Successful aging requires everyone to take a critical look at the many challenges we will meet along the pathway of a long life. First and foremost is the need to have a realistic understanding of what we may anticipate as we age. Informed judgments about one's health and mental condition can help determine lifestyle choices and expectations.

A common major challenge is an unexpected fall. Unexpected falls represent a very serious health concern to our senior population. Recognizing that falls will inevitably occur, steps should be taken to minimize risk factors that lead to falls, such as nurturing one's personal health and accommodating one's living environment.

Falls create some of the most discouraging and frustrating moments seniors face each day. My heart valve surgery and recent hip replacement surgery gave me a realistic glimpse into the frustrating and worrisome realm of poor balance and the imminent threat of falling.

The statistics relating to falls by seniors are very sobering: more than one-third of persons 65 years or older fall each year, and half of those falls are recurrent. About one in 10 falls results in a serious injury such as a hip fracture, other fracture, significant head injury or other serious soft tissue injury (back pain, leg pain or neck pain, for example). And, the rate of falling and the prevalence of risk factors for falling increase steadily after the age of 70.

A two-pronged approach is best to address the serious health concern that falls represent in the senior population:
• Taking proactive steps to try and minimize or eliminate risk factors that can lead to falls.
• Maximizing one's personal health status to try to reduce the risk of serious injury should a fall occur.
Good planning and caring about, and for, each other will help us prepare for these challenges and enhance the quality of our lives.

Risk Factors for Falling:
A comprehensive inventory of your personal risk factors for falls can identify areas of focus to improve or compensate in planning for fall prevention. That inventory includes the following:
• Physical impairment: Gait and balance problems are extremely common findings among seniors for falling.
• Visual difficulties: Blurred vision, diabetic retinopathy, glaucoma, cataracts, macular degeneration, depth perception difficulty and visual field cuts bring greater risks of falling.
• Hearing loss: Inability to hear warnings or follow verbal directions.
• Errors in judgment: A failure to remember to use assistive devices such as canes or walkers; your denial of any need for support; and, poor safety judgment.
• Medical conditions: Irregular heartbeat, blood pressure drop with changes in position, blood sugar fluctuations, seizure disorders and chronic pain disorders bring greater risks of falling.
• Medications: Certain types of medications, either through direct effect, side effects, or adverse reactions, or interactions with other medicines can have a significant impact on an individual's risk for falling. Some examples of these types of medications include pain relievers, narcotics, cold and sinus preparations, anti-hypertensives, cardiovascular agents, anti-coagulants, diabetic medications, diuretics, sleep preparations, and anti-anxiety, antidepressant and antipsychotic medications. Ask your doctor to review your medication regularly to look for possible drug interactions, and be sure your doctor knows about any over-the-counter medicines that you take.
• Environmental factors: Wet floors, poor lighting, throw rugs that can slip, improper footwear and cluttered pathways bring greater risks for falling.
• History of falls: Once someone falls, the odds are great that he or she will fall again doing the same or similar activity that caused the first fall.

Personal Health Maintenance:
Good health maintenance is essential in trying to reduce the risk of serious injury that can occur from a fall. Some of the important things you need to consider are:
• Regular medical follow up with your personal care physician and ophthalmologist.
• Maintaining a daily walking or mild exercise routine to strengthen bones and keep joints mobile.
• Assuring good nutritional status and drinking adequate fluids daily.
• Adhering to treatment recommendations for arthritis and osteoporosis both of which conditions can cause bone weakening.

Emmet White is an advocate on senior issues and is president and CEO of Arcadia and 15 Craigside senior living communities.