Anyone who has seen an elderly client disappear between table and walker in the residence dining room doesn’t have to be told how important fall prevention is. And yet, the statistics remain grim.

One in every three people over 65 years will have a fall this year; that’s nine times greater than those younger. Almost 62 per cent of injury-related hospitalizations of seniors and more than 90 per cent of all senior hip fractures result from a fall. In addition to causing injury, falls often threaten independence, mobility, confidence and function.

No wonder preventing falls is a major concern for both seniors and those who work with them. But warding off tumbles isn’t straightforward. The Public Health Agency of Canada (PHAC) describes the complexity of prevention. Risk factors are numerous and often interact; they may be health-related, environmental, income-related, behavioural or all of the above.

Medical problems that affect balance and gait, such as Parkinson’s disease, vision deficits or the effects of a stroke, increase the risk of falling. Those with chronic illness such as osteoporosis, arthritis, hypotension or cognitive impairment are also in greater danger. Medications sometimes up the probability further.

Environmental risks can be lowered with improved lighting, non-skid flooring, bathroom grab bars, walk-in showers, hand railings and wide, even sidewalks. Retirement residence owners usually look after these. But it is much more difficult to guard against their clients’ scatter rugs and stray cords, overstuffed apartments, unwise footwear – and too many walkers in tight corners.

Behavioural risk factors often arise out of medical issues. One fall increases risk of ›› another threefold. A senior who is afraid of falling again or becoming light-headed often cuts back on or drops out of exercise class. Then she loses muscle strength, increasing her risk of a fall by four or five times. Balance, flexibility and co-ordination also suffer. So any program that keeps seniors exercising, in or out of retirement residences, is high on the prevention list.

The American Academy of Neurology recently issued guidelines regarding fall risks, suggesting that doctors be sure to ask patients about any tumbles they’ve taken. If seniors open up about their falls, doctors will be able to check their medications and prescribe exercises suited to their health.

For much the same reason, those who live and those who work in retirement residences have reason to co-operate on fall prevention. Today we understand better that falls aren’t an inevitable part of aging. While seniors may be more at risk, continuing exercise can greatly reduce their odds of falling. Most residences offer exercise programs regularly, some using material produced by governments and health organizations across the country. (The Public Health Agency of Canada has an inventory.)

And more and more new residences come complete with substantial fitness centres and wellness programs. For example, Amica has developed its own strength and conditioning program that uses machines, free weights, elastic resistance bands, and exercises for balance and body weight. Their testing found improved balance and increased strength of hips and thighs; Amica believes the program also increases confidence. When Tapestry’s Village Gate West opened last year, it offered a well-equipped fitness centre, a staff kinesiologist, personal or small-group training, balance and core conditioning activities and aquafit classes in a therapeutic pool.

At the same time, technology companies are producing new products to detect and prevent falls. AMM Technologies has developed Gait Guard, a fall alarm that uses sensor motion detection to alert others to partial or actual falls. The analysis and record provided also helps assess mobility.

If a bad fall does occur, or a stroke intervenes, a retirement resident often has
to gain independence again or move to a facility that provides more assistance. Since research in neural plasticity has shown our brains have the capacity to relearn lost motor abilities, new technology is now becoming available to help seniors get back on their
feet more quickly.

NeuroGym Technologies is one company developing products to help people stand and walk again. Now frequently used in long-term or assisted-living homes, this type of equipment may also soon be seen as a reasonable addition to retirement residence fitness centres. It would allow aging residents to stay longer and remain independent. And it may make retirement residences more attractive to hospital discharge planners releasing patients after fall injuries.

For example, the NeuroGym Sit-to-Stand Trainer uses a counter-weight mechanism to help people gradually strengthen weight-bearing muscles, increasing their standing stability and endurance. It requires a five-to-six-minute practice three times a week with a program assistant or therapist.

The NeuroGym Bungee Walker improves mobility safely, allowing graduated weight-bearing so people can relearn gait and natural protective reactions. Some homes use it in combination with Wii games to strengthen the upper body and improve co-ordination at the same time. A program assistant can lead a person securely attached to a Bungee Walker in gentle dancing, soccer or balloon volleyball. Of course, these exercises are also a good way to help keep unsteady residents from having that bad fall in the first place.