DRHOOK- Tumblers: Falling wrecks the life of your love

the handsome doctor John Hong of Charlottesville

Falling and tripping make a lot of people laugh– until it happens to them. 

I don't know why people laugh when they see others get hurt, like on that show America's Funniest Home Videos. I refuse to watch it because I don't understand what's so funny about seeing someone hit the ground. As a figure skater, I can tell you that landing on your back is about as much fun as a tooth extraction– sans anesthesia. (Hmm, maybe seeing evil CEOs of corporate America fall back to Earth would be a great thing!)

"I've fallen, and I can't get up" should not be funny. With our increasing numbers of senior citizens, falls are a significant problem. For those aged 65 and older who live in the community (not nursing homes), 30-40 percent will fall each year, and 50 percent of those 80 years or more will fall! Holy Tumble, Batman!

One half of the folks who live in long-term care facilities fall each year, and 60 percent of them will fall again.

It's estimated that falls cost the USA over $12 billion a year. Falls account for 62 percent of senior citizen non-fatal injuries leading to ER visits, and 5 percent of them will be admitted to the hospital. Bruises and scrapes occur in 41 percent of falls in our senior citizens. For major injuries (like fractures and concussions), about 6 percent are among community residents, and 10-30 percent among nursing home residents.

One half who fall are unable to get back up on their own. Someone I know, who is in her 80s and lives alone, fell down in her home. She was unable to get up for 14 hours! Complications of lying on the floor for an extended period of time include dehydration, muscle breakdown that can lead to kidney failure, pain and suffering. Unfortunately, according to a survey, 80 percent of older women prefer death to a bad hip fracture that would end up in a nursing home admission. So quite a few of our senior citizens refuse to give up living alone– which I understand.

About 2 percent of injurious falls seen in the ER actually result in death right there. However, complications from the fall can lead to death down the road. Falls lead to a lot of morbidity: nursing home placement, greater use of medical services, decline in functional status. For those who live in the community, up to 75 percent will not fully recover from a fall. 

Risk of falling usually is multifactorial. We often hear our aging parents become more mentally inflexible as they get older, but their bodies can physically become less flexible too. So reaction times, coordination, gait, and balance can all be a little off and can lead to a fall. Cardiovascular problems can cause a person to fall when the blood pressure drops, especially when moving from sitting to standing. Those with an acute illness (fever, dehydration, heart arrhythmia) can find themselves down on the Persian rug before they know it. 

Physical disabilities like a weak leg from a stroke, arthritis, and Parkinson's disease make it easy to fall. So having an occupational therapist do a house safety inspection is a great thing. The last thing a person with a walking problem or visual impairment needs is a bump in the rug or narrow stairway without good handrails. 

Folks with dementia might be confused at night and fall. Medications that can confuse a senior citizen or alcohol can "throwdown" a person harder than Bobby Flay ever could.

Unfortunately, most senior citizens don't report falling down to anyone. So it's a good idea for us to periodically ask our senior citizens if they have fallen, or if they think they might fall down. We don't want any of them to "take the fall" because of our lack of concern. 


Dr. Hook cracks a joke or two, but he's a renowned physician with a local practice and a website, drjohnhong.com. Email him with your questions.