According to the New York State Department of Health, injuries, both unintentional and intentional, affect hundreds of thousands of New Yorkers each year and result in more than 7,250 deaths annually. Injuries are the leading cause of death for New Yorkers aged one through forty-four years and a leading cause of death for all other New Yorkers. Those who survive their injuries often suffer long-term or permanent disabilities, have costly medical expenses, miss school or work, and endure pain and other hardships.
Through surveillance and programs such as, fall prevention, the Genesee County Health Department is committed to work to reduce the prevalence of injuries, including those due to violence, in our community.
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Eldery Falls: Take Action and Prevent Long-term Disability
The following was composed by Arun Subramanian, M.D. ~ Dr. Subramanian is working with the Genesee County Health Department, during the Spring of 2012, to complete his student practicum.
Public health aims to prevent the major killers, such as heart disease, cancer, diabetes and injuries, but it also uses set of measures for early detection and prompt intervention to control number of problems common in elderly patients that can adversely affect their independence and quality of life. These include elderly falls, osteoporosis, over-medication, impairment of vision and hearing, and Alzheimer’s and other dementias. The impact of falls and resulting injuries on elderly individuals, their families, and society is quite significant. The Centers for Disease control and Prevention’s statistical data on elderly falls shows the seriousness of this public health concern in the United States.
Bone loss is common with age, especially in women. This leads to osteoporosis, “porous bones” which tends to break easily. Bone loss among women is greatest in the years following menopause. Smoking and alcohol consumption increase the risk of osteoporosis; obesity reduces the risk (one of the few health benefits of being overweight). Clinical research has shown that Vitamin D supplements can reduce the risk of falls independently of their value in osteoporosis prevention. Most osteoporotic fractures occur when elderly people fall. Thus, in addition to osteoporosis prevention, public health effort focuses on preventing falls to prevent significant proportion of disabilities among the elderly population.
According to New York State Department of Health, the rate of falls increased from about 450 in the year 2000 to 600 in 2010 per 10,000 people aged 85 and older in Genesee County. In the United States, more than one third of people 65 years and older fall each year; many of them fall repeatedly. About one fall in ten results in a serious injury, such as a fracture or head injury. Many older people have a high risk of falls because of medical conditions that affect their mobility, such as arthritis, stroke, and Parkinson’s disease. Other risk factors include vision impairment, muscular weakness, problems with balance, and the side effects of medications. The use of four or more prescription drugs is considered a risk factor for falls. Psychoactive drugs such as antidepressants, tranquilizers, and sleeping pills are especially dangerous.
The Centers for Disease Control and Prevention recommends five measures older people can take to prevent falls. They should exercise regularly. Muscle strengthening exercises can significantly increase their mobility, strength, and balance. People should have their medications reviewed by their physician regularly to reduce drug interactions and side effects. They should have yearly eye exams. They should improve their lightening in their homes, and they should reduce fall hazards in the home. The environment can be fall-proofed by such means as covering floors with tacked-down carpets, keeping walkways clear of obstacles, equipping bathrooms with grab bars around toilets and tubs, keeping stairway well lit, and using night lights.
Elderly falls is among the key public health issues that increase the risk of long-term disability in the elderly and thus drive up medical costs. The best hope for avoiding rising medical costs and rationing, and at the same time improving quality of life for the elderly, would be to device a way of integrating public health education and health promotion with the medical system to prevent chronic disease in the elderly, thereby reducing the need and demand for medical care. This is a realistic hope in that the baby-boom generation is relatively well educated as compared to preceding generations, and more education correlates with better health in the elderly as in other age groups.
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Lead Poisoning Prevention
As we wait for good weather here in Genesee County many of us are planning for home improvement projects, but we need to exercise some caution when it comes to remodeling and renovating. Many houses and apartments built before 1978 have paint that contains high levels of lead. According to the EPA, lead from paint chips and dust can be a serious health hazard and removing lead paint improperly can increase the danger to you and your family.
Lead based paint can be found in and out of the house, and in soil outside that has been contaminated by old exterior paint and past use of leaded gasoline in cars. This paint is not a hazard when it is in good condition and is not in a place where it is subject to friction or impact, such as a window, but it is a hazard when it is chipping, peeling, chalking, cracking or damaged. Lead dust can be formed when a lead paint surface is dry scraped, dry sanded or heated, and can settle on surfaces and objects that people touch, and can reenter the air when it is swept, vacuumed or dusted, or walked through.
