Disclaimer: This podcast is for informational purposes only and is not intended to be used as personalized medical advice.

Joey Wahler (Host): Taking a fall can cause serious injury, but the risks can be reduced. So we're discussing fall prevention. This is Be Well with Skagit Regional Health. Thanks for listening. I'm Joey Wahler. Our guest, Paul Ross, Trauma Program Manager for Skagit Regional Health. And Paul, thanks for joining us.

Paul Ross: Thank you for having me.

Joey Wahler (Host): So, first, what makes you so passionate about the subject of fall prevention?

Paul Ross: Well, the passion comes that it's 65% of all of our traumas at Skagit Regional Health, and reducing those risks to our population.

Joey Wahler (Host): When we talk about it being preventable, what are some things that people should keep in mind there?

Paul Ross: Multiple levels of prevention that can be provided: regular doctor's visits yearly, having your fall assessment completed by your provider, medication adjustments, hearing and eyesight correction, regular exercise routines and having your house evaluated for clutter, such as loose rugs, extension cords and then just making sure that everything is within reach.

Joey Wahler (Host): Interesting. Well, one of those you mentioned stands out to me, getting your eyesight checked. Do people tend to let that fall by the wayside more than maybe some other health checkups?

Paul Ross: They do because part of it is insurance-related. A lot of eyesight type injuries are not covered under some insurances such as Medicare to the full degree and it may be a price to the patient.

Joey Wahler (Host): Gotcha. So before we go any further in terms of age and whatever other factors there may be, who's most at risk of falling?

Paul Ross: So the people that are most at risk of falling are those that are 65 and older; poor nutrition; poor conditioning, such as getting enough exercise and keeping your muscles conditioned; people that are on multiple medications; people that use assistive devices such as canes, walkers, crutches; and, again, to mention the poor eyesight and hearing-type issues; and then, anybody that has balance issues especially after postoperative procedures such as any kind of amputations you may have from diabetes.

Joey Wahler (Host): Well, you mentioned there are canes, walkers and crutches. When people need those, be it temporarily or permanently, how big an obstacle for people in the medical field is getting some people to agree to use them in the first place, because especially as people get older, sometimes that can be an issue, right?

Paul Ross: Correct. And I think it's just a big challenge of recognition that we all are getting older. And many people don't want to admit that their capabilities aren't what they were many years ago. And so using these devices in their regular household isn't always the safest bet when you're going through doorways, thresholds, hallways, trying to get in and out of your bathroom with walkers. Some of their houses just aren't quite built for those kind of assistive devices.

Joey Wahler (Host): So really it sounds like much of this fall prevention surrounds convincing a person just to adjust their behavior or surroundings, right?

Paul Ross: That's right, and that's where the family members can really come in and help us out with this as well.

Joey Wahler (Host): So talk to me about that. How do you kind of grease the skid, so to speak, if you're a relative of someone that needs to move in the direction of making changes that will keep them on their feet, but it may involve one or two things that they're just not used to?

Paul Ross: I think the most important thing that families can do is to physically go in their home and look for obstacles and look around the house and move extension cords, make sure everything's in reach within the kitchen, all the common items, lamps that are in reach of the couch and do their very best to just make everything a little more accessible for them.

And then, sometimes it's just a conversation with a little bit of tough love. You know, we're not where we used to be when we were younger. Our conditioning starts to go down, especially after a fall. We get too worried and we may sit around a little bit more and get worsening conditioning and then develop pneumonias and other types of health concerns.

Joey Wahler (Host): It so happens I have a relative in his late 80s who recently suffered a partial hip replacement. And as part of his rehab and recovery, he was given a cane, using one for the first time. And I spoke to him recently. He's doing great, fortunately. But he said to me, "You know, I probably don't need the cane anymore, but I don't want a recurrence, so I'm going to stick with it just to be safe," and that's the perfect attitude, right?

