Robert Myers, M.D. (‘63) : Falls - Prevention and Mobility

A note forwarded to Guy from Sam Francis (‘64) contains an excellent list of “do’s” to prevent falls. This list could not have been more timely. (yale63.org/samfrancis.htm)

Balance is critical. To Sam’s forwarded list of do’s I would add: a) On following pages, five photos of devices that those with a balance problem may find useful in active no scatter rugs to trip on and b) try to engage in exercise of hamstring muscles to strengthen rising from a sitting position.

Anyone with a fall predisposition should not let some figment of personal pride prevent them from having some in-house or outdoors walking assistance. One may Google and search for “fall prevention: simple tips to prevent falls” or “syncope” at the mayoclinic.org, yalemedicine.org/Syncope & Falls Assessment Program , or at one’s preferred health information website.

On following pages, five photos of devices that those with a balance problem may find useful in active fall prevention and increased mobility. The VELOPED (see below) has been a life-saver for my wife, Emily, who can walk a mile on our Halls Mill Road that includes a hill.

Best all,
Bob
email: myers.robert@mayo.edu

Images (5) on next pages:

Devices for balance and mobilty

Dear Member of the Yale ’63 Family,
I’m forwarding some timely reflections from Sam Francis 
of the Yale Class of 1964

Guy


From: Sam Francis, Yale Class of 1964 

Sent: Thursday, April 4, 2024 1:32 PM
To: Struve, Guy Miller 
Subject: Dangers of falls
    An email from Sam Francis, Yale '64
Dangers of falls
    April 4, 2024
    To the Class of 1964:
    After the sad and sudden death of Joe Lieberman due to complications
    from a fall (see Joe’s In Memoriam page), there has been a flurry of
    classmate email correspondence regarding the prevalence and dangers
    of falls among us. Joe’s death is a cautionary tale, as was classmate
    Dennis Upper’s death 5½ years ago when he fell down a flight of 13
    stairs and died the next day (see his In Memoriam page). Because I’m
    an EMT on an ambulance squad, I was urged by some of you to
    communicate some thoughts on the subject.
    As an EMT dealing with medical emergencies of all kinds, I’m well
    sensitized to the dangers of falls, which are the most frequent cause of
    ambulance dispatches in my town by more than a factor of two over the
    next most frequent emergencies (motor vehicle crashes, breathing
    difficulties). More than a third of seniors in our age bracket report a fall in
    the last year, and half of those seniors report multiple falls. These
    statistics are undoubtedly lower bounds on the problem, because such
    incidents are generally under-reported. In short, falls are not just
    something that happens to other people, and are nothing to take lightly.


Some of my dispatches turn out to be simply lift assists for patients who
have fallen and can’t get up. But at our age, falls can have very serious
consequences, due to osteoporosis and other frailties, with risks
exacerbated if you are on a blood thinner, as many of us are for atrial
fibrillation. Head trauma can lead to subdural hematoma (internal
bleeding), the deadliest of head injuries. Hip fracture from a fall is
common and often devastating, with 50% of geriatric patients with a hip
fracture dying within six months.
What can you do to keep from falling? Most precautions are quite
obvious, once you stop to think about it.
   # Develop a healthy fear of falling, even if you’ve never fallen. It only
     has to happen once, as Joe’s and Dennis’ stories attest.
   # Install and use grab bars in your shower and bath.
   # Install and use railings on your staircases, preferably on both
     sides. And install free-standing handrails for your outside steps.
   # Be obsessively careful when climbing or descending stairs,
     watching each step (literally), particularly when going downstairs.
     Don’t ever carry anything with two hands. Keep one hand free and
     grip the railing.
   # Stay off ladders and stepstools unless you can brace yourself. Let
     someone else clean the gutters.
   # Stay well clear of icy surfaces.
   # Consider investing in a medical alert device and wear it all the
     time, even in the shower. This is particularly important if you live
     alone. An Apple watch or smartphone may serve much the same
     purpose, allowing you to call for help, but you’re unlikely to take
     those devices into the shower with you..
   # Exercise for half an hour most days of the week, for strength and
     balance. And don’t sit in one position for long periods. Stretch and
     walk around at least once an hour.
   # If you have balance issues, use a cane.
   
My experience is that most 9-1-1 fall victims can’t tell you why they fell,
which means they weren’t paying close attention to where they put their
feet. And if they don’t know why they stumbled, it’s difficult to prevent a
recurrence.
Be careful out there. And I’ll see you in New Haven next month!
(Register here for the reunion.)
Best wishes,
Sam Francis
sfrancis@fast.net

Return to yale63 web site 

Tales from Yale 1963

Pride goeth before the fall !!

Suggested web content at

check http://mayoclinic.org, site

OR http://clevelandclinic.org, site

OR http://yalemedicine.org, site

From reported experiences obviously preventable:

• reports of falls on stairs; installing a second handrail
• falls caused by loose fitting footwear, sandals,
flipflops, or those with straps 
• stepping on long shoe laces
• leg giving out or dizziness when standing up quickly
from sitting position
• falls or trippings caused by cords,
leashes, or irregular surfaces
• unexpected impacts from
removal of tree limbs or branches

Compiled list of miscellaneous falling events reported by Classmates:

I fell face
first down a flight of stairs recently.

Tripped on my Birkenstocks.

Landed on the wood deck and was able to lay
flat and distribute the load.

I did a face plant on the
driveway falling off a ladder putting up Christmas lighting.

Balance issue - Standing up after sitting for a long time

Not noticing uneven sidewallks or small items in ones
backyard

misjudging the final step(s) in descending stairs (with
unmarked front edges)

Falling due to possible syncope or
fainting

Misstep loose fitting shoe/slippers/flip-flops -

Medication known to cause dizziness

Descending
stairs but not holding on to railing; greater risk
when carrying item

Fall down a flight of
stairs by a retired colleague that I think was related to
alcohol and subsequent misfooting


Stepping on ones long shoe lace

Misjudging height of a stair riser and  stairs without a hand rail

"black" ice - esp. for those in the
North


Jon Larson and Jim
Courtright

Return to yale63 web site