Falls and the Elderly: The Culprit Might Be in the Medicine Cabinet



As a result of altered visual, perceptive, and physical capabilities, older adults are more likely than younger patient groups to sustain debilitating falls in the home.  For people over age 65, falls often lead to injuries, prolonged hospital stays, or, in the most severe cases, deaths.  Clinicians, nurses, and home caregivers can implement strategies that reduce the risk of falling.  They can also get to know specific medications charged with increasing fall risks in elderly patients.

According to the American Geriatric Society, there are several simple ways to make homes as fall-proof as possible.  Secure rugs and carpets with non-skid backings.  And encourage clients to wear shoes with non-skid soles even when inside the house.  Additionally, as many falls take place in bathrooms on wet, slippery surfaces, it is important to remind patients to install rubber mats in the shower.  Sturdy grip bars can also be pivotal preventative tools - attach them to walls next to toilets and stairs.  Lastly, address any visual barriers to safe ambulation.  Insert night lights along dark hallways and in areas with outcropping or low furniture.

  Even in dwellings well-equipped for them, elderly clients may fall as a result of decreased alertness caused by medications. A list of implicated medications, compiled by researchers from the University of North Carolina, was recently printed in the New York Times.  The list includes some common, frequently prescribed and over-the-counter drugs.  Of note: researchers found that older adults who take four or more medications of any type have the greatest fall risks. 

Unsurprisingly, drugs that depress the nervous system increase the risk of falling.  So presumably all over-the-counter medications with sedating effects could make elderly clients vulnerable to falls.  Allergy medications, sleeping aids, and some cough or cold medications fit this description.

Anticholinergics are the worst offenders.  Other categories of drugs cited by the University of North Carolina researchers are seizure medications (such as phenytoin and gabapentin), painkillers (such as codeine, diazepam, and oxycodone), and certain antidepressant or anti-anxiety medications (such as those known by the trade names Xanax, Wellbutrin, Zoloft, and Prozac).  For a complete list of medications which may pose fall risks to older adults, please visit the following web address:  http://uncnews.unc.edu/news/health-and-medicine/some-drugs-increase-risk-of-falling-unc-researchers.html. 

On a case-by-case basis, health care providers should weigh the benefits of certain medications against the potential fall risks they pose.  It may be possible to switch some patients from drugs that carry greater fall risks to prescriptions that present less risk.  Elderly clients and their caregivers should be told about the dangers of taking sedating medications given what we already know about the prevalence and consequences of falls among this population.   



Falls Are Top Cause of Injury, Death Among Elderly. (2008, July 19). HealthDay.

Parker-Pope, T. (2008, July 10). A List of Drugs That Increase Falling Risk. The New York Times.



Copyright 2008- American Society of Registered Nurses (ASRN.ORG)-All Rights Reserved


Articles in this issue:


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    Editor-in Chief:
    Kirsten Nicole

    Editorial Staff:
    Kirsten Nicole
    Stan Kenyon
    Robyn Bowman
    Kimberly McNabb
    Lisa Gordon
    Stephanie Robinson

    Kirsten Nicole
    Stan Kenyon
    Liz Di Bernardo
    Cris Lobato
    Elisa Howard
    Susan Cramer

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