To Avoid a Fall, Lower Your Risk

How Working Hard to Prevent a Fall Can Change a Life

HAMILTON, NEW JERSEY - In early 2009, Hamilton resident Melissa Cartlidge began to notice she was feeling a bit off balance. By spring, she required a walker to get around her own home.

Physical therapist, Katie Matonis (right), acts as a spotter for patient, Melissa Cartlidge, during an exercise to help Cartlidge improve her balance.

Cartlidge is one of tens-of-thousands of people in New Jersey at high risk for a fall. Her yet undiagnosed condition is causing Cartlidge to have balance problems, one of the leading causes for falls that result in serious injury - and in some cases, even death.

Most of the people in the high-risk category due to physical risk factors such as balance problems, muscle weakness, vision impairment and multiple medications are over the age of 60 - which accounts for about 16.7% of New Jersey's population.

"A fall can have such a devastating impact on a person's life - especially our older adults. One fall can cause fractures to the spine, hip or extremities and even traumatic brain injury. More than 15,000 Americans over age 65 died in 2005 from injuries related to unintentional falls," explains Shirley Roberts, community health educator at RWJ Hamilton specializing in the senior population.

In Mercer County, 4% of residents over the age of 60 were treated and released in an emergency department as a result of a fall, while 71% of residents age 60 and over seen in the emergency department for falls were admitted as inpatients.

Fear is Major Risk Factor for Falls
In addition to the physical risk factors for falling, there is a major psychological risk factor: fear of falling.

"There is a common cycle that typically begins with one of the physical risk factors. A person who experiences anything from a wobble to a fall will often begin to modify their movements to avoid having a bad fall. The modifications lead to increased fear and decreased activity, which then leads to decreased muscle tone, and an increased risk of falling," explains RWJ Hamilton physical therapist Katie Matonis, PT, DPT.

This fear of falling is all too familiar to Cartlidge. "The feeling of having little control of my body's movement made me very anxious all the time. I would think, 'maybe I can't take that step,' and I would be paralyzed by the fear," says Cartlidge.

To combat the fear, Matonis acts as a spotter throughout her patients' appointments. "I push them as much as I can while they're with me. I give them reassurance I will be there if they are unsteady. If they're not secure with me, they're not going to do these important exercises," Matonis explains.

Getting Stronger Every Day
These days, Cartlidge is working with RWJ Hamilton physical therapist, Katie Matonis, two days per week. Cartlidge admits the physical therapy program is challenging for her and there are times her fear creeps back up on her.

"I just have to take a moment to see how far I've already come. When I started physical therapy with RWJ Hamilton, I couldn't walk on my own at all," says Cartlidge. "

Today I walk with a cane most of the time, and when I'm working with Katie, I walk from exercise to exercise with little or no assistance," she says.

An Ounce of Prevention is Worth a Pound of Cure
Although she and her physicians are still in the process of determining a diagnosis, Cartlidge is feeling better about her ability to stay on her feet. She thanks her physical therapist and her own perseverance for that.

"Katie can anticipate my anxiety, so she knows when to push. For me, everyday life has become easier because of the hard work I'm doing with Katie. I'm thankful that I can do things like walk my dog and do laundry in my basement downstairs," says Cartlidge.

Her advice for anyone feeling unsteady on their feet? "Go to your doctor. Make your doctor aware of the problems you're having so that you can get to the bottom of it," she says.

"Then, take the steps to prevent a fall. Try to overcome your fear of falling, stay active, and if you need it, go to physical therapy. It can be hard at times, but the most important thing is not to give up. Even if you're aching or feeling anxious, go to every appointment and do your homework. You'll feel better in the long run."

More About RWJ Hamilton
Robert Wood Johnson University Hospital Hamilton (RWJ Hamilton) is the only New Jersey hospital to receive the Malcolm Baldrige National Quality Award. Located in Hamilton Township, NJ, the hospital is part of the RWJ Health System and Network and is affiliated with the University of Medicine and Dentistry New Jersey-RWJ Medical School and the Cancer Institute of New Jersey.

The RWJ Hamilton Health Care Corporation serves communities within a five-county area and includes an acute care hospital, the Cancer Institute of New Jersey Hamilton, three affiliated medical groups, seven Lakeview Child Centers, and the RWJ Hamilton Center for Health & Wellness, home of a medically-based fitness center and the hospital's extensive community education program. Over 1,900 hospital employees and 650 medical staff physicians share RWJ Hamilton's passion for Excellence Through Service. For more information, visit www.rwjhamilton.org.