Laguna Woods resident Terry Cantine took a nasty spill outside her house while heading out for a walk.
“I was not focusing and fell and could not get up until a man helped me,” recalled Cantine, who gives her age as “over 75.”
She suffered bruises and a hurt knee, but no broken bones — or so she thought. Two weeks later, while she was getting prepped for an unrelated surgery, she learned that her clavicle had been fractured.
“A lip on the cement path stood out,” she said.
Cantine also fell in the shower once, slipping while tossing a bathing suit into the sink.
“I did this pirouette and let go of the grab bar,” she said. “No more fancy business. With age you have to be smarter.”
According to the U.S. Centers for Disease Control and Prevention, nationwide at least 1 out of 4 seniors over age 65 falls each year. About 36 million falls are reported among older adults each year, resulting in more than 32,000 deaths. About 3 million older adults are treated in emergency departments each year for a fall injury, and at least 300,000 older people are hospitalized for hip fractures. Women fall more often than men.
At MemorialCare Saddleback Medical Center in Laguna Hills, 1,842 patients were admitted to the emergency room in 2022 due to falls, according to emergency services manager Luke Schademan. (MemorialCare does not keep statistics on how many of those patients were Village residents.)
“Before the pandemic, ambulance calls due to falls were the biggest problems here,” said Marcy Sheinwold, president of the Foundation of Laguna Woods Village.
At the time, the foundation had an intern who figured out that 50 percent of ambulance calls out of the Village were due to falls, Sheinwold said.
“It’s right up there with heart disease,” she added. “I have fallen three times in the last six months. It’s an issue.”
Marcelle Paja, a physical therapist at MemorialCare, said she sees fall patients start to come in around age 60. She recommends getting checked for fall risks.
“Get evaluated for walking, posture, muscle strength, picking stuff off the floor, getting out of bed, sitting down and rising,” she said. “We catch things that patients may not be aware of.”
This summer, the Foundation of Laguna Woods Village partnered with MemorialCare to provide fall prevention classes free of charge at Clubhouse 2, with Medical Center staff leading the sessions. The program was offered as one-month segments with three one-hour sessions.
The sessions filled up fast. One in July was fully booked with roughly 18 students learning how to keep their bodies strong, stable and balanced to prevent falls and, if they were to fall, how to put themselves upright again, if possible.
Yolanda Roetcisoender, a MemorialCare physical therapist who led the class, first tested students for their risk of falling – a risk that is exacerbated, she said, if one is afraid of falling. She had the students sit down on a chair and then get back up – down and up repeatedly, the more times the better, indicating a lower risk of falling.
Altogether, Roetcisoender led the group through three sessions that included chair exercises, stretches and strengthening (though without weights) to help improve strength and stability.
She also offered home safety advice and behavioral safety. Students learned, for instance, that in the home, good lighting and clear pathways with no loose rugs are important. They learned that when out walking, students need to look where they’re going and not get distracted. Among other advice: Carry a cellphone or keep a phone receiver in every room, and don’t rush to answer calls.
Lastly, Roetcisoender demonstrated how to – ideally – fall. “Protect your head, try to fall on fleshy body parts and roll out of a fall,” she said.
If you can’t get up, it’s best to drag yourself to the nearest chair and pull yourself up, or to a telephone to call for help, she added.
For those living alone, a device designed to alert first responders in case of falls is recommended. In some circumstances, these medical alert devices can be obtained through laguna Woods Village Social Services.
Devices for residents with limited finances have been subsidized by the foundation. So far it has funded 70, Sheinwold said.
Larry Agle, 90, fell off a stepladder while moving boxes in a storage room.
“I had a bump on my head the size of a tennis ball,” he recalled. “I fell on a concrete floor but did not lose consciousness.”
That fall brought a valuable lesson: “I learned to avoid stepladders — but then, I used to climb on chairs before that.”
Since he suffered a mini-stroke 18 months ago, Agle’s equilibrium has been shaky, though he doesn’t like walkers and canes, he says. To keep up his strength, he walks 30 minutes a day and uses hand weights at home.
