As a young child whose life was intertwined with that of my grandparents and their friends, I believed that getting older involved an inevitable process: You fell, you were hospitalized, you died.

Overheard frequently at my grandmother's busy table was this exchange:

"How is Mrs. So-and-so?"

"She fell," would come the reply.

The answer to same question days later would be: "She went to the hospital."

And then: "Poor thing. She died."

What else could a 4-year-old conclude? Falls were basic to an older person's life.

Fortunately, science has proved this thinking false. But many Americans continue to believe it and act accordingly.

Across the United States, falls are the major cause of injury among the aging population, experts say. Among Americans age 80 and above, 50 percent will suffer a fall. In San Mateo County, falls are listed as the leading cause of death due to injury for those 75 and over.

And they're expensive. In the county in 2004, the most recent dates available, the average cost of a hospital stay for a fall patient was $41,500. In 2006, falls among county residents older than 60 resulted in more than 1,500 hospitalizations and 27 deaths.

But it doesn't have to be that way.


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"The research is clear that falls are not an inevitable part of aging," said Ellen Corman, director of the Farewell to Falls program, developed at Stanford University Medical Center. "Aging contributes to some factors that lead to falls. We do lose muscle tone and visual acuity as we age. But falls can be prevented. That is the key."

The program, started in January 2005, aims to reduce the incidence of falls in people 65 and over. While originally serving communities closer to Stanford, it is currently seeking midcounty residents, especially those in the Peninsula Health Care District, including San Mateo, Hillsborough, Foster City, San Bruno and South San Francisco.

Older people fall not simply because they are old, as my 4-year-old brain concluded, but because, as they age, they don't recognize their risks for falling.

According to Corman, these risks include: a history of falls, problems in walking or balance, "polypharmacy" (taking four or more medications, which sometimes leads to dangerous drug interactions), visual problems, and the use of alcohol. Sedentary lifestyles can lead to problems with muscle tone and flexibility.

"People who engage in physical activity have injuries (that are) less severe and often get up from a fall by themselves," she said. "That's a contrast to those who fall in their homes and need a Life Alert because they cannot move."

Older people often have slower reaction times.

"If you are younger and you trip, the body gives immediate feedback — there's a physical reaction to right yourself," Corman said. "But an older person may have less physical strength and a slower reaction time. The younger person trips, but the older person falls."

In and outside the home, Corman's tips ranged from watching out for uneven surfaces and throw rugs to the importance of listening to one's body.

"If the doorbell rings and you feel faint as you rise from the chair, don't rush," she said.

Farewell to Falls is offered by Stanford in cooperation with the San Mateo County Health Department, with support from the Peninsula Health Care District. Free to participants 65 and over who live in their home, apartment or senior retirement setting, the program is conducted in their place of residence.

Here's how it works: Over the course of a year, an occupational therapist visits the home two times to check for home safety, medications, and the client's strength and balance. Participants are shown home-based exercises and receive a DVD or videotape, which they can follow at home.

In the intervening months, the client receives monthly contact by telephone to check progress. Finally, the therapist returns for a third visit to assess changes. It's a convenient, effective way to say "farewell" to falls.

For information, call 650-724-9369.

FREE HEALTH FAIR OFFERS SCREENINGS IN SOUTH SAN FRANCISCO: South San Francisco Senior Services and Kaiser Permanente will offer free health screenings for glaucoma, blood pressure, body fat and vision from 9 a.m. to noon on March 20, at the 12th annual South San Francisco Senior Health and Fitness Fair, which will be held at the Municipal Services Building, 33 Arroyo Drive.

Representatives from community health agencies and exercise and stress reduction workshops will also be available. It's all free. For information, call 650-877-5996.

For story ideas and comments, contact Joan Aragone at 650-348-4332 or fogbelt2@aol.com.