Fragile Bodies, Serious Injuries

Why falls and other types of trauma can mean trouble for older adults

New Care for Elderly Patients

When Nancy,* 85, arrived at Lehigh Valley Hospital after a serious car accident last summer, she and her family watched the hospital’s new geriatric trauma team spring into action. An orthopedist was called in to set Nancy’s broken bones, and a cardiologist examined her heart. Because she was taking several drugs for her heart and diabetes, the trauma team also asked a pharmacist to review all her medications. After she was medically stable, a social worker talked with Nancy and her family about whether it was safe for her to continue driving and what support she would need at home.

The Geriatric Trauma program is the first of its kind in the Lehigh Valley and among the first in the country. “We recognize the unique needs of older adults and address those needs by coordinating care with other specialists and services,” says trauma surgeon Robert Barraco, M.D., of Lehigh Valley Hospital and Health Network.

* This fictional person is typical of an elderly trauma patient.

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Preventing Trauma in the Elderly
March 23

When children fall, they get right back up again, none the worse for wear. But as we grow older, our bodies become less resilient and injuries are more serious. “Older people don’t bounce back as well from trauma because their bodies tend to be more fragile,” says geriatrician Francis Salerno, M.D., of Lehigh Valley Hospital and Health Network. “Their hearts may not pump as well, and they may have existing diseases, such as diabetes or thyroid problems, that make recovery more difficult.”

The most common injuries in people over age 65 are from falls and car accidents. Poor balance is a prime factor in their risk for falling. “As people age, they lose the ability to right themselves when they fall, so they can’t protect their upper bodies as they go down,” Salerno says. “As a result, falls lead to injured necks, shoulders and upper arms.” Dementia, too, can be a factor in falls and accidents, says Salerno’s colleague, psychiatrist Shanthi Lewis, M.D.

Natural changes in hearing, vision and reaction time play a role in older people’s risk for accidents of all kinds. “They may have cataracts, misjudge distances and lose the ability to move their foot quickly from the gas pedal to the brake,” Salerno says. Finally, older adults often take multiple medications. Drug side effects or interactions can affect blood pressure and cause balance difficulties, dizziness—and accidental injuries.

Want to Know More about trauma and the elderly, coping with the changes of aging and preventing falls? Click here.

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