Falls are a big problem for old people. About a third of people over 65 fall each year, and for those over 80 it's more like half. Falls often lead to hip fractures, and hip fractures often lead to death. So anything that increases your odds of falling is worth paying attention to.
One of the biggest risk factors for falls turns out to be something most people don't even think about: medication. Lots of common medications increase your chances of falling. Some dramatically. If you're over 65 and taking four or more medications, your odds of falling in a given year double.
The scary thing is that many of these medications don't feel like they're affecting you. You don't feel dizzy or unsteady. But they are affecting you, just below the threshold of what you notice. It's like those optical illusions where two lines look the same length, but one is actually longer. Your brain is being fooled.
The medications most likely to cause falls are ones that affect your brain or blood pressure. Sleeping pills are particularly bad. They don't just make you sleepy at night. They make you slightly sleepy all the time, even the next day. And "slightly sleepy" translates to "more likely to fall."
Blood pressure medications can also be dangerous. They're meant to lower your blood pressure, but sometimes they lower it too much. If you stand up quickly, your blood pressure might drop so much that you get dizzy and fall.
Antidepressants are another big culprit. Even if they're not making you noticeably drowsy, they're affecting your balance and reaction time. Pain medications, especially opioids, have similar effects.
What's particularly pernicious about medication-related falls is that they create a vicious cycle. You fall and hurt yourself, so you take pain medication. But the pain medication makes you more likely to fall again. Each fall makes the next one more likely.
So what can you do? The most important thing is to be aware of the risk. If you're over 65 and taking multiple medications, you should assume you're at increased risk of falling. Talk to your doctor about whether you really need all the medications you're taking. Often you don't.
For each medication, ask three questions:
Do I really need this?
Is there a lower dose that would work?
Is there a safer alternative?
Don't stop taking medications on your own. Some can be dangerous to stop suddenly. But do have the conversation with your doctor. They may not have thought about the cumulative fall risk of all your medications.
There are also things you can do to reduce your fall risk that don't involve changing your medications. Exercise, particularly exercises that improve balance and strength, can help a lot. So can making your home safer by removing tripping hazards and improving lighting.
But the medication issue is one that's often overlooked, and it's one where a small change can make a big difference. Just reducing your medications from four to three can cut your fall risk significantly.
It's worth paying attention to, because falls are one of those risks that sneak up on you. You feel fine, right up until the moment you don't. And by then it's too late.
The phrase "an ounce of prevention is worth a pound of cure" is a cliche, but cliches often become cliches because they're true. In this case, an ounce of prevention — in the form of carefully reviewing your medications — really could save you from a broken hip, or worse.
So if you're over 65, or if you have parents or grandparents who are, take a look at those pill bottles. They might be hiding a risk you never knew was there.
As you consider making your home more accessible and comfortable for aging-in-place, remember that a Certified Aging-in-Place Specialist (CAPS) can provide invaluable expertise. These professionals are trained to understand the unique needs of older adults and can help create safe, functional living spaces that promote independence. If you're looking to hire a CAPS professional in your area, don't hesitate to contact us for recommendations. We can connect you with experienced specialists who can turn your aging-in-place vision into reality. On the other hand, if you're inspired to become a CAPS professional yourself and join this rewarding field, we encourage you to explore the opportunity. Click here to learn more about the CAPS certification process, including upcoming training dates and requirements. Whether you're seeking assistance or looking to start a new career path, the world of CAPS has much to offer.
Fritzi Gros-Daillon MS, CSA, CAPS, UDCP, SHSS
Household Guardians, Owner
2019 NAHB Instructor of the Year
Published author of "Grace and Grit: Insights to Real Life Challenges of Aging"
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