Paul Ross: It is the perfect attitude. And then, you know, an evaluation by a physical therapist wouldn't be a bad idea at all. Some of the other issues that you also have to worry about is weather when you're using these assistive devices; icy weather, any kind of snow, wet surfaces. You have to be aware that you're using these devices on those other types of surfaces, not just in your home.

Joey Wahler (Host): Right. How about the long-term effects of falls, especially as you get older? It's potentially a lot more dangerous and damaging than just bumps and bruises.

Paul Ross: Correct. And the long-term effects, really, with falls come into play when there are hip fractures, which account for a very large number of fall-type injuries. I believe 95% are caused by falling. And worsening concerns beyond that are unsteady gait from after your hip is repaired. They're very difficult and long surgeries to recover from. Also, creating balance issues, fear issues, again, dementia and pneumonia. People that fall on blood thinners and hit their heads are a trauma in my hospital, and it is in most hospitals across the nation as well. Due to the increased bleeding risk, there's an increased risk of you bleeding in your brain as well, which can be debilitating for a long period of time.

Joey Wahler (Host): Sure. Let me ask you because you are Skagit's Trauma Program Manager, what can you tell us about how common it is for older people to fall, and also how often, whatever caused it, is in fact preventable? In other words, you're telling us you know that it is, how much So? Maybe give people an idea of how often you find that someone that fell didn't have to if you will.

Paul Ross: We don't have the percentages on whether they would've fallen or not. I can tell you that women are experiencing more falls than men and more hip fractures than men as well. I believe they fall two-thirds more often than males do and suffer these injuries due to osteoporotic changes in their bone structures.

Joey Wahler (Host): But even if there's no data necessarily to support it, I would imagine sometimes you hear stories about how or why someone fell and you think it's unfortunate beyond the obvious because it's something that could have been avoided had they just made some of these adjustments that we're talking about, right?

Paul Ross: Sure. You know, installing different assistive devices in your bathroom such as handholds and stuff like that. And again, seeing physical therapy, talking to your doctor, having your house assessed. And oftentimes, the medics will take a picture of their home and you do think, "Boy, there are so many ways that this could have turned out much better."

Joey Wahler (Host): A couple of other things, how about the potential psychological impact of falling that we're trying to avoid here? Like the fear of a recurrence? Maybe if it happens one time, especially if you're older, if you're not what you once were physically, that could change your whole outlook in terms of getting around to the future, right?

Paul Ross: It does. And so, oftentimes, those people will sit more often and lay in bed for longer periods of time, causing further deconditioning of their bodies. And then, you know, eventually developing bed sores, pneumonia, all the other things start coming into play that they weren't expecting and they wanted to prevent, but it was due to that fear that these other things occurred.

Joey Wahler (Host): And then, also, if someone sees that a loved one or someone they know needs to make one or two of these adjustments we've discussed ahead of time to prevent and avoid the risk of a fall, what's the best method if you know they're reluctant? Because we all know that as people get older, they become more set in their ways. Often they poo-poo some of these changes. What's a good tip or two to try to convince them to do some of these things before the fact as we've discussed?

Paul Ross: I think if you have somebody that's in that situation, it's very difficult to get their loved ones to listen. And so some of the changes you can make is, you know, look around their house and maybe buy them a new pair of sneakers and then, maybe hide their flip flops and say, "You know, you should really wear these around the house more often." So I think sometimes it's just working it from a little bit of a back angle. Again, you know, changing someone's personality and everything else can be very difficult. I think just sitting down and having a conversation with them is the best and first method that anybody should try. But I think there are several things you can do without them really even noticing.

Joey Wahler (Host): Understood. Well, folks, we trust you're now more familiar with fall prevention. Paul Ross, thanks so much again.

Paul Ross: Thank you for having me.

Joey Wahler (Host): Thank you for being here and for more information. Please visit SkagitRegionalHealth.org. Again, that's SkagitRegionalHealth.org. If you found this podcast helpful, please share it on your social media. And thanks for listening to Be Well with Skagit Regional Health. Hoping your health is good health, I'm Joey Wahler.