As we say goodbye to summer and welcome to autumn, it’s a good time to learn about outdoor fall prevention and how we can reduce our risk of falling outside. On my morning runs, I’ve had at least two minor falls in the past year. One involved me and an exposed tree root (the root won) and the other was an uneven surface on the sidewalk that caught the heel of my shoe. What I’ve discovered all on my own is that outdoor falls are more common for middle aged adults than indoor ones. In fact, 72 percent of falls among middle aged adults occur outdoors. Falls continue to be the leading cause of injury-related hospitalization in Manitoba. They are a major threat to the health and well-being of older adults and one in three adults aged 65+ will fall each year.
Most of the research on fall prevention has focused on indoor falls and eliminating home hazards and personal risk factors. According to a study published in the Archives of Gerontology and Geriatrics and reviewed in Science Daily, outdoor falls receive far less attention when it comes to education and prevention. Subsequently, many older adults lack an understanding of the risk factors involved. The study also looked at the demographics for outdoor falls, which varied from indoor ones. People who fall outside tend to be younger, active and more often than not, male. Those who reported a fall experienced physical injuries like open wounds, head injuries and fractures coupled with, an emotional response to the fall – including a fear of falling again or embarrassment. The participants identified a number of environmental factors that contributed to the fall. These included things like uneven or slippery surface conditions, debris like rocks or branches, and outdoor stairways. Furthermore, participants frequently blamed themselves for the fall, citing reasons like walking too fast͛, not paying attention͛ or wearing inappropriate footwear.
Another research study published in the Journal of the American Geriatrics Society examined the most frequent locations where outdoor falls occurred. They were sidewalks (23%), yards or gardens (14%), streets or curbs (14%), outside stairs (13%) and parking lots (6%).
These insights into where falls happen and why are the first important steps in reducing your fall risk. For example, the next time you’re walking on an uneven path with some loose rocks, slow down and be mindful of each step you take. Our Manitoba winters can make navigating the outdoors extremely challenging. It’s not surprising then that an associate professor and researcher from McGill University in Montreal found that when a freezing rain advisory was issued, there was a 20 percent increase in falls for older adults. Another interesting statistic from this Canadian study is that men were 31 percent more likely to fall in hazardous freezing rain conditions in comparison to other days. The author of the study theorized the reason may be that men tend to go out more often in inclement weather than women.
The Staying on Your Feet website from the Winnipeg Regional Health Authority highlights the importance of proper footwear in any fall prevention strategy. When choosing footwear consider the following: 1) Wear footwear that fits snugly; laces or Velcro fasteners are a good choice so you can adjust the shoe to your foot. 2) The sole of your footwear should have a good grip. Always wear shoes with a non-slip sole. 3) During winter, wear boots that have good traction on the ice and snow. 4) If you are experiencing foot pain or problems with your feet, be sure to see your healthcare professional or a podiatrist. For more information on choosing footwear, please visit http://preventfalls.ca/older-adults/footwear/
Safe outdoor walking strategies would also include using caution when going up or down stairs, stepping over curbs, or carrying items like grocery bags when navigating an uneven surface. Most importantly, pay attention at all times and slow down if you are walking at night on an unfamiliar path, especially if there is no outdoor lighting. Finally, you may want to consider a mobile personal help button in case of an accidental fall or emergency while you are outdoors. Recognizing that older adults today lead active lives, Victoria Lifeline launched GoSafe last year, a mobile button with fall detection and six advanced locating technologies. GoSafe uses assisted GPS (satellite systems) and Wi-Fi locating technology to leverage Wi-Fi hotspots throughout the city. It also has two-way voice communication right through the button and an audio beacon that can be activated by the Lifeline Response Centre if you fell outside and could not be easily seen by emergency personnel. This new generation of Lifeline help buttons gives people the freedom to go where they want, when they want knowing they can access help in an emergency. For more information on GoSafe or to watch a video on how the service works, please visit victorialifeline.ca. Please note that GoSafe relies on cellular network availability.
Krystal Stokes is the communications and public relations manager at Victoria Lifeline, a community service of the Victoria General Hospital Foundation.