Broken Hips: Preventing A Fall Can Save Your Life

1/1/2014

Lauren Silverman

Last October, Jeanette Mariani was an independent 87-year-old, living alone in Dallas and getting around with a walker. Then one night she switched off the light and tried to make her way into bed. A chair was in the way. And she fell.

“There I was, lying on the floor,” she recalled. “I pulled down one of my pillows. I didn’t reach very high, just pulled it down, put my head down on it and thought: ‘Well, I’ll wait until morning.’ ”

The next day, she called for help.

A fall from a chair or a bed may not seem like a death sentence — but for an older person it can be. Falls are theleading cause of death from an injury for older Americans. For women, it’s especially bad: Three quarters of those with hip fractures are women. For many, the broken hip starts a chain reaction — usually because older people also suffer from underlying conditions such as diabetes, arthritis, hypertension or dementia.

Every moment counts after a fall, says Dr. Amy Moss, an assistant professor of geriatrics at the University of North Texas Health Science Center in Fort Worth. When you’re bedridden or hospitalized, your odds of developing everything from bed sores to pneumonia increase dramatically.

Studies show that delaying surgery after a fracture for just 24 hours increases the chance of complications and death. “The most common scenario is they die of pneumonia after a hip fracture,” Moss says.

After spending the night on the floor, Jeannette Mariani called her daughter Janet, who took her to the hospital.

“After her fall, I knew that she was going to decline,” Janet said. “You had that sixth sense, you know.”

That sixth sense is backed up by real numbers. Almost 1 out of 10 people over the age of 50 will die within a month of surgery for a broken hip. That rises to 1 in 5 if the patient already has an acute medical problem.

Jeanette worked hard in rehab to become stronger, but underlying health problems caught up with her. Previous lung problems got worse, and her lymphoma returned.

“After she left the hospital, she died within a month,” Janet said.

The greatest predictor of a future fall is a previous fall.
– Chris Ray
More than 90 percent of hip fractures are caused by falls. But falls can beprevented. Common-sense steps like removing rugs, installing better lighting, and getting an updated prescription for your glasses are a good start. So is addressing the physical and psychological side to falls. It might sound silly, but it turns out that people who are afraid of falling are actually more likely to fall.

Nine years ago, Joyce Powell was in hospital, on her way to the bathroom, when she fell and broke her hip. She recovered, but she hasn’t gotten over the fear of falling.

“It stays with you,” says Powell, who is 80 and lives in Arlington, Texas. “You’re aware that you can’t function like you once did.”

That’s why Powell attends a fall-prevention program at the University of Texas, Arlington — not just to get stronger but also to face her demons. Participants are in their 70s, 80s and 90s, and their workouts involve everything from balancing on exercise balls to playing Wii games.

“The greatest predictor of a future fall is a previous fall,” says Chris Ray, director of the Center for Healthy Living and Longevity at UT-Arlington.

The greatest risk for older people who’ve fallen is that they’ll simply stop exercising, Ray says.

One of the keys to preventing a fall is improving balance. As we age, Ray says, natural changes make it hard to stay upright: changes in hearing, vision and proprioception — the awareness of where one’s body is in space. If seniors can learn to use these senses better, they will be less likely to fall.

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