Muriel Ash hasn’t fallen since she began using Nordic walking poles on her walks, she says. The poles are touted to improve balance and stability by providing extra support while users walk, thereby reducing the risk of falls.
Before she discovered the poles, Ash fell four times in three years.
“The last time I fell, I was wearing my Apple watch. I had tripped on a curb and the watch asked me, ‘Shall we call 911?’ I feel very good about that watch and wear it every day,” she said. “You have to concentrate on what you’re doing and not get distracted.”
Audrey Comport, 89, said that she has been doing everything right, and that she and her husband, age 93, have not fallen so far.
“We took the fall prevention class, and we’re doing the exercises the teacher taught us for our knees and back,” she said. “My husband and I go to the fitness center; we’ve gone there for 13 years.”
She also makes sure there are no cords or throw rugs at home to trip over.
For information on fall prevention programs, Laguna Woods Village residents can call the Foundation of Laguna Woods Village at 949-268-2246. For information on medical alert devices, residents can call Village Social Services at 949-597-4267.
Common causes, effects and prevention of falls for seniors
Dr. Marc Taub, medical director of emergency services at MemorialCare Saddleback Medical Center, spoke about the causes and effects of falls on seniors and how to prevent them.
Q: Why are seniors in particular danger of falling?
A: Falls are the leading cause of injury among older adults in the U.S. While there is no specific age cutoff for higher risk, the likelihood of falls increases with age. Taking care of seniors after falls is a common condition we treat here at the emergency department of MemorialCare Saddleback Medical Center. We assess both immediate injuries as well as look for underlying causes for the fall.
Q: What are some common causes of falls?
A: Some of the reasons that might cause an older adult to fall include impaired posture control, changes in sensations, decreased muscle strength, visual impairment. Also inadequate footwear, not using canes and walkers as recommended, household hazards such as slippery surfaces and loose rugs. Other conditions: low blood pressure as a result of old age, medications, dehydration or illness. Chronic conditions like Parkinson’s disease, arthritis, osteoporosis and dementia. Medications for pain and sedatives, alcohol use.
Q: What are common injuries seniors sustain in falls?
A: Minor injuries such as bruises and minor skin injuries are the most common. More serious injuries include head trauma, spinal injuries and broken bones such as wrist, rib or hip fractures.
Q: What are the most common permanent consequences of falls? Some say a broken hip can be a death sentence.
A: Fortunately, most falls lead to less severe injuries; healthy older adults with minor falls can expect to recover with time and needed therapy. More serious falls, such as those causing head injuries and fractures, can lead to permanent decline in function and the ability to perform usual activities of daily living.
Regarding hip fractures, it is true that many patients with hip fractures can experience prolonged decline in function afterwards. However, hip fractures are rarely fatal in this day and age. In hospitals with outstanding orthopedic and geriatric programs such as Saddleback Medical Center, physicians aim to accurately diagnose hip fractures, take measures to prevent complications, repair the fracture surgically and follow up right away with physical and occupational therapy.
Q: What steps can be taken to shorten the recovery process for seniors after a fall?
A: Seniors may take longer to recover from falls due to underlying health conditions and preexisting disabilities. That’s why it is important to follow doctors’ recommendations on recovery, including coordinated therapies improving strength and balance and mobility and occupational therapies to help maintain the ability to perform daily living activities. For some patients, that may require time in an assisted living or rehabilitation facility.
Q: What are your recommendations for fall prevention?
A: There are many steps seniors can take to reduce risk of falls and build up resilience for recovery should a fall occur. Regular exercise: walking, swimming, flexibility, balance and aerobic conditioning, dancing and tai chi. Keep moving. Work with doctors to stay current on medication, especially pain medications, sedatives, sleeping pills and blood pressure medications.
Reduce hazards at home with proper lighting, rails. Lots of falls happen at night. Get up slowly. Keep canes and walkers at bedside. Have a plan in case of a fall, especially when living alone. Staying on the floor for a long time causes more problems. Have a way to call for help such as an alarm necklace or watch. Most importantly, take fall prevention classes whenever they are offered.