If you think the house you are living in has lead hazards there are some steps you can take immediately to reduce your family's risk: clean up paint chips immediately: clean floors, window frames, window sills and other surfaces weekly with a mop or sponge and a general all-purpose cleaner or a cleaner specifically made for lead: clean or remove your shoes before you enter your home to avoid tracking in dirt and soil: if you rent, notify your landlord of chipped or peeling paint.
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Prevent Heat Related Illness
The Genesee County Health Department recommends that everyone understand the warning signs of heat-related illness and take special care of those at risk. According to Randolph Garney, retired Interim Public Health Director, "The elderly and young children are at particular risk for heat illness. People suffer heat-related illness when their bodies are unable to properly cool themselves; normally accomplished through sweating. When humidity levels are high, sweat will not evaporate as quickly, preventing the body from releasing heat quickly. Other conditions lending themselves to increased risk are obesity, fever, dehydration, heart disease, mental illness, poor circulation, sunburn, prescription drug use, and alcohol use.”
Air conditioning provides the best protection from heat exposure and heat-related deaths. However, some people may be fearful of high utility bills and limit their use of air conditioning. This places people who may be already at risk for heat illness at increased risk. Many people think electric fans are sufficient during extreme heat. Fans may provide comfort, but they will not prevent heat-related illness when the temperature is in the high 90's. The Genesee County Health Department suggests the following:
- Take a cool shower or bath.
- Drink plenty of water.
- Don't drink liquids that contain caffeine, alcohol, or large amounts of sugar - these actually cause you to lose more body fluid. Also, avoid very cold drinks because they can cause stomach cramps.
- Stay indoors and, if at all possible, stay in an air-conditioned place. If your home does not have air conditioning, go to a shopping mall, senior center, or public library - - even a few hours spent in air conditioning can help your body stay cooler when you go back into the heat.
If you must be out in the heat:
- Limit your outdoor activity to morning & evening hours.
- Cut down on physical activity.
- Drink plenty of water.
- Try to rest often in shady areas.
- Protect yourself from the sun by wearing a ventilated hat (such as straw or mesh) and sunglasses, and put on sun screen.
- Wear lightweight, light-colored, loose-fitting clothing.
- NEVER leave anyone in a closed, parked vehicle.
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Epilepsy Awareness
Epilepsy has far too long been a "hidden" disorder that fosters misconceptions. Seizures caused by epilepsy are among the most common disorders of the nervous system. Epilepsy affects people of all ages, races and ethnic backgrounds. It can develop at any age, although epilepsy most commonly develops in children under the age of 18 and adults over 65. Sometimes epilepsy is inherited; however, there is often no known cause.
More than 2.7 million Americans are living with seizures caused by epilepsy. Within the brain, nerve cells pass electrical signals to one another, controlling the way the body functions. A seizure is a change in sensation, awareness or behavior brought about by the interruption of these signals. Seizures may vary from a momentary disruption to short periods of unconsciousness, staring spells or convulsions.
For a person with epilepsy, seizures can happen randomly and unpredictably. But a variety of situations can trigger seizures, including extreme stress, lack of sleep, watching flashing or strobe lights, low blood sugar, excessive intake of alcohol, certain medications, hormonal changes and illness. Some people with epilepsy can pinpoint the triggers for their seizures. For people on medication to control their seizures, the most common trigger is not taking their medication as instructed.
Should you be around a person who is having an epileptic seizure, stay calm and keep the person safe until the seizure stops naturally by itself. Other things to remember are:
- Move things out of the way to help the person avoid injury.
- Don't hold the person down or try to stop his or her movements.
- Loosen any tight clothing around the neck.
- Put something flat and soft, like a folded jacket, under the head.
- Turn him or her gently onto one side. This will keep the airway clear. Do not try to force the mouth open with your fingers. It is a misconception that a person having a seizure can swallow their tongue.
- Time the seizure with your watch for future reference for the individual and caregivers.
- Do not attempt CPR unless the person doesn't’ start breathing again after the seizure has stopped.
- Offer to call a taxi, friend or relative to help the person get home, if necessary.
- Call an ambulance if the person was injured during the seizure or if the seizure lasted longer than five minutes.
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For more information contact the Genesee County Health Department at (585) 344-2580, ext. 5000.