Loss of balance could signal underlying medical condition

DEAR MAYO CLINIC: My grandmother, who is 82, has no major health issues, but she’s become rather weak and frail over the past several years, and her balance isn’t very good. Several weeks ago, she fell in her bathroom. Although her injuries were minor, my family is worried. Is there something we can do to help keep her from falling again?

ANSWER: You’re wise to be concerned about your grandmother’s safety. Falls are the leading cause of injuries for older Americans. Falls not only threaten seniors’ safety, but also their independence.

Having a conversation with your grandmother is a worthwhile place to begin. She may fear falling, which can decrease her mobility within the home and participation in her community. And even though your grandmother doesn’t have any significant health concerns, it still would be a good idea for her to visit her doctor. It’s possible that her weakness and loss of balance could signal an underlying medical condition.

A physical exam and a discussion with her doctor about her overall health could reveal specific fall risk factors or a need for health care services, such as physical therapy. A physical therapist can recommend exercises that would be helpful to her. Even gentle, low-impact activities can improve strength, balance, endurance, flexibility and coordination. A physical therapist also can determine if a walker or cane could provide safer mobility.

Your grandmother’s doctor also should review any medications she’s taking to make sure those medications don’t have side effects that might contribute to a risk of falling. Review calcium and vitamin D requirements for optimum bone health. Annual vision and hearing checks are important, as well.

To help your grandmother prevent another fall, take a close look at the environment within her home to ensure that it’s safe. Taking basic steps to make a home safer can go a long way toward lowering the risk of falls. That includes eliminating tripping hazards by removing boxes, newspapers, electrical cords and phone cords from walkways. Take coffee tables, magazine racks, plant stands and coat racks out of high-traffic areas. Secure loose rugs with double-faced tape or a slip-resistant backing — or simply remove the rugs. Repair any loose floorboards or carpeting. Store clothing, dishes, food and other frequently used items within easy reach.

Lighting within the home also can make a big difference. Along with keeping her home well-lit during the day, your grandmother could put nightlights in her bedroom, bathroom and hallways, and place a lamp close to her bed. You may want to consider installing glow-in-the-dark or illuminated light switches, so they are easy to find in low light. Pathways to those switches should be clear of tripping hazards.

Because you mention that weakness and balance are issues for your grandmother, make sure her home is well-suited for easy mobility. For example, there should be handrails on both sides of the stairways and nonslip treads on steps made of wood or other slick surfaces.

The bathroom can be a particularly risky area, but making a few adjustments can help. A raised toilet seat or a toilet with armrests can make it easier to get up and down without losing balance. In the shower or tub, installing nonslip mats, grab bars, a sturdy plastic seat and a handheld shower nozzle to use while sitting down can make it less likely your grandmother will slip and fall while bathing.

Many communities now have fall prevention programs specifically designed to help seniors reduce their risk of falling. Often offered as group classes, these programs usually focus on education, exercise, balance and fitness. It sounds like your grandmother could benefit from such a program. To find out if there is one in your area, ask your grandmother’s doctor, or contact your local Area Agency on Aging for more information. — Connie Bogard, P.T., Ph.D., Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minn.

(Mayo Clinic Q & A is an educational resource and doesn’t replace regular medical care. E-mail a question to MayoClinicQ&A@mayo.edu. For more information, visit www.mayoclinic.org.)