A group of elderly adults exercise together and smile.
An American 65 or older visits the emergency department every 13 seconds due to a fall. This can and should be prevented, according to a safety expert who offers classes on how to do just that. (For Spectrum Health Beat)

Laura Maclam is talking about older folks and falls, and she is getting pretty worked up.

“I want to scream it from every rooftop: Falling is absolutely not a natural part of aging,” she says.

She’s a woman on a mission, all right. And that mission is to keep seniors standing on solid ground. Even if she has to stand on a rooftop.

Maclam, who co-leads a Safer Seniors presentation, knows how devastating a fall can be, especially for an older person.

A former paramedic and Aero Med flight nurse, she is an injury prevention coordinator at Spectrum Health. She has seen plenty of fall victims in her career.

But what got her revved up about the topic was not an individual victim—it was a number.

52 percent.

Grandma doesn’t need another Yankee candle. She needs grab bars in the bathroom.

Laura Maclam
Spectrum Health injury prevention coordinator

Maclam found that number when her boss asked her to look at emergency department records and identify the most serious problems of adult trauma patients—the conditions that require an ER patient to be admitted to the hospital.

She was sure car accidents would be No. 1.

It was falls.

“Fifty-two percent of admitted adult trauma patients over 65 in 2014 were secondary to a fall,” she said. “These are people with multi-system trauma.

“They might have a brain injury and a broken pelvis. They are the highest acuity, highest risk, sickest trauma patients.”


Four tips to stay strong

Laura Maclam suggests these actions to improve strength and flexibility in daily life:

  1. At the grocery store, take an extra lap or two around the store to increase the number of steps you take.
  2. When you have a counter or item available for balance, stand on one leg and count to 10. Switch and stand on the other leg.
  3. Do ankle pumps while sitting. Stretch the legs in front and flex the feet up and down. Add in ankle rolls and knee lifts.
  4. Get up from a chair without using the arm rests (assuming it is not on wheels). To do so, you will straighten the spine and work the core muscles.

Her first thought was: What are we doing wrong in West Michigan?

But then she looked at national figures for the same year. She found that 2.4 million Americans over the age of 65 went to an emergency room because of a fall. That’s an ER visit every 13 seconds.

“This is a national problem that is almost epidemic or pandemic at this point,” she said. “Clearly, we need to address this.”

She faces one major stumbling block—yes, bad pun—and that is passive resignation. Too many people see falls as an inevitable part of aging. It happens. What can you do about it?

Plenty, Maclam says.

First, recognize that falls are serious. As serious as a heart attack. Or a stroke. Or cancer.

“One fall could be devastating,” she said. “You could end up unable to live independently. The cost sometimes is enough to be catastrophic.”

And half of those who fall once will fall a second time.

The risk rises as people age because of health conditions, medication and inactivity.

“As we get older, we sit and become more immobile, which leads to deconditioning and increased risk of falling,” she said.

Because those changes sneak up on folks, many underestimate their fall risk.

Second, focus on prevention.

Researchers have honed in on six steps shown to reduce fall risk:

  1. Home modification. Get rid of slippery rugs. Declutter. Make sure you have good lighting. Keep the driveway clear. Fix steps that are cracked.
  2. Mobility and balance. Do physical activities every week that help keep you strong and balanced, like tai chi and aquatic exercises or fitness classes.
  3. Talk to your doctor. Do you take meds or have a condition that can make falls more likely? Has your vision, hearing or reflexes changed? What can you do to reduce fall risk?
  4. Get an annual eye exam.
  5. Wear solid footwear.
  6. Have your hearing checked. Your balance center is in your inner ear, so changes in hearing will affect balance—and hearing aids might improve it.

As Maclam worked to spread the message of fall prevention, she found an ally in the Grand Rapids Police Department.

She told a friend, Officer Richard Atha, about her mission, and he said the police frequently get requests to speak to senior groups about scams that target older adults. They decided to team up and offer a combined presentation—called Safer Seniors—about fall and fraud prevention.

“We have the exact same goals,” she said. “We want a healthy, safe community.”

She hopes the message will reach family members of older adults, too. She urges them to raise the issue with loved ones, offer to take walks or do activities together, and help with home modifications.

“Grandma doesn’t need another Yankee candle,” she says. “She needs grab bars in the bathroom.”

Ultimately, Maclam strives to reach a non-event—a change in behavior that keeps people safe, independent and enjoying life, injury-free.

“Really, my big goal is that I never get to meet you in the trauma bay,” she says.