I know this seems like overprotectiveness, but seniors are often on anti-coagulant medications that might cause a simple fall to progress into a serious bleed. Also, while your husband may be quite sharp mentally, many seniors are not for lots of reasons. Because of their diminution of mental acuity, they might not connect certain symptoms to a need to get immediate medical care.

I suggest you take time to read the NCOA publication on senior citizens and falls.

Your doctor should be asking that question every time you visit.

Get the facts

It sounds like the infantalization of older people to me. Surely a 70 year old can be trusted to know whether or not falls are a problem for her.

I fell not too long ago because I was walking in the dark, and now I keep the hall lit better when I am walking through it, as it has a drop-off into the sunken dining room, and the floors are travertine. I was carrying a glass of water when I fell, and when the glass broke, it cut my hand rather severely. I would have gone to the Urgent Care office except that it was late at night, and so I just bandaged my hand (with my brother's help) instead. I probably should have had stitches, but it did heal well enough in time. It's a good thing I was not alone.

I do get these kinds of questions each year when I go for my annual physical exam. More important (or as important) is the regular visit to my dermatologist, since he found melanoma on my back, and my regular doctor did not even notice it. I started going to the dermatologist because of a sore on my upper arm that did not heal for probably a couple of years. Finally my doctor sent me to the dermatologist, and he determined that it was basal cell carcinoma, and he found several other instances of this on me as well. I now have to go back in three months for another check for melanoma, which I guess spreads faster than carcinoma. Whatever I have, I want it to be treated sooner rather than later so that the scars will be more minimal. If I had only had carcinoma and no melanoma, I would be on a six month return instead of three month.

There are very good reasons why seniors tend to fall more than younger folks and it is nothing to pass off as "patently crazy"!! Even if the fall resulted in no injury at all it just makes good sense to get checked out as the the fall itself maybe symptomatic of other, underlying health issues of which you may not be aware. Falls are the primary etiology of accidental deaths in persons over the age of 65 years and the deaths may be only incidental to the fall itself.

You may very well think this is ridiculous but it is not and the questionnaire serves a very valuable purpose that should not be treated lightly!

btw, trying to do something that you could do in your 30's blindfolded and without falling that you can no longer do now in your 70's without falling and your eyes wide open should be telling you something..............40+ years makes a big difference in reaction time, cognitive recognition and internal balance.

"I now have to go back in three months for another check for melanoma, which I guess spreads faster than carcinoma."

Lars, I am sorry you are going through this. But, melanoma IS carcinoma. There are three types of skin cancer. Basal cell, squamous cell, and melanoma. Basal cell is the "least serious" of the three, but even a basal cell carcinoma can lead to death if left untreated. Skin cancer is nothing to mess with. I've had four skin cancers removed from my face -- two basal cell and two squamous cell. My most recent Mohs surgery was in May of this year.

With regard to falls -- they can lead to internal injuries and/or internal bleeding. After receiving a cardiac stent, I was put on Effient - an anti-platelet medication. I was cautioned that if I fell I was to report it right away, and that because I would bruise more easily (and I have always been prone to easy bruising, so some days I look like I've been in an alley fight) I need to immediately be seen if I develop any bruises on the trunk of my body.

When I was first prescribed Effient I was given the generic (prasugrel). I was horribly, horribly dizzy 24/7. I nearly fell several times when getting up in the night to go to the bathroom. When my first 90-day prescription was due to be refilled, I asked for the authorized generic. The pharmacy only had a 60-day supply and couldn't get more (because the pharmaceutical company marketing the authorized generic reached the end of their contract and Lilly hadn't entered into a new contract for an authorized generic. So, for 60 days I took the authorized generic, which is exactly the same as the brand name. I wasn't dizzy at all. When I had to get another refill, and for all refills since then, I have gotten the brand name only (there is still not an authorized generic available). I pay $100 for a 90-day supply as opposed to $10 for a 90-day supply of a generic, but my health and safety are worth it to me. I do not like to be dizzy at all, and I do not like to fall, either.

"this isn’t what dr’s really want to spend their time doing" WRONG!

After a fall, looking for the etiology/cause is just as important as evaluating for any injuries sustained. Causes include central nervous system dysfunction, TIA, vestibular balance deficits, vision impairments, cardiovascular dysrhythmia, orthostatic hypotension, anemia, electrolyte imbalance, hypovolemia, thyroid dysfunction, sepsis, medication side effects, and muscle weakness. Falls are warning signs, particularly in the elderly.

