A Clear and Present Danger for Stroke Survivors

By Walter Kilcullen



It first occurred to me that stroke survivors face the risk of falling when I took a 42 year old stroke survivor to a restaurant in Philadelphia, Pennsylvania, for dinner. As we got up to leave, she slipped on the tile floor and took a terrible fall. Many people rushed over to help. Fortunately, she was okay. I checked the floor to see if it was wet. It was not. The fact was she had lost her balance.


Another friend and stroke survivor is confined to a wheel chair, not because she can’t walk, but because she has chronic seizures and her doctor fears that she will have a seizure and fall. Seizures are common in stroke survivors. My friend told me that she lives in fear of falling.


I have since noticed that other stroke survivors that have been affected by weakness in a leg often carry a cane. Many times they never put the cane to the ground, but they carry it as a sort of security blanket. This indicates a second problem. The fear of falling can interfere with the survivor’s life style both physically and psychologically.


There have been many studies done concerning the danger of falling for stroke survivors. These studies show that between 36% and 40% of stroke survivors will fall depending on the study and the population that was used in that study. These findings suggest that many stroke survivors will experience multiple falls and a significant number will sustain injuries. As a result, rehabilitation will be interfered with, and the quality of life may be diminished.


Physical Therapist Jackie Harry, reported in an article for Stroke Smart Magazine that “…studies have shown that stroke survivors are twice as likely to fall following a stroke and more than three times as likely as the general population to fall multiple times. (Stroke Smart Magazine, Jackie Harry, Jan./Feb. 2007; pp. 6-7).


It is well documented that the reason for such a high incidence of falls among stroke survivors is twofold. One reason involves the impaired physical condition of the patient after a stroke. The other is due to the living environment of the patient.


The physical condition is key. Weakness and loss of feeling on the affected side after a stroke increases the possibility of falling. Other factors include proneness to dizziness, loss of vision, loss of balance, and overall poor health.


There are several things that can be done to decrease the risk of falling. Staying healthy; eating well, exercising, giving up smoking, and having regular eye exams are important. The first step for improving balance is to set up a program with a physical therapist emphasizing balancing exercises.


The patient’s neurologist and Primary Care Physician should also make fall prevention a part of their routine care. And if a patient does fall, it is important to deal not only with his physical recovery, but also with his emotional recovery so he doesn’t live in fear of having another fall.


Dr. Edgar J. Kenton III, Director of the Stroke Prevention/Intervention Research Program at Morehouse University School of Medicine in Atlanta, Georgia, states, “The living environment of the patient, must also be examined, evaluated, and modified to lessen the chance of a fall.” The environment may be the hospital, the nursing home, or the patient’s private residence. If the patient lives at home, he or his caregivers must take responsibility for creating a safe home environment. Every room must be evaluated for safety.


The Brain Injury Association distributes a pamphlet called, Heads Up! Seniors: A Guide to Preventing Falls. It is a checklist to help seniors prevent falls.


Preventing Falls


  •  Keep the stairs, handrails, and stair coverings in good repair and make sure walking areas, inside and out are well lit.
  •  Remove throw rugs from your home and use double-sided tape to secure edges of area rugs to the floor.
  • Remove ice, snow, and leaves promptly from walkways and driveways, and repair cracks in exterior walking areas.
  •  Use not skid mats around the bathtub and shower.
  •  Grab bars are a good idea near the toilet and in the shower.
  •  Reorganize items in work or storage areas to within easy reach.
  •  Remove obstacles from floors and walking areas. These include magazines, books, cords, and low furniture.
  •  Spills should be cleaned up immediately.
  •  Wear supportive, low-heeled shoes.
  •  Review medications with your doctor or pharmacist for possible side effects and keep medicines well labeled.
  •  Exercise regularly, with a doctor’s approval, to improve your strength and balance.


Walter is a volunteer Mentor for the Brain Injury Association of New Jersey and presently mentors four stroke survivors and four TBI survivors. He have also published two articles in Stroke Connection Magazine.



Copyright © January 2009

The Stroke Network, Inc.

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