Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.
Are the Risks for Falling, and What Causes a Fall?
Factors that increase the risk for falling
Muscle weakness around the hip joint
Increased unsteadiness when on the feet
Intake of more than
Using a cane when its rubber tip is worn through
Causes of falling
Loss of footing: Loss of footing means a loss of contact between a foot and the ground. Footing can be easily lost if people use things for purposes other than what is intended, for example, using a kitchen chair as a ladder or stool.
Loss of traction: Loss of traction occurs when the surface is wet or slick and a person slips or when the ground is uneven and a person trips.
Vision problems: Usually, wearing glasses can correct vision problems that develop with age. However, these glasses are often bifocals, which have one level of vision correction at the top of the glasses' lens (for looking far away) and another level at the bottom of the lens (for looking close up). This means that the vision is distorted when looking down at the feet through the bottom of the glasses' lens, making it easy to lose balance and fall. Also, for many older people, glasses cannot fix their vision changes, so they cannot see clearly and their chance of falling is increased.
Loss of balance or balance problems can cause falls.
Diseases that impair mental or physical functions: Certain diseases affect circulation, sensation, mobility, or mental alertness. These diseases can increase the risk of falling.
Certain medications (such as sedatives): Older people often have medical conditions that require taking several medications. People who take certain medications (such as blood pressure pills, heart medicines, diuretics or water pills, or muscle relaxers or tranquilizers) or
multiple medications are more likely to fall as a result of drug-related side effects such as dizziness, confusion, disorientation, or slow reflexes.
Change in reflexes: Reflexes are automatic responses to something in the environment. For example, stumbling to catch one's balance or reaching out an arm to catch the body as one trips are reflexes. Reflexes become slower as one ages, making it harder to regain balance after a sudden body movement.
Changes in muscle and fat: The strength and amount of muscle (muscle mass) changes as a person ages. Muscle mass usually decreases because people exercise less and become less active as they age, meaning muscles are weaker. With age, the loss of body fat that cushions and protects bony areas, such as the hips, occurs. This also affects the soles of the feet, which changes the ability to balance.
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