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Fall Prevention Forum attendees get moving to some Zumba moves. (Photo by Chris Frost)
Wednesday, October 2, 2019

By Chris Frost


Oxnard—The South Oxnard Senior Center was filled, Sept. 20, as Ventura County Area Agency on Aging, along with the Fall Prevention Coalition hosted a Fall Seminar.


Attendees heard from Dr. Paulo Carvalho and Dr. Thomas Duncan, who educated the crowd about superhero methods to prevent falls and solutions. The event also featured information about kitchen and bath burn prevention from Debbie Karaman a focus on balance from Camile Torgeson and using Tai Chi for better balance from Carol Vaughn.


Carvalho said there are 29 million falls that take place each year.


"People in poor health will fall more frequently," he said. "For older adults in long term care settings, about 50 percent of the people will fall every year. If you have a history of falls, then you’re 60 percent more prone to falling again."


People who fall face consequences, which he said is the impetus behind the seminar.


"Studies have found that 10 percent of any falls will result in several injuries," he said. "There will be head trauma, and also some lacerations. Most people who fall and have a hip fracture will never recover and be able to do what they were able to do before."


The reality, he said, is that 5 percent of all falls among seniors result in hospitalization.


"Falls are the leading cause of death from injury in people over 65," he said. "This is together with cancer deaths, heart disease, diabetes, stroke, and is the fifth leading cause of death in older Americans. It's a big reason why we need to prevent falls."


People fall for multiple reasons, he said, and people have mechanisms to keep a stable posture that gets eroded from age.


"We lose some of that sense of balance, cardiovascular function, and muscle coordination," he said. "The consequences worsen if you have a sickness, like a fever, or you're dehydrated, or you were started on a new medication."


New environments can also cause falls, or there is an unsafe walking surface.


"The more of these you come across, the higher the risk there are of falls," he said. 


Another significant risk factor is lower extremity weakness.


"Many studies document that lower extremity weakness, muscle loss, will increase the fall risk," he said. "Dementia, Alzheimer's, and as we live longer, there is a higher risk of Alzheimer's. Arthritis is also a big risk for falls."


Carvalho discussed sensory and muscle system in the body as people age and said sensors in lower extremities tell what position your body is in and how to maintain posture.


"We lose function in those sensors as we age," he said. "On the muscle side of things, as we age, there are muscles in the lower extremities that need to activate to keep a good posture.  "We start using muscles, maybe the quadriceps, in our lower extremities, and we are at an increased risk to fall because of that. If we trip, we have mechanisms that we can catch ourselves, but as we age, we lose some of that responsiveness, and we end up falling."


Finally, he said as people age, they lose muscle mass and have increased fat inside their muscles which is paramount in increasing the risk of falls.


"Arthritis is common as we age," he said. "The reason why it affects mobility is that we favor one extremity over the other that might be affected by arthritis, and the mechanisms that keep our stability are off-balance."


Studies of dementia and loss of brain function reveal there is a higher risk of falls and hip fractures.


"If you have a hip fracture, as I said, the majority of those patients will not recover their function status," he said. "In a study of 1,600 people over age 75, the risk of a hip fracture doubles when there is a lower brain function."


He said caregivers need to be aware of patients with dementia and Alzheimer's.


"Some of the patients will wander outside the house," he said. "They do activities that need to be supervised."


The relationship between medications and falls should be discussed with the person's physician.


"Multipole medications of any sort, or sleep and anxiety medication, like opioids, all increase the risk of falls," he said. "The more risk factors you have, the higher the risk factor for falls."


Exercise plays a crucial role in preventing falls, he said, and people who initiate activity helps them avoid falling.


"Continuing to exercise and choosing the right exercises will be beneficial," he said. "Muscle-strengthening exercises also help prevent falls."


Ana Salinas led the group through a spirited Zumba session that got people out of their chairs and moving to the beat. The crowd enthusiastically joined in the fun.


"I am a volunteer, and I was asked to do a Zumba presentation for our seniors," she said. "We want to incorporate some movement into their lives and have some fun. They did great. I was surprised by how wonderful they did."


Duncan is the Ventura County Medical Center Trauma Director and told the crowd that his hospital sees all kinds of trauma.


"We see patients that fall, people who have been in a motor vehicle and motorcycle crashes, who have been stabbed and beaten up and have been shot," he said. "We see the entire spectrum."


In the past hour, he said four people got taken to the trauma center.


"This is our 12th forum," he said. "It takes a lot to put all this together. Falling can change the outcome of our lives. We have resources in the back of the room, and you should take advantage of them."


Mostly, he said the people who are running the forum care about everyone.


"I would rather see you here than in the hospital," he said. "If I see you in the hospital, it is probably not a pleasant experience. I am not sure anybody likes being in the hospital."


He too is not fond of hospitals.


"I'm scared of doctors," he said. "I look in the mirror, and I scare myself, but I have to go to the hospital to take care of people."


Thomas spoke about his dad, Joseph Thomas Duncan, who is 86 years old and fell six years ago.


"He fell once out of bed, but he got up and went to the hospital and went home," Duncan said. "The second time he fell, he had some injuries to his neck. It was so bad that my dad couldn't walk anymore, and he had to go to a rehab facility."


While at the facility, he became fearful of walking, and he developed stiffness in his legs.


"His legs got bent, and he can't move them back," he said. "He's bedbound for the most part, and he can't get up and walk around.  He aspirates, and it goes into his windpipe, so he has a feeding tube."


At one point, his dad was young and vibrant, and now this is his condition.


“Falling can change your lifestyle all together,” he said. 


Thomas spoke about the value of a medical alert device, and when his dad fell, he punched a button, and the paramedics came out to take of him.


“If you live alone or with someone elderly, it behooves you to get one of these,” he said. “It works out well.”


He asked how many people fell over the last year, and a significant number of people raised their hands.


“It’s no fun when you fall and get transported (to the hospital),” he said. “That’s the reason why we’re holding this today.”


According to the Centers for Disease Control in 2017, Thomas said the 10 leading causes of death are:10 suicide, 9 kidney disease 8: diabetes, 7: Alzheimer’s, that his mom had, 6:stroke, 5: chronic raspatory disease 4: unintentional injuries, which he said is huge. 3: Cancer, 2: deaths from the opioid epidemic, and 1: heart disease.”


He delved into the unintentional injuries, the opioid epidemic, and there is a big problem in the nation.


“That’s the reason why when you go see a doctor these days, rather than being given 30, 60, or 90 of NorCal, Vicodin or Percocet, they’ll give you a limited supply,” he said. “It’s not because they don’t want to treat your pain; people have issues when they give 60 or 90, and the patient only takes a few pills, and they have a lot of pills left behind. Then, their teenagers take it, or other adults and they become addicted.”