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Concussions are Not Just a Problem for Football Players!

Dr. Rein Tideiksaar - September 28, 2015 10:22 AM

Most elders are not so much frightened about falling as they are about the consequences of falling. The possibility of falling, breaking a hip, and ending one’s life in a nursing home is one of the biggest fears elders have. While hip fractures are very serious events, it turns out that broken bones may not be the only consequence of falling to be worried about.

Suffering a head injury needs to be added to the list of worries. Recently it was reported that head injury (or more commonly known as a concussion) is strongly associated with developing dementia in persons 55 years of age and older. More than two-thirds of concussions in elders are caused by falls! Having dementia doubles one’s risk of falling; because of the failing mental facilities, persons are unable to differentiate between safe and unsafe activities and environments.

What is a Concussion?

A concussion is a brain injury caused by a fall or blow, jolt or bump to the head that causes the brain and head to move back and forth rapidly. While most young people recover from mild concussions quickly, elders can have symptoms that last for days or weeks.

What are the Symptoms of Concussion?

A person doesn’t have to pass out (lose consciousness) to have a concussion. Some people will have obvious symptoms of a concussion, such as passing out or forgetting what happened right before the injury. But other people won't. Signs of concussion can include:

•    Headaches and blurry vision
•    Dizziness, lightheaded-ness, and nausea
•    Balance problems (making standing and walking difficult)
•    Sensitivity to light and noise
•    Irritability, anxiety, and sadness
•    Lack of energy and sleepiness
•    Impaired concentration, not thinking clearly, or having trouble organizing daily tasks.

Concussions in elders can be dangerous. Signs of a serious problem include:

•    A headache that gets worse or does not go away.
•    Weakness, numbness, or decreased coordination.
•    Slurred speech.
•    Extreme drowsiness or you cannot wake the person.
•    Problems in recognizing people or places.
•    Increasing confusion, restlessness, or agitation.

How Are Concussions Treated?

Any elder who hits their head following a fall (especially if symptoms are present) needs to see a doctor. The doctor will:

•    Ask questions about the fall and injury.
•    Test ability to pay attention
•    Assess learning and memory.
•    Check strength, balance, coordination, reflexes, and sensation.

Sometimes a doctor will order imaging tests such as a CT scan or an MRI to make sure the person’s brain is not bruised or bleeding.

How Long Will It Take To Get Better?

Following head injury, some elders feel normal again in a few hours. Others can have symptoms for weeks or months. Recovering from concussion is different for each person. It depends on many things, such as:

•    How severe the head injury was.
•    What part of the brain was injured.
•    The person’s age.
•    How healthy the person was before the head injury.
•    How long it took you to get the right medical treatment.

Healing takes time. Elders in good health tend to get better faster than less healthy people. Those with medical conditions or other problems that come with aging may take longer to get well.

It is very important to allow the person time to get better and to slowly return to their regular activities. If symptoms return when doing an activity, stop and rest for a day. This is a sign that the person is pushing themselves too hard. It is also important to call the doctor if the person is not improving as expected or getting worse.

It’s important to get plenty of rest. Rest helps the brain to heal. Get plenty of sleep at night, and take it easy during the day. With rest, most people fully recover from a concussion. It’s also important to:

•    Avoid activities that are physically or mentally demanding.
•    Make sure to avoid any activities that might increase the risk of falling and injury again. Repeated concussions or a severe concussion may lead to long-lasting problems with movement, learning, or speaking.

How Can Concussions Be Prevented?

Family members and other caregivers of elders can help protect a person’s health and safe mobility by:
•    Reducing their risk for falls.
•    Recognizing signs of concussion after a fall occurs, and
•    Taking appropriate steps when signs of concussion are observed.

Reducing the risk of falling is achieved by:

•    Asking the doctor to check the elder’s health status (including medications). This will identify conditions that increase the risk of falling, and help to develop a plan to reduce the likelihood of falling.  

•    Starting a regular exercise program. Exercise is one of the best ways to reduce the chances of falling. Exercises that improve balance and coordination, like Tai Chi, are most helpful. Always check with the doctor about which exercises are best and safe. .

•    Making the home safer (such as remove clutter from stairs and floors, add bright lighting, install bathroom grab bars, etc.). Nearly half of all falls occur in the home.

•    Getting an annual vision check. Making sure that eye glasses are correct and that there are no conditions that limit vision (such as glaucoma or cataracts). Poor vision increases the risk of falling substantially.

Rein Tideiksaar Ph.D., PA-C (or Dr Rein as he is commonly referred to) is the president of FallPrevent, LLC, Blackwood, NJ, a consulting company that provides educational, legal and marketing services related to fall prevention in the elderly. Dr Tideiksaar is a gerontologist (health care professional who specializes in working with elderly patients) and a geriatric physician's assistant. He has been active in the area of fall prevention for over 30 years, and has directed numerous research projects on falls and has developed fall prevention programs in the community, assisted living, home care, acute care hospital, and nursing facility setting. To learn more, check out the Doctor’s professional profile on LinkedIn: http://www.linkedin.com/pub/dr-rein/6/759/592. If you have any questions about preventing falls, please feel free to email Dr. Tideiksaar at drrein@verizon.net

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