"The NYT ran a piece about how doctors today are not well acquainted with older people, not having much contact with them in their regular family life."

That's got to be one of the silliest, most over generalized statements I have read in a long time!! First, it negates the fact that a great many doctors might be seniors themselves. There is no mandatory retirement age for physicians and many continue to practice successfully and competently well into their golden years. Second, it implies all younger doctors are orphans........or have no living parents or older relatives themselves. And finally, apparently the NYT has never heard of geriatricians or physicians who specialize in the health care of the elderly.

I've fallen at least once this year, sprained my "good" ankle. You wouldn't believe the number of patients who call or their family member that calls days after a fall where they hit their head or might have hit their head. Or they hurt their back but waited until they can barely walk.

Or died.

Well gardengal, the issue is silly enough to warrant having it added to several medical schools' curriculums. Too bad no one thought to check with you before making the decision. Next time.

I fell two weeks ago( I’m 66) and took a header full weight into the edge of the kitchen countertop. Stitches needed right between my eyes above my nose. Two horrible black eyes. Went to ER minutes after.Not one thing was said about concussion or anything done resembling a neurologic exam. Told to ice it. That’s all!

From the NYT:

Dr. Ronald Adelman, co-chief of geriatrics at Weill Cornell, developed this annual program — which includes a theater piece and is required for all second-year students — after he realized that medical students were getting a distorted view of older adults.

“Unfortunately, most education takes place within the hospital,” he told me. “If you’re only seeing the hospitalized elderly, you’re seeing the debilitated, the physically deteriorating, the demented. It’s easy to pick up ageist stereotypes.”

These misperceptions can influence people’s care. In another classroom down the hall, 88-year-old Marcia Levine, a retired family therapist, was telling students about a gastroenterologist who once dismissed her complaints of fatigue by saying, “At your age, you can’t expect to have much energy.”

Then, in her 70s, she switched doctors and learned she had a low-grade infection.

At least 20 medical schools in the United States have undertaken similar efforts to introduce students to healthy, active elders, said Dr. Amit Shah, a geriatrician who helps direct the Senior Sages program at the Mayo Clinic School of Medicine.

In health care, “you hear a lot of infantilizing language: ‘sweetie,’ ‘cutie,’ ‘honey,’” said Tracey Gendron, the gerontologist who started the senior mentoring program at Virginia Commonwealth University School of Medicine. “You hear that people are not worth treating because of their age.”

Interruptions are “ubiquitous in medical encounters,” said Dr. Adelman, but older patients contend with them more often.

Dr. Adelman has recorded and analyzed doctors visits in which a spouse or adult child accompanies a patient and begins asking and answering the questions. “The older person, who is cognitively fine, is just excluded, referred to as ‘he’ or ‘she,’” Dr. Adelman said. “It can undermine the relationship between the older patient and the doctor.”

"Doctors today" is a very different group from medical students. I have to agree that many doctors today have a lot of experience with older people. My primary doctor (whom I've had for 25 years) specializes in geriatrics, and my urologist retired last year at age 84, at his wife's insistence. He was also a professor at UCLA.

I think it is good to educate medical students about geriatrics, but this does not mean that "doctors today" are not familiar with the problems. Some may be but certainly not enough to make such a blanket generalization, IMO. Whoever wrote the article was probably ignorant of geriatric problems and projected his own ignorance onto others. That's my best guess.

If your doctor is not familiar with geriatrics, perhaps you need to change doctors. When my mother was 84, one of her doctors told her that she had lived long enough, and so I am aware that some doctors are unsympathetic to or ignorant of geriatric issues.

PS Because I have the NYT app on my iPad, I can't get to the url for the story. The article is entitled, Every Older Patient Has a Story. Medical Students need to Hear It. It was published October 12, 2018, by Paula Span.

I'm always addressed as Mr. Surname, not sweetie or honey. I'd file a #MeToo complaint if that was the case.

That's right, Lars, one piece in he NYT is not a comprehensive survey of all doctors practicing today. It simply reflects the thinking of 20 medical schools which saw a need to improve the curriculum.

Michael, I am sure this will come as a surprise to you, but women are infantilized more often than men.

I'm all for improving the medical curriculum!

