It's Your Health Radio, a special podcast series presented by Henry Mayo Newhall Hospital. Here's Melanie Cole.

Melanie Cole, MS (Host): Welcome to It's Your Health Radio with Henry Mayo Newhall Hospital. I'm Melanie Cole. And today, we are talking about preventing falls. This is such an important topic. And joining me today is Zach Tarrillion. He's a physical therapist in the outpatient physical therapy department at Henry Mayo Newhall Hospital.

Zach, thank you so much for joining us today. Tell us why preventing falls is such a big issue for older adults and their families. As people start to get older and our balance starts to, you know, go a little awry, why is preventing falls really so important?

Zach Tarrillion: Well, first of all, thank you for having me, Melanie. I'm going to hit you with some statistics just right off the bat here. Current research shows that over 30% of people 65 and older will fall at least once a year. That number goes up to 50% for people over age 85.Twenty percent of those fallers will need to seek medical attention. This has a huge impact on our society and medical system, as 40% of hospital admissions for people over the age of 65 are from falls, with the average hospital cost over $30,000. So for older adults and their families, this has serious consequences, both physical and psychological.

Falls are the leading cause of a move to a skilled nursing or long-term care facility. And depending upon severity, there can be possible long-term pain following. Besides that, psychologically, families and caregivers can be overly protective now, leading to a loss in self-esteem, independence, and overall quality of life.

Melanie Cole, MS: Well, it certainly is true. And, you know, Zach, as someone who's done this a long time and worked with so many older people to help prevent falls, I hear you when you say all of those statistics. So, if someone listening is thinking that they feel a little unsteady, but maybe they're not that old, I mean, I'm 62, and I catch myself wobbling a little when I'm putting on one shoe or putting on shorts. Why is now the right time to start thinking about preventing falls instead of waiting until something happens? I mean, we want to get ahead of this, right?

Zach Tarrillion: Right, Melanie. Prevention is definitely key . One more interesting statistic, 10% of falls result in fracture or a serious injury. Like you said, we want to be ahead of that. Those fractures or serious injuries can cause long-term pain or suffering, which is further going to impact overall mobility and independence. Plus, unfortunately, as we age, how quickly we heal from such injuries is negatively impacted and starts to slow down. Prevention is definitely key.

Melanie Cole, MS: Well, since we're saying that prevention is the key, are there warning signs? Are there red flags, Zach, that someone is a higher risk of falling even maybe before the actual fall happens? Is there some way we can maybe predict a little bit ahead of time?

Zach Tarrillion: Absolutely. There's going to be telltale signs that are going to tip us off to this, such things like holding onto furniture or the wall while walking, difficulty when standing up from a seated position, gait changes where the person is shuffling instead of taking nice long full steps. Maybe there's been a couple of close calls, near falls. They might be experiencing dizziness or vision impairments. And you might see a subtle change, like loss of interest in doing things outside of the house, not socializing as much, especially when it involves something physical or outdoors.

Melanie Cole, MS: Okay. Are there certain people that we can identify? You've given us some really good red flags to pay attention to. Now, what about risk factors? we obviously know older adults, right? And our proprioception, our ability to think about our balance starts to go a little bit by the wayside, but are there other groups that are higher at risk?

Zach Tarrillion: Of course, older adults are primary on this list, especially over 80 years, but there's other groups too. Groups that have musculoskeletal issues, things like osteoarthritis, or maybe they had a long-term hospital stay where they were in bed for a while. They aren't regularly engaging in physical activity and exercise anymore because of pain or some kind of other movement dysfunction. That's going to place someone at higher risk. Those populations with neurological conditions, such as a history of cerebrovascular accident or stroke, Parkinson's disease, dementia, or a couple of other examples, they can all be at increased risk also. Lastly, those with vestibular issues. People that are experiencing vertigo or dizziness, or even something like orthostatic hypotension. These can all be factors that can lead to serious injury from a fall.

Melanie Cole, MS: Well, thank you for all of those. So now, let's do some actionable items. We've identified the risk factors and the red flags. If we're the child of an older adult or we notice some of these things, let's start with the home, Zach. How can we make our homes safer? The most important changes to reduce those fall risks. We think of bathrooms, bathtubs, showers, we think of those, but ways to make those less of a fall risk, and even carpets, the corners of carpets can get pretty dangerous too, right?

