A Conversation with Lee Cutler
Each year, millions of older men and women around the world are disabled, sometimes permanently, by falls that result in broken bones. Falls account for more than 90 percent of all hip fractures among Americans over the age of 65, and fall-related injuries are the leading cause of accidental death for people in this age group. Moreover, many people with hip fractures never regain their previous mobility and have a heightened risk of repeat fractures.

For information about things people can do to reduce their risk of falling, Bay Area Summit spoke in October 2004 with Lee Cutler, a member of Marin County's Older Adult Fall Prevention Task Force. A division of the Marin County Commission on Aging, the task force educates seniors and their families, as well as physicians and other eldercare providers, about ways to prevent falls.

Mr. Cutler is also the community relations director of Bay Area Vital-Link, a Berkeley-based company that provides emergency response systems for disabled and older adults. Bay Area Vital-Link's core product is a two-way voice console that is connected to a client's telephone line. Clients are provided with a pendant, to be worn around the neck or as a wristband that can transmit a signal to the console and enable people to call for help from any location in or around their home.

Bay Area Summit (BAS): It's often said that most accidental falls could be prevented. What are some of the things you advise people to do to reduce their fall risk?

Lee Cutler (LC): The first place I look to make changes is in the home. There are a lot of obvious things that can make your home safer. For example, many people have throw rugs that can slide. I suggest that people fasten these rugs to the floor with tape. Or put the rug on the wall if you like to look at it.

BAS: What are some other home safety tips?

LC: Most are really common sense. Like minimizing clutter in rooms and hallways and making sure there is adequate lighting throughout the home. Phone cords, electrical cords, coffee tables and other items you can trip over should be kept out of the way of foot traffic. Make sure there are handrails you can grab onto along your stairways. It's also a good idea to have a nightlight in your bedroom and bathroom. In bathrooms, it's good to place grab bars and non-skid tape in showers and bathtubs. You can reduce the risk of falling out of bed while you're asleep by placing side rails on your bed.

BAS: What else can people do?

LC: It's very important to wear supportive shoes that fit properly. Shoes should have rubber soles and low heels. Sandals and other floppy shoes are a no-no. Also, it's a good idea to have your vision and hearing checked regularly, as many accidents result from poor eyesight. Getting a bone density test is another good idea - if you have osteoporosis, which makes bones more fragile, you are more likely to break a bone in a fall.

BAS: What about the effects of medication?

LC: Good point. It's important that your doctor or pharmacist knows what medications you are taking, even non-prescription drugs, and explains their side effects to you. Drugs can affect your balance and coordination and make you dizzy, which increases the chances of falling. In a similar vein, it's best to limit the amount of alcohol you drink, especially if you are taking medications. Even a small amount of alcohol can affect your alertness and balance. Also, remember to drink plenty of water! Water keeps the body hydrated and it helps flush out the toxins in your system.

BAS: Can exercise help?

LC: You bet. Regular exercise and physical activity will increase your strength, energy and balance. Exercise also improves bone health, which reduces the risk of osteoporosis, and it helps you maintain a healthy posture. You don't need to go to the gym or lift weights - walking, gardening or playing with your grandchildren are great ways to get exercise. Activities like yoga and Tai Chi are great ways to improve balance and flexibility.

BAS: Any other tips?

LC: Many falls happen when people are in a rush and aren't paying attention to their movements. One example is when people wake up at night and get out of bed too quickly. They take one step, two steps, then get dizzy and fall. It's a good idea to wait for about 30 seconds before moving when you're waking up or after you finish eating to let your blood pressure settle down. It's also a good idea to use a cane or a walker if you have problems with balance or if you're on uneven ground.

BAS: But not all falls can be prevented. So what advice do you have for people if they do fall?

LC: After you fall, you should do a quick assessment. If you are not injured, do all you can to get up by yourself. If there is a chair or sofa nearby, move over to it and try to swing yourself up into a sitting position. If you think you have a serious injury, call out for help and try not to move. It's a good idea to place several telephones around your home, at a low level so you can call for help if you're on the floor. This is also an argument for having an emergency response system like the one Bay Area Vital-Link provides. These systems allow you to summon help just by pressing the button on a pendant you wear around your neck or as a wristband. Also, we can listen in once our service is activated, and send the appropriate help.

BAS: Is there anything you can do to lessen the force of a fall?

LC: If you sense that you are going to fall, try to turn your body so you land on your buttocks, where your body has more padding. Falling sideways or straight down is more likely to result in a hip fracture. For people with balance problems, it's a good idea to pad the hip area with extra clothing or wear a hip protector.

For information about Bay Area Vital-Link, call (800) 752-5522 or see www.vlink.org. For information on preventing falls and fractures, see www.maringeneral.sutterhealth.org/healthinfo/home_safety.html.

Disclaimer: The views and opinions expressed by the subject of this interview are not necessarily those of Bay Area Summit's staff or its sponsors.

(This article originally appeared in the Fall 2004 issue of Bay Area Summit)

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