By Janice Harvey, RPh, CDE
The importance of preventing injuries related to falls cannot be overstated. Falls are, by far, the leading cause of injury-related hospitalizations among Canadian seniors. In fact, 20% to 30% of people aged 65 and older have one or more serious falls each year. Half of these falls happen at home. (1)
Let’s look at these numbers for Vancouver Island. In 2019, for individuals age 65+, there were 158 hospitalizations due to injuries from motor vehicle accidents. In comparison, there were 3,199 hospitalizations due to injuries from falls. And the hospital stays were longer: averaging about 18 days for injuries from falls versus about 14 days for injuries from car accidents. (2)
Why does aging increase the risk of falls?
Some changes occur naturally with aging, such as vision changes, delayed reflexes, and weaker muscles. These can make it easy to lose one’s footing when walking on uneven ground, such as when stepping off a curb. As well, aging is often accompanied by an increase in the number of medications that people take to treat various health conditions, and many of these medications cause dizziness and drowsiness, which may contribute to falls.
A medication review can identify medication concerns
It is common for seniors who have several health conditions to take multiple medications, sometimes more than one medication for each condition. This is referred to as “polypharmacy.”
Regular medication reviews are especially important for seniors who are taking multiple medications, as prescription drugs may interact with each other and with vitamins, herbal supplements, OTC medications, and certain foods. Some interactions may increase overall side effects, while other interactions could reduce the effectiveness of medications. You might also find out that you’re taking medications that are no longer needed. Or you could be using one medication to treat the side effects of another!
During a medication review, your pharmacist will ensure that you are using your medications properly, address any concerns about drug interactions and side effects, and consider whether it might be possible to discontinue some medications. Drug dosage should also be reviewed, since aging causes changes in how the body responds to medications. For example, if kidney function declines below a certain point, it might be necessary to stop a medication or reduce the dose. Our pharmacists can review your recent lab results to ensure that you are using a safe, appropriate dose of your medications.
In recent years, health professionals have started to limit — or stop — the use of certain types of drugs in older adults due to their increased risk of side effects. For example, sleeping pills, antidepressants, and drugs for anxiety or agitation may improve some symptoms, but the increase in injury and falls, as well as cognitive impairment and confusion, could outweigh the benefits. “Deprescribing” (stopping) some medications may be the best option. Our pharmacists can recommend the best approach, as not all medications can be stopped or changed abruptly.
HOW WELL DO YOU KNOW YOUR MEDICATIONS?This medication safety checklist comes from The Safe Living Guide – A guide to home safety for seniors. You can find the full publication online or download it as a PDF file. |
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| YES | NO | |
| Have you talked to your health care professional about alternatives to medication? (Medication may not always be the best solution.) | ||
| Have you told all your doctors and your pharmacist about all the medicine you’re taking (prescription, OTC or herbal) as well as your use of alcohol and/or tobacco? | ||
| Do you read the instructions on each of your medication containers? | ||
| Do you take your medication exactly as prescribed or know of any alternative instructions should you forget to take it? | ||
| Do you have a list of the medications you are currently taking, and is your family aware of it? | ||
| If you have medication allergies, do you wear a bracelet or necklace to show this? | ||
| Do you use only one pharmacy for all your prescription needs? | ||
| Have you gone through your medicines and discarded any that are past the “expiry” date? | ||
| Whenever you get a new medicine, do you ask for and obtain all the information on its use and side effects? | ||
We can do a complete review of your medications every six months, plus follow-up reviews when there are drug changes, up to four times per year. There is no cost to you for this service. Please bring all of your medications with you: prescription medications, herbal remedies, over-the-counter and non-prescription drugs. Let us know if you are also using any recreational drugs, as these can interact with many common medications.
What else can you do to prevent falls?
There are many resources available that help assess the risk of falls, give tips for preventing falls, and teach how to get up safely after a fall. Here are some key strategies to follow: (3,4,5)
- Exercise regularly to improve your strength, muscle tone, and balance. Walk if you can. If you cannot walk easily, swimming is a good option.
- Don’t rush when walking or getting up. Use a cane or other mobility device if needed.
- Get your sight and hearing checked regularly. Use eyeglasses and wear hearing aids, if needed.
- Limit the amount of alcohol you drink. Alcohol can impair your balance and other senses.
- Wear well-fitting, sturdy shoes. If you wear loose-fitting shoes because of calluses or corns, you can lose your balance and fall. Talk to your doctor if you have numbness in your feet.
- Get enough sleep. Eat well and stay hydrated. You may get dizzy if you do not drink enough water.
- Make sure you have proper lighting in hallways, stairs and walkways, as well as in the bedroom and bathroom.
- Keep stairs free of clutter and exterior stairs and walkways free of clutter, ice or snow.
- Install handrails along stairs and safety grab bars in the bathroom.
- Check your home for slipping and tripping hazards, and use non-slip mats or rugs.
- Ensure regularly used items are within reach.
References
- Public Health Agency of Canada. Seniors’ falls in Canada: Second report. [Internet] 2014. [cited 9 Aug 2023]. Available from https://www.canada.ca/en/public-health/services/health-promotion/aging-seniors/publications/publications-general-public/seniors-falls-canada-second-report.html
- Canadian Institute for Health Information. Falls and vehicle collisions top causes of injury hospitalizations for seniors. [Internet] 2019. [cited 9 Aug 2023]. Available from https://www.cihi.ca/en/falls-and-vehicle-collisions-top-causes-of-injury-hospitalizations-for-seniors
- Saskatchewan Health Authority. Preventing Falls in Older Adults. [Internet] 2024. [cited 16 Nov 2024]. Available from https://www.saskhealthauthority.ca/your-health/conditions-diseases-services/healthline-online/ug2329spec
- Falls in Seniors. [Internet] 2024. [cited 16 Nov 2024]. Available from https://parachute.ca/en/injury-topic/fall-prevention-for-seniors/
- Public Health Agency of Canada. The Safe Living Guide — A guide to home safety for seniors. Ottawa, ON: Public Health Agency of Canada, 2015.