Clinics Help Seniors Learn to Stop Falling Taking a fall can be debilitating for older people, particularly those over the age of 80. Doctors, recognizing this danger, have begun to set up fall clinics. NPR's Patricia Neighmond reports on how these clinics are helping older people learn how to stop falling.
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Clinics Help Seniors Learn to Stop Falling

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Clinics Help Seniors Learn to Stop Falling

Clinics Help Seniors Learn to Stop Falling

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SUSAN STAMBERG, host:

For older people, falling can be devastating, especially for those over 80. One out of every five who falls is seriously hurt, hospitalized or even dies, so medical centers are establishing clinics to help people learn how to stop falling. NPR's Patricia Neighmond reports.

PATRICIA NEIGHMOND reporting:

Myrtle Hill(ph) is 78 years old. She's energetic and works hard to stay in shape. She walks two miles a day. But she's had three major falls over the past two years, which is why she made an appointment to see geriatrician Susan Charette at UCLA's falls clinic.

Dr. SUSAN CHARETTE (Geriatrician, UCLA Falls Clinic): Now, Ms. Hill, what I'm going to do is I'm going to walk through and get a little bit of history about you and about your falls.

Ms. MYRTLE HILL (Patient): Right.

Dr. CHARETTE: And then we're going to try to sort out what's the cause or what are the risk factors or what things are contributing to those falls.

NEIGHMOND: About a week ago, Hill says, she fell out of bed and, when she hit the floor, she hit hard, hurting her head, neck, shoulder and leg.

Dr. CHARETTE: So what did you do after you found yourself on the floor?

Ms. HILL: I kept fighting and trying to get up. I couldn't hardly get up.

Dr. CHARETTE: Uh-huh.

Ms. HILL: I had to crawl and finally I got myself up.

Dr. CHARETTE: How long did that take?

Ms. HILL: About 15 minutes, 20 minutes, because...

NEIGHMOND: Hill had no help. Like many older people, she lives alone. She waited 12 hours for her daughter to come over and take her to the ER. Hill was lucky this time, no fractures. But a fall a few months before resulted in a broken leg.

Dr. CHARETTE: Tell me about that fall.

Ms. HILL: Well, it was dusk dark. That's why I had to get home and I knew I should have been home.

Dr. CHARETTE: Uh-huh.

Ms. HILL: And I was exiting the bus and other people were exiting the bus. I don't know--it was the pressure from the other people or what...

Dr. CHARETTE: Uh-huh.

Ms. HILL: ...but I found myself from the first step of the exit bus, down--and I was sliding on the ground, sliding almost to the curb and almost out into traffic.

NEIGHMOND: Charette asks Hill if she felt light-headed when she fell. `Yes,' says Hill, `like in a daze.' That's an important clue for Charette as she takes Hill's medical history. Hill's on four heart medications, which Charette says could lower her blood pressure, affecting the flow of blood to the brain and resulting in a dazed, disoriented feeling, a major risk for falling. A physical exam confirms that Hill has trouble maintaining her balance.

Dr. CHARETTE: I'm going to take your toe and I'm going to--this is up and this is down. Close your eyes. Up or down?

Ms. HILL: Up.

Dr. CHARETTE: And now?

Ms. HILL: Down.

Dr. CHARETTE: And now?

Ms. HILL: Down.

Dr. CHARETTE: Good. Now...

NEIGHMOND: One way to test balance is with this foot exam, along with another one which tests the bottom of Hill's feet for sensitivity to soft and sharp, to determine Hill's capacity to feel centered. At the end of a two-hour exam, Dr. Charette has a pretty good idea why Myrtle Hill is falling a lot.

Dr. CHARETTE: First of all, we have your arthritis. I think, second, you have a pretty significant weakness in your legs and your hips. You have some changes in your blood pressure when you go from one position to another.

NEIGHMOND: Charette maps out a plan for treatment--a bone density test, an eye exam, a discussion with Hill's internist about medications and possible side effects. A physical therapist has already scoured Hill's home for possible falling risks--throw rugs, for example; extension cords across the floors; poor lighting; clutter on the floor. But clearly, the most important change Hill can make, says Charette, is how she rides the bus.

Dr. CHARETTE: Sit near the front. I would like you to be sure that the bus is at a stop before you're standing. Take advantage of people offering you a seat and don't stand on the bus.

Ms. HILL: Oh, yes.

Dr. CHARETTE: And when you come to a stand or get up, get up very slowly. Take your time. You deserve it.

NEIGHMOND: Soon, Hill begins physical therapy. Dr. Laurence Rubenstein directs geriatric research for the Greater Los Angeles VA Medical Center. He says that when you consider, between the ages of 40 and 70 people lose one-third of their muscle strength, exercise is crucial.

Dr. LAURENCE RUBENSTEIN (Geriatric Research, Greater Los Angeles VA Medical Center): A general strengthening program that will improve your walking strength and your ability to get out of a chair and avoid obstacles. Another thing that's been shown to be effective are balance training. A classic example of that is tai chi exercises.

NEIGHMOND: Where you stand on one leg and then another in slow, rhythmic motions. Increasing muscle strength and balance, says Rubenstein, reduce the risk of falling by 50 percent or more. And after that, he says, everything else gets better, too--endurance, strength and even mood.

Patricia Neighmond, NPR News.

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