No Fall Insurance

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n former president Ronald Reagan fell and broke his hip two weeks ago, he joined a group of more than 350,000 elderly Americans who fracture their hips each year. At 89 and suffering from advanced Alzheimer's disease, Reagan is in one of the highest-risk groups for this type of accident. The incidence of hip fractures not only increases after age 50 but doubles every five to six years as the risk of falling increases. Slipping and tumbling are not the only causes of hip fractures; weakened bones sometimes break spontaneously. But falling is the major cause, representing 90% of all hip fractures.

These injuries are not to be taken lightly. According to the American Academy of Orthopedic Surgeons, only 25% of those who suffer hip fractures ever fully recover; as many as 20% will die within 12 months. Even when patients do recover, nearly half will need a cane or a walker to get around.

When it comes to hip fractures, the most dangerous place for elderly Americans, it turns out, is their homes; nearly 60% of these dangerous spills will occur in or around the patient's domicile. This isn't all bad news, however, because a few simple, inexpensive modifications could prevent a lot of accidents.

The first thing to do is to get rid of those throw rugs and runners that line hallways and entrances. They often fold over or bunch up, turning them into booby traps for anyone shuffling down the hall.

Entering and leaving the house is a particularly high-risk activity, which is why some experts suggest removing any doorsills higher than 1/2 in. If the steps are bare wood, you can increase traction by applying nonslip treads.

Because many seniors suffer from poor balance (whether from neurological deficits or from the inner-ear problems that increase naturally with aging), it also helps to install grab bars and handrails in bathrooms and along hallways.

The bedroom is another major hazard area that can be made much safer with a few adjustments. Avoid satin sheets and comforters, and opt for nonslip material like wool or cotton. Easy access to devices is important, so place a lamp, telephone and flashlight near the bed within arm's reach. Make sure the pathway between the bedroom and bathroom is completely clear, and install a night-light along the route for those emergency late-night trips.

It's a good idea to rearrange the furniture throughout the house, so that the paths between rooms are free of obstructions. Also, make sure telephone and appliance cords aren't strung across common walkways, where they can be tripped over.

In addition to these physical precautions, there are the health precautions every aging body should take. Physical and eye examinations, with special attention to cardiac and blood-pressure problems, should be performed annually to rule out serious medical conditions. Blood pressure that's too low or an irregular heartbeat can put you at risk for fainting and falling. Don't forget to take calcium and vitamin D, two critical factors in developing strong bones. Finally, enrolling in an exercise program at your local gym can improve agility, strength, balance and coordination--all important skills that can keep you on your feet and off the floor.

Related Links:
Senior Care Web:Preventing Falls

National Osteoporosis Foundation

American Academy of Orthopedic Surgeons

Dr. Ian is a medical correspondent for NBC's Today Show. E-mail: ianmedical@aol.com