Zalco, look at that statement on its face - with no further explanation offered - and tell me how reasonable it sounds. The New York Times is not the be-all and end-all of journalistic excellence and they can certainly make overgerenralized and improperly researched statements. And most medical schools already offer this as part of their curriculum and have a mandatory 4 week rotation focusing on geriatrics. This is nothing new. Baby boomers - the seniors now being treated - constitute the largest medical demographic and more and more facilities and treatment plans are undertaken with senior health issues in mind.

And I'm not all sure why we need to take this personal and snarky. I didn't create this issue and the outrageousness of that statement is easily verified by a whole host of other, medically based sources.

Zalco, your assumption is dead wrong. I'm not surprised or ignorant of it. I'm very aware of it. My daughter is an oncology nurse navigator and she is working hard to eliminate that type of discrimination. I'm speaking for myself, not you or other women. Apology accepted.

In case you don't know.

Oncology nurse navigator:An oncology nurse navigator (ONN) is a professional registered nurse with oncology-specific
clinical knowledge who offers individualized assistance to patients,
families, and caregivers to help overcome healthcare system barriers.

Gardengal, The issue is familiarity with healthy older adults, not the practice geriatrics, or even understanding how to treat unwell older folks, so you have misunderstood the article.

I actually fell more when I was younger. I have not had to take the test but I have fallen twice recently and neither was because of old age. Before that, I sprained my ankle last spring getting out of a chair. I hike over four miles a week on the Appalachian trail over rocks and roots and sprained my ankle on a chair. It was tender and slightly swollen but not a big deal. A few months ago I tripped in the dark over my 25 pound Maine Coon cat who refuses to move. I landed on my right side and thought I was in trouble. To my surprise, nothing hurt but my knee and that was only when I knelt on a hard surface...the fleshy pad beneath the bone. Then a little later I fell on my all in one computer. I saw a spot on one of 12 windows in my sunroom and stood on my desk chair with wheels(I know) and it went out from under me and I landed on the $600 computer. No injuries at all to me but I did get a cool new replacement computer. My two-story 180-year-old house is a doctors worst nightmare with five pets underfoot plus all their toys and lots of rugs.

No, I have not.

Sue

Sheesh go to the doctor every time I fall because I am "elderly". LOL

Let's see, I fell off a park bench this year when a passing ankle biter attacked my Rottie and I got pulled off in the fray. I fell a few times simply when learning to dismount horses properly. I'm short, horses are tall. It's a long way down at first. LOL New skills require being able to take a fall now and then, figure skating for example.

Oh and I do have a vestibular disorder but decades of sports requiring body awareness and balance have helped me compensate.

I've gotten those Medicare Surveys in the mail. I always give up and toss them after trying to answer a few questions. The questions simply don't apply to me.

I haven't fallen in decades and each time I did it involved icy walkways. As I get older I am more and more careful. I use ice creepers when necessary and salt my decks and walkways. Also I firmly hold onto my car door when stepping out onto a parking lot. I have put my foot out and nearly done a banana peel type skid on a sheet of ice.

So far...so good.

Went into Wegmans pharmacy entrance yesterday. Very cold and snowy. The bottom of their yellow caution cones said "Walk like a penguin" with a cute picture.

I really couldn't stand when other nurses or CNAs would pat our older patients on the head and call them honey, sweetie or baby. I think it's just a regional thing but still.

You need to consider why you fell and what you injured. Never discount hitting your head; you could have started a silent bleed around your brain.

I also think it is a regional thing, but I'm not sure which region.

I’ve had a rough year. Was waiting for knee replacement, but then my back went out and my neck froze up. Cancelled the knee til next year. Then I took a hard fall. Laid on the floor crying, half and half out of the house. When I finally got up I looked out the window and there was DH standing on THE TOP STEP of a 6’ ladder sawing off a branch! At least he didn’t fall. I didn’t go to urgent care, but recently saw the foot doc who said I have damaged

my ACL on one foot and trauma on the top of the other.

it sure hurts to get old, I’m only 71!

No I have not fallen in a long time. I am 71 and I take more care when using a ladder or doing certain things than I used to. i know I can’t scamper up and down a step ladder like I used to do. I also do many balance exercises regularly and have excellent balance and strength for someone my age. DH is the same.

I see a lot of older people who do not pick up their feet or walk confidently any longer. In my view, a person’s gait has a lot to do with tripping and thus falling as does lack of balance. Yes, medication can play a part, but general well-being helps tremendously. Sure an accident can happen any time, but preventive measures help as we age.

