Mom’s Fall in the Big Apple Reawakens My Passion for Injury Prevention

It can be very disheartening when your parents age and are subjected to declining health. One of the most common health concerns among seniors is falling, and alas, this has happened far too many times to my dear mom.  Having launched many PR/media campaigns on head injury prevention in my last position over the course of seven years, I know quite a bit about traumatic brain injury, causes, and statistics – and I am passionate about injury prevention. While my mom has fallen quite a few times and sustained broken bones as a result, this is the first time that a tumble has led to a serious head injury.

I was quite upset when she called me from NYC (after having recovered sufficiently) and told me they walked back to the hotel after she fell outside the Chrysler Building. She was bleeding profusely from the wound sustained in her head, exacerbated by being on blood thinners. They should have called 911 immediately instead of walking back to the hotel and then calling an ambulance. My mom spent 17 hours on a gurney in the infamous Bellevue Hospital ER as a result of this fall, but the good news is that she did not suffer a concussion. And thankfully there was not a traumatic brain injury such as a subdural/epidural hematoma  or skull fracture, which can be deadly.

Remember the tragic death of actress Natasha Richardson after incurring a seemingly benign bump to the head after falling on a beginner ski slope in Quebec? Several factors led to her death including not being diagnosed and treated quickly enough for the epidural hematoma incurred from her fall (she was not wearing a helmet, but I’ll leave that for another blog). An epidural hematoma is a blood clot between the skull and the dura, the tough tissue covering the brain. Many patients experience a lucid period and appear fine before rapidly deteriorating. Initially, there are often no obvious physical signs of injury, or only minor signs such as a bump. Cognitive signs of injury appear later and often may develop quite rapidly. Timely treatment of epidural hematomas is critical for outcome, and literally, can make the difference between life and death.

I personally know two people who died from head injuries caused by falling inside their homes – I don’t know the clinical factors involved in their falls – only that they proved fatal. One person tripped down the stairs due to wearing high heel shoes and the other person slipped on the kitchen floor after the dishwasher sprung a leak and the floor was saturated with water.

Every year an estimated 2.8 million children and 2 million people age 65 and older are treated at U.S. hospital emergency rooms for accidental falls – the leading cause of non-fatal injury among Americans of all ages. Among Americans age 65 and older, falls are the number one cause of fatal injuries, half of which are attributed to a traumatic brain injury suffered during the fall. A moment of distraction, hastiness, or carelessness can lead to a life-altering or even fatal head injury, but most injuries can be prevented by taking a few simple precautions.

My mom could easily have become one of these statistics, but she is one feisty lady from a medical standpoint. A 13-year breast cancer survivor, she has suffered a variety of other health issues and is on some serious medications, which have contributed to her frailty and imbalance problems. Most recently she was diagnosed with Afib, which has put her at risk of stroke, so she is on Warfarin. A head injury should always be taken seriously, but when sustained in somebody on a blood thinner, especially so since hemorrhaging can occur.

While falls are common outside, many more falls occur inside the home. The following 10 home-related categories contributed to the highest number of estimated head injuries treated at U.S. hospital emergency rooms in 2010 (based on U.S. Consumer Product Safety Commission Statistics).

1. Floors or Flooring Materials – 393,082
2. Stairs or Steps – 181,908
3. Beds or Bedframes (other or not specified) – 162,739
4. Tables (not classified elsewhere) – 97,465
5. Ceilings and Walls (completed structure) – 96,558
6. Chairs (other or not specified) – 79,003    
7. Bathtubs or Showers – 55,764
8. Cabinets, Racks, Room Dividers and Shelves – 52,097
9. Doors (other or not specified) – 42,658
10. Sofas – 39,703

So what could my mom have done to prevent this unfortunate fall? She should be using a cane – often a hard thing for an older person to accept after being fit and active for many years. Her balance has never been great but it has gotten worse due to the medications she takes. When my dad told her to look up at the majestic Chrysler Building, he didn’t expect her to fall backwards on her head, and perhaps this would not have happened if she had a cane. Again, most falls can be prevented by following a few simple precautions.

Preventing Falls Inside the Home

• Secure loose electrical cords and put away toys and any other items that are lying around
• Buy bath mats and rugs with slip-resistant backing and secure them
• Do not walk on slippery, freshly washed floors and avoid floor waxes
• Install grab bars and handrails if you are frail or elderly
• Improve the lighting in your home; dim lighting can increase the risk of falls
• Install night lights in halls and bathrooms, and keep a flashlight near your bed
• Store products in easy-to-reach places; use stepstools/ladders only when absolutely necessary and do not climb up on furniture to reach things
• Wear proper shoes with slip-resistant soles
• Use a walker or cane when necessary
• Educate yourself about your medications and any side effects

Preventing Falls Outside the Home

• Inspect and remove debris and ice from walkways, driveways, porches, and yards
• Inspect and remove debris from lawns before mowing or gardening
• Make sure that ladders are stable and secure before using them
• Install outdoor handrails if elderly or frail

During the holiday season and winter, fall-related injuries spike due to several factors. There are many warnings about too much merriment leading to alcohol-related motor vehicle accidents, but this can also lead to fatal falls. To prevent becoming a statistic this holiday season and all year-long, think first, be sensible, and follow simple precautions. Have a safe and wonderful holiday season.