may feel like they are swaying while walking. This is also a major cause of falls.
• Gait disorders: Some people walk very slowly, others walk quickly with small steps, some walk with their legs spread wide, and others walk like a bed. We call these changes in walking patterns ``gait disorders``. These can also make it easier to trip over something on the ground, slip, and fall.
• Distraction (mild cognitive impairment): As people age, their memory may deteriorate and they may have difficulty paying attention to one thing. This condition is called mild cognitive impairment. This can cause them to fall while walking, climbing stairs, or even walking around the house.
• Heart palpitations: When the heart suddenly starts beating faster, or beats very fast, or the rhythm of the heartbeat becomes irregular, you may feel dizzy and faint.
• Orthostatic hypotension: Do you feel dizzy or lightheaded when you suddenly stand up from a bed, chair, or sitting position? Many people have experienced this. The reason is that blood pressure drops suddenly when you change position. This is medically known as orthostatic hypotension. This is also a major cause of falls.
• Vision impairment: When your eyesight is weak, you can't see obstacles in front of you, stairs, or even small objects on the ground. Then, you are more likely to get caught in them and fall. Diseases like cataracts and glaucoma also affect this.

Other external and lifestyle-related causes:

• Home hazards: This is one of the most overlooked areas in the home , but it is one of the most dangerous. Think about it:
• Toys, newspapers, shoes, wires, and other things scattered all over the floor.
• Like places where there is no light, especially when going to the kitchen or bathroom at night.
• Slippery rugs, carpets, polished floors, tiled floors.
• The bathroom has soapy, slippery surfaces and water pooling on the floor.
• The lack of handrails on the stairs, the broken edges of the steps.
• Chairs and tables that aren't quite high enough.
• Climbing up a chair to get things from the shelves above in the kitchen.

"Our neighbor, Aunt Soma, slipped on a small rug that was on the floor while going to the bathroom last night and fell. Luckily, she wasn't seriously injured, but her hand was badly bruised. It seems like a small thing, but it can be a big problem, right?"

• Certain medications: Some medications you take can cause dizziness, drowsiness, weakness, and loss of balance. For example:
• Antidepressants
• Medicines given for certain mental illnesses (`Antipsychotics`)
• Benzodiazepines (medications that help you sleep and reduce anxiety)
• Some painkillers
• Some medications for high blood pressure (especially at the beginning)

Therefore, it is essential to tell your doctor about all medications you take (even vitamins and Ayurvedic medicines).

• Vitamin D deficiency: Vitamin D is very important for the strength of our bones and the functioning of our muscles. When there is not enough vitamin D in the body (Vitamin D deficiency), the bones become weak and can break easily if you fall. Also, due to the weakness of the muscles, balance can also decrease.
• Previous falls: If you have fallen before, you are more likely to fall again. This may be because of an injury from a previous fall, or because you have changed your way of walking and doing daily activities because of the fear of falling again.
• Lack of physical activity: Without exercise, when you spend most of your time sitting in one place, your muscles gradually weaken, your flexibility decreases, and your balance becomes impaired. This increases your risk of falling.

What happens during a Fall Risk Assessment?

This assessment usually consists of several steps.

Review of symptoms, medical history, and medications

Your doctor:

• If you have fallen before, they will ask you about it in detail. For example, how you fell, what caused it, what happened after the fall, and whether you received medical treatment .
• They ask about your daily activity level, whether you can do daily tasks on your own, or if you have any difficulties.
• Ask about all the medications you are currently taking (prescribed by a doctor, over-the-counter, vitamins, even traditional medicines) and see if any of them increase the risk of falls. This is very important.

Tests and further treatment

In addition, the doctor may also do the following:

• Your blood pressure (while sitting and standing) and heart rate will be checked.
• They will do several physical tests. These will look at things like your balance, muscle strength, and the way you walk (we'll talk about this in a bit).
• They may do a blood test to check levels of things like vitamin D, or they may order a DEXA scan to check bone density. This can help detect bone-thinning diseases like osteoporosis.
• You may also be referred to an occupational therapist. He or she can come to your home and look for potential hazards in areas you frequent (e.g., slippery rugs, poorly lit areas) and help you avoid them.

What tests do doctors use in fall risk assessment?

