As an occupational therapist in the Odette Cancer Program, Leslie Gibson often receives questions about falling — a very real risk for people with cancer as well as seniors. Here, Leslie takes on some of the frequently asked questions.
Why does cancer or cancer treatment put me at a greater risk for a fall?
Cancer, and its treatments, increases the risk of sustaining a fall. Research has found that falls occur in 30-50 per cent of people with cancer over the age of 65.
Various chemotherapy medicines affect physical functioning and can cause vision changes, nerve issues (that can cause decreased sensation in your feet), muscle weakness and loss. There’s also a risk of osteoporosis. Both chemotherapy and radiation cause fatigue, which puts you at higher risk for a fall.
After cancer surgery you might feel fatigue or dizzy, and you may have muscle weakness or loss.
Anti-nausea and pain medications can cause drowsiness and sedation, increasing the risk of falls.
Is a fall something serious? Why?
According to the Public Health Agency of Canada, falls are the leading cause of injury among older adults in Canada:
- 20-30% of seniors experience at least one fall each year
- 95% of all hip fractures are due to a fall
- 50% of all falls causing hospitalization happen at home
Falls can also cause head injuries, hand and arm fractures, all of which can affect an individual’s ability to manage their day-to-day activities.
What can I do to reduce my risk of falling?
- Wear footwear that has good support, low/no heels and a good tread, even inside your home. Avoid wearing stocking/sock feet or going barefoot.
- Inspect your home for falls risks. Ensure that your home is well lit, inside and out. Use night lights. Ensure you have a handrail for use on all stairs. Keep your home tidy and remove any clutter that might cause you to trip — cords, boxes, pet toys. Consider removing all area rugs as they pose a falls risk. If they are not removed, ensure they are well secured with either non-skid backing or double-sided tape. Clear outdoor walkways of leaves, snow and ice.
- Many medications used to treat common health issues like sleep problems, anxiety, depression, blood pressure, pain, arthritis, bladder control, colds and dementia can affect your balance. Talk with your doctor and pharmacist about side effects of your medication, including all prescription medications, over-the-counter medicines and herbal products. Have a medication review with your pharmacist. Make sure you are taking your medications as prescribed. Consider the use of a medication dosette or a blister pack.
- Consider the use of assistive devices. Canes, walkers and rollaters can provide support for people with balance issues or weakness in their legs. Ensure that the rubber tip on the cane is not cracked or worn down. If using a cane outdoors in the winter, use an ice tip for the end of the cane to grip ice and snow. Other equipment that can help prevent falls, particularly in the bathroom which is a common spot for falls, include grab bars, bath chairs, hand-held showers, non-slip tub mats and raised toilet seats. Consider the use of an emergency response system, which will help you and your family feel more secure about being home alone.
What should I do if I do fall?
Stay calm and don’t rush to get up off the floor. Ensure that you are not injured before trying to get up or letting others help you up. If you aren’t injured and can get up, roll onto your side and slowly push up so that you are on your hands and knees. Crawl to a sturdy chair. By grabbing the seat of the chair and bringing one foot forward with your knee bent and foot flat on the ground, slowly push up from the kneeling position, rise, and turn your body to sit in the chair.
If you cannot get up, shout for help. Call 911 if your phone is nearby. Use an Emergency Response System.
Now that I hear all this, I’m scared I’m going to fall. Should I just reduce my activity and stay home and stay put?
No! Being inactive actually can increase your risk for falls.
- Exercise: Cardiovascular and resistance exercises can help increase muscular strength, flexibility and power, and can also improve balance.
- Consider a Home Safety Assessment with an Occupational Therapist. The therapist can identify areas in your home where falls risks exist and can provide recommendations to reduce your risk of falling. Take to your care team.
- Falls Prevention Clinics in the community. The Sunnybrook Falls Prevention Program involves consultation with a geriatrician and a physiotherapist to assess people over the age of 65 who are having falls or are at risk of falling. This six-week group exercise program is designed to improve strength, balance and gait, and is run by a registered physiotherapist. Education sessions include information about home safety, home exercises and safe medication practices.
- Have regular medical appointments with your physician. Talk to your doctor about any drowsiness, dizziness, blurred vision, unsteadiness or falls you have experienced.
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