Falls scare seniors because bone doesn’t absorb impact the same as younger bone—but not necessarily from the initial injury. Where a 40 year old gets a bruise by 80, an 80 year old shatters his/her wrist or hip. It’s all down to density—or lack thereof. By the time many age into their 70s and 80s, bones are like shattered glass, no longer created to support a lifetime of independent movement. Where falls are an inconvenience to a 40-year-old, to an 80-year-old they’re potentially life-changing.
Recognizing what actually occurs within aging bones helps clarify why falls become so preventable but simultaneously it’s one fall that ruins a life unknowingly.
Bone Density Isn’t As Strong As Most Believe
Bones are not static. They come and go throughout life. However, by middle age—the critical window for women is post-menopause—the loss of bone density occurs at a more rapid rate than bones can create to compensate. Therefore, bones look intact from the outside but inside, they’re porous, fragile. Yet when people age into their 70s and 80s, they’re practically honeycombs with holes where cemented bone should be. Therefore they cannot sustain impact.
They require support to successfully maintain correct movement all the time or else something as simple as falling can change everything—and this is where senior care Philadelphia services come in and provide assistance to keep bones strong with good nutrition and ample movement.
The worst part? Bone loss happens for no one any wiser until it’s too late. There’s no discernable pain or symptoms until the first fracture happens.
Hip Fractures Change Everything
Everyone fears hip fractures—and for good reason. They are extremely common among seniors as hip bone density has declined but falling tends to land an individual right on his/her hip. However, it’s not the fracture that changes everything, it’s the aftermath.
Most hip fractures require surgeries that are scary to any age and particularly older ages where comorbidities exist. In addition, recovery from a fall is weeks of involuntary inactivity. In that time, muscle degeneration increases, comorbidities worsen and complications occur (blood clots, pneumonia) where adults who fracture their hips never return to who they once were before their fall. One hip fracture leaves someone in a previously independent living situation requiring live-in assistance.
Wrist Fractures and Spinal Fractures Are More Common Than Expected
While people gear their focus toward fractured hips, wrist fractures and spinal fractures occur even more often and result in significant differences as well. Wrist fractures occur when someone attempts to catch his/her fall—a natural response to an unfortunate situation. It makes sense with adults who have solid wrist bones but not so much with those who have extremely fragile ones.
These wrist fractures incapacitate hand use for significant amounts of time—months—with challenges attempting simple situations (getting dressed, preparing meals, personal hygiene). For someone already on the fence between independent care vs assisted care makes it all the more difficult to acquire assistance across the board.
Spinal fractures are insidious. They occur from picking up a bag of groceries or bending over. Sometimes seniors have spinal fractures without even knowing—from having lost some height or suddenly experiencing back pain. Compression fractures alter posture and increase risk from balance issues when transporting.
Fracture/Fall/Fracture Cycle
This is the ultimate concern: fractures increase chances of falling which increases fractures. After breaking a bone many seniors develop a fear of falling and grow increasingly cautious thus less mobile and avoidant of such group activities—even with decreased movement feeds muscle atrophy and worsened stability which increases chances of falling.
Simultaneously, the fracture itself may have changed how someone now addresses/can use muscles or joints post fracture. Once healthy wrists no longer bend appropriately. Once healthy backs no longer support good posture; instead they support hunchbacks—and this makes complicated mobility even less stabilized and increases chances of falling.
It becomes a downward spiral that’s impossible to reverse.
What Actually Strengthens Bones At This Age
The sad reality is that it’s incredibly difficult to build back bones after they’ve been severely lost (not counting avoidable osteoporosis). Calcium and Vitamin D supplements help but not really. Weight-bearing exercise can decrease bone density loss, even build some up again but only if done correctly.
Therefore unless someone stops falls from breaking these already vulnerable bones, complications persist for research team members as well as caregivers/family who want nothing more but to help but find limited decent options.
Osteoporosis medications are available but slowly at this point; side effects aren’t for everyone—they’re the treatment but not everything.
Prevention Is Better Than Treatment
Because it’s hard to rebuild bones after you’ve already lost them; prevention is key for before age 70—solid amounts of calcium and Vitamin D throughout life; extensive weight-bearing workouts; no smoking; limited alcohol intake—but for those who’ve crossed the line into advanced old age with less bone density they must center their focus on avoiding fallen fractures at all costs.
Thus it’s essential for environmental safety—tripping hazards removed, increased lighting, grab bars placed everywhere, proper footwear worn—practical measures trump fallen fractures which otherwise any attitude will undermine but isn’t typically helpful.
This does not mean people should be put into bubbles; instead they should be supported through stability-sustaining efforts; assessment of medications that undermine balance access for all.
They’re most effective when regularly assessed so bone density testing can determine who’s part of a high risk team—you want to prepare certain interventions PRE-emptively before people start falling.
How This Changes People’s Behavior
It’s one thing to say someone has porous bones as they’re “getting older” but it’s another thing entirely to see them functionally fall apart—even if family members can’t notice them or assess small portions of porosity; it’s important to note that this change isn’t superficial as it functions like other muscles/joints/interdependent systems on the body.
Thus families don’t need to go overboard protective or assume independent functioning has to be taken away prematurely—but acknowledge there’s a new normal with little margin for error.
A fall that’s nothing now would have been barely avoided ten years ago. That means increased caution against understanding what’s risky/prevention/preach that receiving help needs to be taken seriously now for additional activities before it becomes too late.
Further Reading
