It’s Not Normal: Falls


Cleveland, MaryJo 4x6Maryjo L. Cleveland, MD
Medical Director, Post Acute & Senior Services
Chief, Division of Geriatric Medicine
Summa Health System
Akron, Ohio 

It is the middle of winter here in Cleveland and we have experienced an unusual amount of snow, sleet and ice. In fact, if you live anywhere with winter, I’ll bet this weather has been challenging. One problem that we see more of in the winter is falls. I ask all of my patients if they have experienced a fall.  Can you  guess the most common answer I get? It isn’t “no”— it’s “not yet.”  Isn’t that interesting? That answer means that they expect to fall sometime. In other words, they think it’s normal. But we are here to find out otherwise!

Falls are certainly common. Most people can tell you about friends or family members who have fallen and suffered a serious injury from a fall, such as a broken hip. Most people also tell me that falling is one of the things they fear the most. The good news is that while falls are common, they are not inevitable. There are well defined risk factors that make it more likely for someone to fall.   And there are also recommendations on how to prevent falls. These recommendations will require you and your healthcare professional to work closely together.

First, if you fall, let me encourage you to tell someone! People often do not report falls because they are fearful of the consequences. They don’t want their daughter to tell them to stop going to the store or their healthcare provider to recommend a cane or a walker.  They certainly don’t want to feel “old.” But falling once puts you at a much greater risk for another fall—even if you don’t hurt yourself. It might be the next fall that causes harm. So, if you do fall, tell someone! Think of it as preventative medicine—like your flu shot. This is something you do to lower your chance of getting hurt or sick in the future.

Second, when you talk to your  healthcare professional,make sure your fall is taken seriously. Don’t let him or her tell you “at least you didn’t hurt yourself” and let it go. A fall is a signal that your healthcare provider needs to check out your risk factors for falling. These risk factors include:

  • How the fall happened
  • Your medications—taking more than 4 medicines, or any medicine that can affect your thinking
  • Your balance and the way you walk
  • Your muscle strength
  • Your blood pressure, heart rate and rhythm
  • Your vision
  • Your feet and what kind of shoes you wear
  • Possible dangers in your environment

Third, your healthcare provider will discuss with you possible ways to lower YOUR specific risk factors for falling. For example, if you have a cataract, maybe it is time to have it removed. If you take many different medications, perhaps some of these can be reduced. If you have muscle weakness or balance problems, you may be referred to a physical therapist. You may get some recommendations to make your home a safer place, such as removing throw rugs, increasing lighting, or installing handrails. It may take more than one step to lower your risk of falling again.

Finally, falling is an area where you have to fully take part in your care. There is not likely to be a pill that you can take to fix this! If you are referred to physical therapy, go! Work hard and do your exercises. It is never too late to improve your muscle strength and your balance. It will help reduce your fall risk  and will also give you more energy, confidence, improve your mood, and help you sleep better. Most studies about reducing the risk of falls have concluded that exercise is the single most important thing you can do. [Click to see our tip sheet for Preventing Serious Falls]

In summary, falls are common but they don’t have to occur. You can lessen your risk by talking to your healthcare provider, having a complete medical exam, and taking steps to improve your functioning and making your environment safer. So, if I ask you if you have fallen, you can confidently tell me “no.” Remember, it’s Not Normal!