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Medication and Environmental Fall Risks

Our Fall Focus on Falls Prevention this week is on Medication contributing to increased Fall Risk and Environmental Risk Factors for Falling. Everyone is at risk for falling, however older adults are at an increased risk for falls and injury, and severity of injuries. Reducing the number of risk factors for falling helps to safeguard your precious independence.



POLYPHARMACY

Polypharmacy (polypragmasia) is an umbrella term to describe the simultaneous use of multiple medicines by a patient for their conditions. Taking multiple medications and taking certain medications can increase your chances of falling and injury.

The Center for Disease Control and Prevention (CDC) states that taking 4 or more medications daily may increase your risk for falling. Specific medication such as Benzodiazepines (e.g. sedatives, hypnotics, anti depressants, Anxiolytics (also termed anti-anxiety or anti-panic drugs) are strongly associated with falls. Common medications to lower blood sugar and blood pressure such as Metformin and Metoprolol are on the BEERS CRITERIA LIST of medications associated with falls among older adults. Side effects from these drugs can change the way you feel or think and can cause drowsiness, loss of balance, changes in vision, slower reaction time, and other effects that increase the risk of falling.


Be aware that taking a new medication can increase your fall risk. Medications such Chemotherapy drugs can cause peripheral neuropathy, peripheral neuropathy in the feet can heighten your risk for falling.


STEADI-CDC provides the following advice to physicians who prescribe medications to older adults:

  • Eliminate medications if there is no active indication

  • Reduce doses of necessary medication to the lowest dosage

  • Avoid prescribe medication where the risk from side effects outweighs the benefit (e.g., muscle relaxants)

  • Reduce or eliminate psychoactive drugs such as benzodiazepines. Medications that have anticholinergic effects, and sedating over the counter (OTC) medications such as Tylenol PM.


You can ask your doctor or pharmacist to conduct Fall Risk Screening, Assessment, and Care Coordination. For more information please visit the American Geriatrics Society Beers Criteria for more information on medications linked to falls.


ENVIRONMENTAL RISK FACTORS FOR FALLING

Hazards that increase the chances for falling are found in and around the home and in your community.

In the home clutter, uneven flooring, poorly designed stairwells, absence of stair rails, unsecured floor mats and rugs, inadequate lighting, chairs that are too low, too deep and too soft, or chairs that are unstable, pets and pet toys and dishes are just a few of the many in home environmental risk factors for falling.



Outside the home unsafe steps leading up to the front-and back-doors, and in or out of the garage, absence of rails to hold on, moss covered steps that are slippery, sloping driveways, uneven sidewalks, unstable outdoor furniture, sidewalks covered with leaves and sticks that hide uneven surfaces or holes, varying curb heights or snow and ice can increase fall risk as you move about in the community.


We have checklist for identifying fall hazards in and around the home. We will be happy to email these documents to you.


Stay safe and be well this fall!





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