Doctors use several simple but effective tests to check your balance, strength, and gait:

• 30-Second Chair Stand Test: This is a simple test. You are asked to sit in a chair and cross your arms across your chest (you can't stand up with your arms). Then, you are asked to stand up completely from the chair and then sit down completely again. The number of times you can do this in 30 seconds is counted. This gives you an idea of ​​the strength of your leg muscles.
• Four Stage Balance Test: In this test, you have to stand in four different positions. You have to hold each position for about 10 seconds. These positions are progressively more difficult. For example, in one, you have to stand with both legs together, in another with one leg forward (tandem stance), and in the last one, you have to stand on one leg. This tests your balance.
• Timed Up & Go (TUG) test: This is also a common test. You sit in an armchair. Then, when told to "go," you get up, walk about 10 feet (about 3 meters) straight ahead at your normal walking pace, turn around, and sit down in the chair. The time it takes to do this is measured. Generally, if it takes more than 12 seconds , you are considered at high risk of falling.
• Cognitive test: Sometimes the doctor will ask you a few questions to check your memory, attention, and decision-making skills, and may also ask you to do some simple tasks. This is because, as we discussed earlier, falls can also be caused by mild cognitive impairment.

What will my results be after this assessment?

Once all of this is done, your doctor will tell you whether your risk of falling is low, moderate, or high.

The important thing is that even if your risk is "low," your doctor will likely advise you on preventive measures (`preventive recommendations`) that you can take to avoid falls in the future.

What are the general tips to reduce the risk of falls?

Depending on the results of your assessment, your doctor may offer you various advice and suggestions, such as:

• When getting up from a bed or chair, stand up straight: Instead of getting up suddenly, first sit in bed, put your feet on the floor, wait a moment, and then stand up straight. This can help reduce dizziness due to orthostatic hypotension.
• Use an assistive device: If you have difficulty walking, it is a good idea to use a properly fitted cane or walker that is appropriate for your height. Your doctor or physical therapist can help you choose the right one.
• Install grab bars in the bathroom: Installing grab bars near the bathroom and toilet can greatly reduce the chance of falling in slippery areas.
• Changing or reducing the dose of medications that increase the risk of falls: If some of the medications you are taking increase the risk of falls, your doctor may decide to change the medication or reduce the dose. Do not stop taking your medication or change the dose without your doctor's advice for any reason.
• Take vitamin D supplements: If your body has low vitamin D levels (`Vitamin D deficiency`), your doctor may recommend taking an appropriate vitamin D supplement.
• Exercise: It is very important to engage in exercises that are suitable for the elderly, especially those that improve balance, muscle strength, and flexibility. ``Tai Chi`` is a very good exercise for this. It is also important to do specific exercises recommended by a physical therapist.
• Increase home security:
• Remove unnecessary items from the floor.
• Provide good lighting, especially on roads used at night.
• Remove slippery rugs, or make them stick to the floor.
• Put a non-slip mat in the bathroom.
• Install handrails on both sides of stairs.
• Wear proper footwear: Wear shoes or sandals that fit well, are non-slip, and have low heels. Avoid walking barefoot or wearing only socks, even indoors.

Your doctor can also refer you to several other health professionals who can help keep you healthy:

• Eye doctor: Check your eyesight regularly, replace your glasses if necessary, and treat conditions like cataracts.
• Physical therapist: Provides specific exercises and instructions to help you build strength, improve balance, and practice walking safely.
• Occupational therapist: A therapist who studies your home environment and the way you do your daily activities and helps you make practical changes to reduce the risk of falls. For example, how to use the bathroom safely and how to do things safely in the kitchen.

Finally, what to remember (Take-Home Message)

So, the bottom line is, don't dismiss falling as a "normal part of aging." Even one fall can have a big impact on your life and your independence. This Fall Risk Assessment is a very important, proactive step you can take to protect yourself and your loved ones from this danger.

Maybe all you need to do is make some small changes to your lifestyle and home. It could be something as simple as choosing a pair of shoes that fit properly, taking some vitamin D, or seeing a physical therapist and learning some exercises.

If you are over 65, or if you are concerned about falling, or have fallen in the past, you should definitely talk to your family doctor (or GP) and consider having a full fall risk assessment. It will be a great investment in your healthy, happy, independent life!

` Falls, aging, fall risk assessment, fall prevention, elderly health, fractures, balance