As a RN, I have to screen every patient for "Fall RIsk" that I take care of. Want to know who that is--young pregnant patients. Falling in a hospital is a huge issue, decreases our ins and Medicaid reimbursement, costs $$ to treat, a reportable offense, etc.

I was a patient in my hospital and got screened. I asked if falling while skiing counting as a fall? The staff laughed at me.

I was a high fall risk and had to wear a bed alarm. I am a young 62 who happened to be very sick at the time.

My objection is to the “one size fits all” approach. If I fall onto plush carpet because a grandkid left a toy on the floor, I’m not symptomatic before nor after, no injury occurred, I’m on no med with bleeding risk, then I am positive the dr doesn’t want to exam me right away & I don’t need his help to figure out why I fell.

If a person answers Yes to the vague question, then the dr probably ought to explore further with the patient the frequency & circumstances of a fall or multiple falls. Fall education would possibly be appropriate, based on further details.

In my/DH healthy situation a simple trip & fall with no injury does not warrant a dr visit/exam. I too view it as infantilization.

True Bee, but if this year you fall once by tripping over something, then the discussions about rugs,etc needs to be had. If next year you fall three times, other things may need to be looked at. Unfortunately, falls in older people often spiral into a chain of events that ends in death.

Like you , I probably wouldn't go to the doctor for a fall with no apparent injury.

When my hospital was just being inspected by the big health care inspectors, every patients chart had to have a fall screening, no exceptions.

I don't consider the questions to be "one size fits all" - I consider it to be "a safety net with no holes". My doctors always follow up if any of the questions I answer raise a red flag. Even a therapist followed up with questions about my answers to the MMPI questionnaire - a test that really does not work well for me. I always end up with a very high "F" score on that test, which means that I answer a lot of questions differently from most people. After I explain why I answer the questions the way I did, I am then diagnosed as "hypervigilant" and eccentric but harmless, neither of which I consider to be a problem.

I fell in February after getting off an 8 hour flight. Broke my rib. Tripped on the toe of my shoe which I didn’t realize had separated. Ruined my first week in Hawaii, but the percocets helped me get through. As a nurse who has also cared for both of my aging parents, falls are a significant cause of morbidity and mortality. Do not take them lightly. Both of my parents had bad falls.

I am in my 30's and have had 3 bad falls in the last 10 years or so. The first time I fractured my foot (and didn't realize it at the time) and had some bruising that still hasn't fully gone away 8 years later. The second time I fell on my driveway and badly skinned both knees. The third time I was coming down my stairs and for some reason thought the first step was the ground so I took a step forward and slammed backwards into the stairs. I was lucky I was not injured but it sure was scary.

My father in law had a fall when he was visiting. He was fiddling with his camera and didn't see the curb ending at the street, and fell flat on his face. He's very athletic (in his 70's) so got up immediately. We were concerned but he did not want to even talk about it and there's no way he would go to a doctor. He had a stroke 3 months ago and waited 5 days after he lost most of the ability to move his right side to finally go to the hospital!

3 friends & I went on a road trip today. While we were traveling I related the story of the generic instructions to seek immediate medical attention in the event of a no injury fall.

We visited a retail shop in an older 2 story house. In the small entry area there were items to peruse & about 5 carpeted steps up to the next level. With 4 of us in a crowded space one of the ladies lost her footing & fell against those steps! Exclaiming “Are you alright, are you alright?” We & she quickly ascertained everything was A-ok, no harm, no foul. (3 of us being nurses, btw)

We chuckled as we pondered whether we should call 911, or seek out an urgent care in this city away from home to check out this non-injured lady. Opting for neither of those, instead we proceeded on into the shop to look over the merchandise.

I could add all kinds of “WHAT IFs” to her situation & this event, but we just used common sense & didn’t even have to tap into our decades of medical knowledge to determine no medical intervention was needed.

Next month I doubt any of us remember this little blip in an otherwise lovely day out.

Edited to add: many responses here are relating serious falls with subsequent injuries. This is not what I’m speaking of. Of course one should seek medical attention if you’re injured or suspect underlying pathology.

My mother’s last fall was the beginning of a very long end. She came through hip surgery just fine. Her Alzheimer’s kicked into high gear afterward. She continued to deteriorate for four years until she died