Zach Tarrillion: One of the easiest ways to reduce risk of falling is controlling the environment. And the home is the perfect place to start, and it makes the most sense because we spend so much time there. Making sure throw rugs are well secured so that they don't slip out from under you. Making sure rooms are well lit, and there are no wires or cords running along the ground posing potential trip hazards. If it's a multi-story residence, all stairways need to have railing that is not broken or loose. The walkways need to be wide enough to accommodate the person and assistive devices they might be using, such as walkers or rollators. You don't want to catch those on a corner. The ground should be free of any kind of clutter as that could pose a potential fall hazard. You mentioned the bathroom, and that's a big one. Anti-slip mats should be placed on the tub floor. Grab bars can be installed in tubs and showers to prevent falls.

Melanie Cole, MS: So, when we think of trying to practice our balance, get better at it, reduce our risk of falling, what are some of the best exercises or physical therapy programs that we can use to improve our balance and strength and hopefully prevent this in the first place?

Zach Tarrillion: These programs are going to be well-rounded, incorporating not just balance, but also strength. The person's going to be doing primarily weight-bearing activity. And very important, they're going to be addressing all three planes of motion. Things where we're moving front to back, side to side, and also rotating. These are things that we do in everyday life, so we want to train for that.

For the balance-specific work, it's going to need to incorporate both static and dynamic activity on two legs, one leg, staggered stance positions. A good example of static balance would be just standing in place on one leg. A better exercise would be the dynamic balance variation, where you're standing on one leg but doing another movement at the same time, like reaching overhead with an arm or leg, or rotating one's head from side to side.

Melanie Cole, MS: Wow. So there's some real things that people can do. Now, when we think of those exercises, we typically think of maybe doing them in a gym or at home working with a physical therapist.

So Zach, if someone has not had a fall, but they want to work on those things you were just discussing, who's the best person to look for? Can they work with a physical therapist? Do they go to a gym? Can they do these things at home? How do they do them?

Zach Tarrillion: I think getting to a physical therapist, maybe I'm a little biased, is the best place to start. They're going to be able to do a full evaluation and come up with a very thorough program that that person can either do on their own, or they can come in for regular follow-ups where those exercises can then be progressed and made more challenging based on that person's progress.

Melanie Cole, MS: Well, that's great information if somebody really needs to see you and they can get a program set, and then they can do it on their own or have some sessions. That's great. Now, if a person has already fallen, how does the evaluation with you work? What is the treatment like? Speak about how you help people.

Zach Tarrillion: If they've already had a fall, there's going to be not just the physical part, but also the psychological part too. They might have lost some confidence like we talked about earlier. The physical therapy evaluation is going to, of course, address the physical component, get them active again, get them doing things on their own. We're also going to address the psychological component. Everything that we do is going to be done in a very safe environment to that person's ability, where they can start to rebuild their confidence again and feel better moving independently.

Melanie Cole, MS: Yeah, that's such great information. Zach, if listeners want to remember three key takeaways from this episode today about preventing falls, what do you want them most to take away from our discussion here today?

Zach Tarrillion: Falls are preventable. We talked about the environmental factors, and I think evaluating the home for safety is a great place to begin. Assistive devices such as canes, walkers, and rollators unfortunately can be viewed negatively. But I encourage them to be viewed as a tool that can promote safety and therefore improve mobility and independence.

Lastly, and probably most important, balance is a skill much like strength or flexibility. Like all skills, it is trainable, but also will diminish with regular usage. Remaining active and maintaining a well-rounded exercise program that incorporates balance activity is paramount in preventing falls.

Melanie Cole, MS: Great information. Zach, thank you so much for joining us today. And you can contact Henry Mayo Newhall Hospital Outpatient Physical Therapy at 661-200-1550, or you can visit henrymayo.com/physicaltherapy for more information and to get connected with one of our providers. You can also visit the free Henry Mayo Newhall Hospital online health information library at library.henrymayo.com. That concludes this episode of It's Your Health Radio with Henry Mayo Newhall Hospital. I'm Melanie Cole.