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Holidays can be tense, but when I landed in Chicago to visit my family, I received an unexpected dose of anxiety, a text message from my mom. "Your father fell and is in the emergency room. I can't pick you up."

For most of my life, falls meant scraped knees and bruises.  Now, as a trainee in geriatrics, I know they are much more menacing, especially for the elderly. One in three adults over 65 falls each year. Serious falls are the fifth cause of death for older adults, just behind heart disease and cancer. But unlike these diseases, falls and their impact are under-recognized, even by physicians.

Luckily my father is a young 68. He works full-time and walks several miles a day. But without any details, I had to wonder, were there things I did not know about his health or medications? Had he had any other recent falls? These are questions a geriatrician asks when seeing a patient who is falling. Many conditions, medications and joint problems affect balance and cause falls. Doctors can diagnose and treat related conditions, adjust medicines and educate patients about falls. I might suggest resources like the Centers for Disease Control website or schedule a home evaluation by a physical therapist to fall-proof the home and teach balance exercises.

Without intervention, patients are more likely to suffer the serious consequences of a fall: a broken hip, head injuries, or death. In the end, bones can heal but the ability to live independently may not. Many older adults need more support after a fall, and some need to be in nursing homes.

My mind raced through all this as I imagined the worst. When I arrived at the ER, I learned that my dad tripped on an uneven sidewalk and landed on his arm -- not great, but not unusual circumstances. His dislocated shoulder was treated and he spent dinner at my sister's as planned, groggy but intact.


With a Perspective, I'm Anna Chodos.

Anna Chodos is a geriatrics fellow at the University of California, San Francisco.