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makes a trip to the emergency room for injuries frequently head injuries and broken bones sustained in a fall. Every 20 minutes an older adult dies from those injuries.

In addition to being the major cause of nonfatal and fatal injuries among seniors, falling frequently contributes to the loss of older adults independence. Our own experiences put a human face on these statistics when those who fall are friends, neighbors or ourselves.

Heart disease or heart failure can cause muscle weakness and fatigue, dizziness, and balance problems. Chronic obstructive pulmonary disease (COPD) can also cause weakness, dizziness or fainting. In addition to muscle weakness, strokes can sensory imbalance on one side of the body.

Low blood pressure, caused by dehydration, aging circulation, and blood pressure medications, can cause dizziness and fainting, especially when changing position from lying or sitting to standing. In addition those with bladder or bowel problems that make them rush to the bathroom urgently are at greater danger of falling, especially if they have low blood pressure on rising.

Pain and joint inflexibility of arthritis can cause an unsafe gait and poor balance. Vitamin D deficiency can cause weakening of bones. Vision problems make it harder to judge distance and avoid obstacles, especially at night.

Parkinson Disease causes muscle tremors and stiff movements, stooped posture, shuffling gait and balance problems. Any dementia or mental confusion can make it harder to respond appropriately and quickly to risky situations.

Several drugs, especially those used to treat blood pressure, mood disorders, sleeping problems and epilepsy, have side effects and interactions that can cause dizziness, drowsiness, or unsteadiness. In addition blood thinners add additional risk for those who fall because they cause excessive bleeding in the brain or from wounds.

If you have had one fall, you are twice as likely to have another. It is important to let your physician know about the circumstances of any fall that you have had so that he/she may suggest treatments and exercise programs that may help. In addition you should go over your medications list with your doctor or pharmacist to see if any medications should be changed to lower falling risk.

A Jan. 3 article in the Sacramento Bee, program teaches seniors how to avoid injury from falling described a safety course in the Netherlands that included both a practice obstacle course that resembled uneven and unsafe walking conditions and also instruction and practice in how to fall with less chance of injury.

While there are of similar course taught by registered physio and occupational therapists in the Netherlands, my search to find something similar in Butte County came up empty. Geographically, the closest we get are two comprehensive fall prevention programs offered at UC Davis, Matter of Balance and On, both small group programs that includes exercises to increase strength and balance, techniques for moving safely, and education about safety hazards in the home and community.

Considering the cost of medical care related to falls $31 billion annually it would make sense for all hospitals to focus on the of prevention rather than the of cure, when it comes to falls. But lacking comprehensive fall prevention classes, it is still possible for elders in this area to take proactive steps to mitigate their risk of falling.

The first step is learning the changes to make in your home environment to reduce fall hazards.

Steps to Fall Proofing Your Home by Scott A Trudeau has many specific room by room suggestions that either the elder or their children or caregivers should consider.

Steps and stairs should have good lighting, be clutter free, have rails on both sides, and for those with vision problems, contrasting colored tape on the edges to clearly define them.

Standing on chairs or step stools with nothing to hold onto is a major cause of falls. Items that are used the most should be located on easy to reach shelves. At risk seniors should ask for help with changing light bulbs or getting objects down from high places.

Get rid of clutter and loose wires on floors. Clean spills immediately. Replace scatter rugs with rubber backed mats. In bedrooms make sure lights and telephones are easy to reach from the bed. Keep the path to the bathroom clear and have plenty of lights to show the way.

Bathroom slips are a main hazard. Place non slip mats both inside and outside the tub or shower. Bath chairs and hand held shower heads should be used by those who feel unsteady. Install grab bars in showers and tubs and near toilets. Make sure they are installed at the proper height and firmly anchored.

Whether inside or outside, it is essential to wear shoes with good treads and adequate support. Slippers should not be slippery but should have rubber treads. Walking in your stocking feet is asking for trouble unless the socks have nonslip soles. Wear your glasses so you can see where you are going, and if bifocals make it hard to see clearly when you look down, consider getting a set of distance glasses just for walking outdoors.

Finally, remember that you should always have three points of contact either two hands and one foot or two feet and one hand in contact with something sturdy when you are moving in any potentially risky way such as getting out of the shower or moving upstairs.

second step to preventing falls is to exercise to increase strength, flexibility, and balance. Unfortunately fear of falling often makes frail seniors cut back on activity, but with the proper guidance all seniors can improve strength, posture, gait, so they are more able to recover from a stumble without falling, or if they fall, fall with less injury.

For those seniors with fairly good mobility, regular attendance at or classes at local gyms can increase body strength, balance and flexibility. Tai Chi and gentle yoga classes use slow, controlled movements and also teach body awareness. Water exercises can build strength in a supportive environment.

In Motion Fitness offers several classes to get a senior body in shape, including Gentle Yoga, Sit N Be Fit, and Senior Wellness. Contact Adeliz Alvarado King for information at 343 5678.

The Chico Sports Club offers Strength Training for Older Adults and Fit 4 Life as well as Gentle Yoga, Aqua Aerobics, Aqua Yoga, Tai Chi Chuan, Classic Cardio and Classic Sculpt.

For those who are recovering from falls or other conditions that might increase fall risk, the Outpatient Clinic at the Enloe Rehabilitation Center offer individualized physical therapy to fit the needs of clients referred by their physicians. Jeff Zelenski, outpatient therapy manager, explained that therapists will use specialized tools such as BalanceMaster and RealEyes infrared goggles to identify problems with balance, gait, neck motion, and visual stability so they can create a personal plan of care.

Also for those whose physical condition is impaired by strokes or other medical conditions, the BEWEL program through the Chico State University Kinesiology Department offers one on one exercise programs that are custom tailored to the goals of the individual. The program is open to all ages for $90 per semester.

In addition to safety checking your home environment and strengthening your body, the third step to preventing falls is to become aware of your body in its environment. Slow down and pay close attention to where you are going. People often report that they were rushing or distracted when they fell.

Especially when walking outdoors, constantly scan the area for about six feet in front of you, looking for raised areas in the sidewalk, slippery patches, upcoming curbs or obstacles. If you live in a cold climate, check for black ice especially on stairs or getting out of car.
timberland hat An ounce of prevention