Experiencing Falls? This Could Be Why!

Carol lives with her daughter, Jennifer, and her family in their ranch style home. One afternoon, while Jennifer was sitting on her sofa reading a book, she heard a thump on the kitchen floor followed by a scream. She ran to the kitchen to see her mother lying on the floor. Luckily, she wasn’t hurt. She has fallen a couple times since, and Jennifer is not sure why.

Carol is in pretty good physical shape, as she exercises regularly and eats healthy foods. What could be causing her to fall? What Carol doesn’t know is that she could be deficient in vitamin D.

Falls are the leading cause of serious injuries in seniors. According to the American Geriatrics Society, each year about one third of Americans aged 65 and older fall, leading to hospitalizations, admissions into long-term care facilities, and even death, so Carol in our example was fortunate that she did not face any serious injuries.

While many health problems, including osteoporosis. arthritis, poor balance, muscle weakness, poor vision, dementia, and certain medications may increase fall risk, vitamin D deficiency plays a surprising role in older adults’ falls.

A Study Proves that Vitamin D Prevents Falls

A recent study that appeared in the Journal of the American Geriatrics Society was conducted on 124 residents of a Boston nursing home. Participants were 89 years old, on average, and most were white women. Sixty-two percent of the group had fallen in the year before the study.

When the study started, 63% of participants were taking a multivitamin. But 57% of the entire group — and 54% of those taking a multivitamin — had low blood levels of vitamin D.

Participants were randomly assigned to take vitamin D or an empty pill (placebo) for five months. Those taking vitamin D were given one of four daily doses: 200 international units (IU), 400 IU, 600 IU, or 800 IU. No one knew what dose they were taking, or whether they were taking the placebo.

Participants were allowed to keep taking multivitamins during the study, if they wanted to, but the researchers didn’t supply anyone with multivitamins. The nursing home was required to keep records of residents’ falls. During the five-month study, 61 participants (59%) suffered falls.

Researchers found that study participants who took a daily dose of 800 international units (IU) of vitamin D for five months were the only ones to show a reduced fall risk. They were 72% less likely to fall during the study period than those taking the placebo. According to researchers,”(e)nsuring that nursing home residents are receiving adequate daily supplemental vitamin D may reduce the number of falls in elderly nursing home residents and could potentially reduce the risk of fracture in this high-risk group.”

The Vitamin D Connection

Guidelines for a healthful diet and lifestyle change almost daily. It can be difficult to keep up with the latest theories and even more difficult to know who to believe in light of conflicting advice.However, one thing is certain: older patients can reduce their risk of falling by consuming the Recommended Daily Allowance of vitamin D.

Vitamin D appears to reduce the risk of falls in older adults by improving muscle function and strength. Here’s why older adults often don’t get enough Vitamin D, and need it:

  • Individuals with limited sun exposure, older patients, and people with dark skin color, who have difficulty digesting or absorbing nutrients from food, patients with chronic kidney disease, those who are obese, or individuals who are taking steroids are at highest risk of developing a vitamin D deficiency.
  • Older adults with vitamin D deficiency have an increased risk of muscle weakness and bone diseases such as osteomalacia (softening of the bones) or osteoporosis (reduced bone density) as well as an increased risk of rheumatoid arthritis and type 1 diabetes.
  • Few foods contain vitamin D naturally, for example, fatty fish such as salmon, tuna, and mackerel. Vitamin D-fortified milk actually provides most of the vitamin D in the diet in the U.S. [at] 100 IU per 8-oz glass, but of course milk is not typically consumed regularly by most adults because of lactose intolerance and other reasons.
  • Some older adults may be unable to properly absorb vitamin D. This is because vitamin D is a fat-soluble vitamin. If an individual has problems with fat malabsorption, they cannot absorb vitamin D adequately.

Supplementing with vitamin D is shown to significantly reduce falls and fractures. Other supplements are shown to be of benefit as well, including B vitamins and antioxidants.

Don’t Overdo it With Vitamin D

Vitamin D is one vitamin you shouldn’t overdo.  The tolerable upper limit for daily vitamin D intake is 2,000 IU for adults 19 and older, according to Institute of Medicine standards. The body stores vitamin D in fat, and it can be unhealthy to let too much of the vitamin build up in the body.

Sunshine and diet are much less likely to cause excessive vitamin D levels than supplements, unless you’re consuming lots of cod liver oil, according to the Office of Dietary Supplements, part of the National Institutes of Health. Consult with your doctor if you have any questions about vitamin D consumption, falls, or brittle or soft bones (osteoporosis or osteomalacia).

Resources for Seniors about Falls

Are you experiencing falls, or are you a caregiver for someone who is? The following are some educational resources that can help you learn more about falls and how to prevent them:

The National Council on Aging (NCOA), which is part of the National Institutes for Health (NIH), offers a free Falls and Fractures page and a toolkit with tips and printable materials to educate people about falls. Additionally, the Centers for Disease Control and Prevention (CDC) launched the STEADI (Stopping Elderly Accidents, Deaths & Injuries) Tool Kit for Health Care Providers. For more details and for CDC fall prevention resources, including older adult falls prevention guides for health care professionals, brochures, posters, podcasts, and more, visit the CDC website.

How Do You Keep an Eye on a Loved One When No One is Around?

So, what happens if a loved one falls and you are not around? Sensor-based home monitoring systems can alert a family member or caregiver of an emergency or when something unusual has happened. For example, if a senior has not left the bathroom for an extended period of time, it could mean he or she has fallen. Personal emergency response systems, known as PERS, can also contain GPS technology. If in trouble, the wearer can press a button and be connected with a call center that can dispatch help and notify caregivers. Many PERS devices only work at home, but a few allow the wearer to get help wherever they are — on the golf course, in the car, or around the block. Read our blog post for more technology options for monitoring family members at risk of falling.

When Taking Preventative Measures Isn’t Enough

When taking preventative measures isn’t enough, assisted living or nursing home care may be needed for your loved one. Nursing homes in Washington, D.C., Fairfax, Virginia, and the rest of Northern Virginia can cost as much as $144,000 per year, while Fredericksburg, Virginia nursing homes and nursing homes in and the rest of Virginia can cost as much as $105,000 per year.

Life Care Planning and Medicaid Asset Protection is the process of protecting you or your loved ones from having to go broke to pay for nursing home care, while also helping ensure that you or your loved ones get the best possible care and maintain the highest possible quality of life, whether at home, in an assisted living facility, or in a nursing home. Call us to make an appointment for an initial consultation.

Fairfax Elder Law Attorney: 703-691-1888

Fredericksburg Elder Law Attorney: 540-479-1435

Rockville Elder Law Attorney: 301-519-8041

DC Elder Law Attorney: 202-587-2797

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About Evan H Farr, CELA, CAP

Evan H. Farr is a 4-time Best-Selling author in the field of Elder Law and Estate Planning. In addition to being one of approximately 500 Certified Elder Law Attorneys in the Country, Evan is one of approximately 100 members of the Council of Advanced Practitioners of the National Academy of Elder Law Attorneys and is a Charter Member of the Academy of Special Needs Planners.