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A Serious Slip for the Elderly : Health: The Pope’s hip injury again points up the need for safety in the home. Experts say frailty and poor balance increase chances of falling.

May 10, 1994|SHARI ROAN | TIMES HEALTH WRITER

He was over 65 and stepping from the bathtub when he lost his balance and fell. He fractured his hip.

What happened to Pope John Paul II in the Vatican last month was a classic-case scenario. Among the elderly, hip fractures resulting from falls are a common injury that often leads to disability and even death, safety experts say.

While the Pope, 73, is reportedly in excellent condition and is expected to recover, he will be left with a metal joint in his right thigh and faces months of physical therapy.

If that is the extent of his injuries, Pope John Paul will be blessed, indeed.

Falling is the most common cause of fatal injury in the elderly, according to the National Safety Council. Moreover, thousands are left permanently disabled from falls, particularly by hip fractures.

About 300,000 Americans–most of them elderly–suffer hip fractures each year. About 20% of those individuals die within one year of the fracture, according to government statistics.

Moreover, this type of injury can transform an active person into a bedridden one. Half of all people with hip fractures who could walk without assistance before the accident cannot walk independently afterward, reports the National Osteoporosis Foundation. And, 41% of those injured need nursing home care during their rehabilitation.

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Elderly people are highly susceptible to falls because of such health problems as arthritis, poor eyesight and hearing, frailty, poor balance and coordination, senility, dementia and weakness or dizziness caused by medications, says Michael Taylor, a spokesman for the National Safety Council.

“For example, just getting out of the bathtub requires you to raise a leg and have balance. This is difficult for some elderly people. Even when they walk, they often shuffle their feet and are unable to pick their feet up,” he says.

Vatican officials have not explained what caused the Pope to fall. He fractured and dislocated his right femur at the point where it connects to his hip.

The aftermath of a fall can be particularly disastrous because of osteoporosis, the bone-thinning condition common among the aged, says Sandra Raymond, director of the National Osteoporosis Foundation. Bones lose mass and weaken as people age. Women eventually lose 30% to 50% of their bone density and men lose 20% to 30%. Osteoporosis is a manifestation of this bone loss in which bones are extremely porous.

“Almost 90% of hip fractures are caused by osteoporosis,” Raymond says. “But part of the problem with these fractures is the people who fall didn’t know they had low bone mass or osteoporosis. This is a shock to them.”

Just as a heart attack or stroke is sometimes the first sign of heart disease, a bone fracture can be the first warning of osteoporosis, Raymond says.

But, she says, the warning often comes too late: “It’s already a catastrophic event. So prevention is the key.”

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Experts say elderly people should discuss their risk of osteoporosis with their physicians and, if necessary, undergo tests to evaluate bone density. Bone loss can be minimized through a good diet (high in calcium), weight-bearing exercise and taking certain medications.

Many doctors will also review fall-prevention strategies with patients at risk for bone fractures, Raymond adds. But fall prevention should be practiced by everyone–young and old. This means assessing your home for hazards, such as loose carpeting, slick floors and cluttered areas.

Bathrooms, in particular, can be made safer by installing grab bars and putting down non-skid rugs and bathtub mats. Bathroom designers prefer rounded edges on counters and sinks to reduce injury. Some bathtubs are equipped with a seat to use while bathing. And there is even a urethane foam padded tub on the market.

Grab bars are extremely protective and can be purchased for as little as $17 each with minimal installation costs, says Dan Kramer of D and D Kitchen & Bath Design in Brea.

Although grab bars are still not common in homes, some bathroom designers say they are incorporating them more in new homes. Grab bars are even available in designer colors.

Most people realize that grab bars are great safety devices, Kramer says, but they shirk from purchasing them “because they don’t look all that attractive. People think of them as being used in institutions more than anything else.”

Number of Deaths Due to Falling

Falling is the most common cause of fatal injury in the elderly. In 1992, 6,200 people died in accidental falls in the home. Most often injured are those very young or very old.

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