CATES: Falls can be devastatingCarol Cates is the chief nursing officer at Odessa Regional Medical Center. You can reach her via e-mail at

Did you know the number one cause of traumatic death for older adults in Texas is not car wrecks, not high risk behaviors and not injuries related to some sort of violence? The number one cause of traumatic death in Texas is falls.
When most people think of deaths and falls, they think of falls from a height. Unfortunately, that is not the case with the deaths I am speaking about, the falls I am speaking about are same level falls. Falls where someone trips, slips, or for some other reason lands on the ground from a sitting or standing position. The person who falls hits something or breaks something vital on their way to the ground or upon impact with the ground, and it costs them their life. My very first job as a nurse was a on an orthopedic unit, and the vast majority of the patients I took care of in that job were hospitalized because of falls.
That job gave me a healthy fear of falls and their potential, and in my 27 years of nursing, I have yet to see anything that has changed that fear of falls. While most of the treatments for those injuries have changed greatly for the better over the decades since I had that job, one thing has not—the same type falls that caused those injuries still happen and they still have the potential to be very serious. Falls can radically change someone’s quality of life and have a large potential to cost a life.
According to the Texas Fall Prevention Coalition, one in four older adults in the US fall annually, resulting in 2.8 million ER visits. In 2011, Texas had 60,000 people hospitalized related to falls at a cost of $3.1 billion dollars. Falls are the number one cause of hip fracture, an injury that can have serious implications on quality of life. The Texas Department of State Health services states nearly 1,500 Texans in died in 2015 related to same level falls. Frighteningly, those numbers are on the rise. Falls have been increasing at a rate of about 1% annually in Texas since 2006. An older adult falls somewhere in the US every second of every day.
Falls are not normal. Anytime someone falls, we should be asking why—even if there are no injuries. Did someone trip or slip? If so eliminate that hazard. Is there another reason? Better Health while Aging states it is important to have a medical assessment after a fall because 1) A fall can be a sign of a new and serious medical problem that needs treatment 2) Older adults who fall are at higher risk for a future fall, and 3) Families and loved ones that are proactive about addressing falls have better outcomes in reducing falls and preventing injury from falls.
The National Council on Aging recommends 6 steps to prevent a fall: 1) Find a good balance and exercise program. Research has shown exercises which strengthen leg muscles and improve balance reduce the likelihood of falls. 2) Talk to your doctor. Ask for a fall risk assessment from your physician, and make sure they are aware of any history of falls you or your loved one may have. 3) Regularly review your medications with your doctor or pharmacist to make sure that side effects and/or interactions are not increasing your risk for falling. 4) Get your vision and hearing checked regularly and update prescriptions. Poor vision is a strong contributor to falls. 5) Keep your home safe. Make sure walkways are clear, that slip and trip hazards are eliminated, that stairs and steps inside and outside homes are well lit and free of slip and trip hazards. Are kitchens and bathrooms arranged so individuals are not having to climb on chairs or step stools to get frequently used items? Are there adequate hand holds in slippery areas? Wear supportive, non-slip shoes inside and outside of the house. The Centers for Disease Control has a great home fall prevention safety checklist available online at
And, 6) talk to your loved ones. Falls are not just a risk for older adults, and the more folks involved in fall prevention in your family, the fewer falls anyone is likely to have.
For the most part falls are very preventable. Please take steps to make sure you and your loved ones are preventing as many falls as possible. Those prevention steps will also help ensure that if you still do happen to fall, the injuries are much less likely to cause serious injury or death.