My grandmother was a lively, caring, wonderful woman, who remained very active late in her life. One spring day, after an unusual April blizzard, she stepped out of her apartment on her way to her weekly bridge game. She fell on the ice, in an event that led to an open ankle fracture and changed the course of the remainder of her life.
We all know that a fall, especially in an elderly or frail person, can result in disaster. Major fall-related injuries such as hip fractures can sometimes precede abrupt decline in function and death in the worst cases. While many falls don’t result in any injury at all, when I discuss falls with my patients, I consider those events near misses and potentially catastrophic for any elderly or frail person.
Falls can have many causes, and often numerous factors contribute. Some factors can be modified by at-risk people, and some cannot. Discussing the mechanism and contributors to falls with one’s health care provider (or even better, a physical or occupational therapist) can help identify those factors. If a person can reduce their risk of fall and injury, by all means we want to help!
Modifiable risk factors might include weakness in large muscle groups, need for and proper use of an assistive device such as a walker or cane, and potential hazards in one’s home such as rugs or bathtubs. Of course, in some patients there may be fall risk factors which cannot be easily modified, which might result in the decision for extra help or a change in living arrangement.
After my grandmother’s ankle fracture, she had a rocky course. She endured surgeries, bone infection, hospitalizations, and other medical complications. She never regained the ability to walk independently again and spent much of the last couple years of her life in a nursing home where she could receive the care she required.
Last summer, my grandmother contracted COVID-19 at her nursing facility and sadly died a few weeks later. A woman who led a truly remarkable life lost her fierce independence after an accidental fall. I’m sure if she could have gone back in time, she would have just stayed home that icy April day. If you or a loved one is worried about falling, I hope you will talk to your primary care provider about it.
Kelly Evans Hullinger, M.D. is part of The Prairie Doc® team of physicians and currently practices internal medicine in Brookings, South Dakota.
