Gennie Odom, 84, worries when she doesn't see her buddies each morning at her residential community in Decatur.
She knows that an absence can mean that someone may have fallen during the night and is lying on the floor, hurt and helpless.
"I have seen so many people fall and seen what it's done to them," said Odom.
Falls --- in youth, just an embarrassment or the cause of minor injuries like skinned knees or a cut lip --- are the No. 1 cause of accidental death among people ages 65 and older, and the most frequent cause of serious injury, doctors said. Falls are among the scariest events a senior can face, and many curtail their activities because they are afraid of falling.
With winter in full throttle, outdoor falls will increase, doctors said, and it is important to minimize risks for falling on slippery porches, steps, parking lots and sidewalks. Also, seniors can become more prone to indoor falls. Their bones become weaker and more brittle from the loss of sunlight from shorter winter days --- and from staying inside for fear of falling on rain-slick steps or those coated with ice or snow.
More than 11,000 deaths from falls for those older than 65 were reported in 2001, according to the Centers for Disease Control and Prevention. Diet guru Robert Atkins, former Washington Post publisher Katharine Graham and Boisfeuillet Jones Sr., president emeritus of the Woodruff foundations, died of head injuries resulting from falls.
Falls also accounted for more than 1 million visits to emergency rooms for seniors in 2001. About one-third of the nation's 35 million seniors fall at least once a year. More than 300,000 fractured hips result yearly from falls, and about half of those accidents disable their victims.
While many of the falls are not immediately life-threatening, their prevalence and the damage they can do cause many seniors to curtail activities they enjoy and also to cut back on exercise for fear of falling, forcing many to live in stress and fear. "Sometimes I walk as if I think I'm on eggs," said Bonnie Darsie, 86, of Decatur. "I try to be darn careful."
Darsie was a regular swimmer until she was injured badly in a car crash in 1999 (she was not at fault). She would love to swim again, but the thought of a slippery locker room floor and pool deck terrifies her.
Darsie's cutback in activities is common. Fear of falling is a chief reason for senior inactivity, even among those who have never fallen.
"It's a very unpleasant thing for people to have to worry about," said Dr. Walter Ray, professor of preventive medicine at Vanderbilt University Medical School and lead researcher of the Tennessee Fall Prevention Program. "There's a profound psychological effect."
For many reasons, falls are common as humans age. Loss of muscle mass throws balance off, and the reflex system slows down with age. Diminishing eyesight also contributes. And certain medications impair balance and vision. Minimizing the risk
Paired with environmental risks such as throw rugs, loose cords or slippery stairs, the aging human body can be a fall waiting to happen. And falls are more serious to seniors than to younger people. Because of loss of bone mass that results with aging, seniors are more likely than younger people to fracture a bone when they fall.
Active seniors younger than 75 may be more likely to fracture a wrist than to break a hip, but the risk of hitting one's head and suffering a serious injury or even death applies to all.
Doctors and researchers have identified several things to minimize the risk of falling. A living environment should be as free from impediments as possible, with no throw rugs, dangling cords or obstacles in a person's path. Handrails should be on all stairs, and lighting should be bright.
Outdoors, make sure lighting is good at every entrance and that every stairway has a railing. On icy or snowy days, ask for help, or stay home, doctors said.
To help with coordination and muscle and bone strength, seniors should try to exercise at least a little every day, said Dr. David Apple, medical director of the Shepherd Center.
"There's a lot of issues with deconditioning," Apple said. "It helps if they can do anything that will maintain muscle mass --- simple calisthenics, stretching." Medication problems
It is particularly important to strengthen the lower body, said Dr. Judy A. Stevens, a senior epidemiologist with the Centers for Disease Control. Seniors who have been inactive for weeks or months should consider working with a physical therapist who has expertise with mobility issues of seniors.
Seniors also should make sure that their vision is corrected properly, doctors said, and make sure that their medications are not causing blurred vision, drowsiness, low blood pressure or loss of motor skills. Some drugs used to treat high blood pressure can cause low blood pressure, which can be a big problem for seniors, many of whom already have a difficult time standing up. Apple said some beta blockers can be bad for coordination, also.
The drug problems can be worsened by the need to find cheaper drugs, the doctors said. Certain generic drugs might cause a reaction with another drug that the branded drug does not. It is important to discuss all drugs with your physician and pharmacist.
Odom was shaken when she fell from a chair in December and cut her arm. Even so, she said she doesn't worry about herself as much as she worries about her neighbors. She remembers finding a fragile friend, who was 90, on the floor one morning after her friend's son had not been able to reach his mother.
"She had lain in the floor all night, and her little cheek was all rough and red," Odom said sadly. Her friend never fully recovered, Odom said, and she quickly lost mobility.
As a result, "I'm very careful," said Odom, who considers herself lucky that she can still drive and help friends to and from the doctor's office.
Darsie, who had to give up driving after her foot was crushed in her car crash, walks with the help of a cane when she is not in her apartment, mainly, she said, for "moral support."
"You don't do certain things, just in case," Darsie said. "The last thing you want to do is fall."
Copyright 2004 The Atlanta Journal-Constitution