Paths to prevent elders' hip injuries
ALICE DEMBNER'S series on hip fractures ("After the fall," Page A1, Dec. 10-12) increased awareness of how serious falls can be for elders. By alerting the public to the fact that 29 percent of elders die within a year of a hip fracture, the Globe has challenged us to address this problem more aggressively.
An issue that the series didn't cover was the relationship between vision loss and falls among the elderly. More than 30 percent of people over age 65 suffer vision loss as they age. Macular degeneration, cataracts, and diabetic retinopathy are a few of the most common causes of vision impairment among elders.
Elders with vision loss are more than three times as likely as their sighted peers to have a fall that results in a hip fracture. And visually impaired elders are four times more likely to remain in a nursing home once they have sustained a hip fracture .
Nursing home costs can quickly exhaust family savings, and the bulk of these costs are borne by taxpayers through Medicaid. In-home services by low-vision specialists can dramatically reduce an elder's risk for falls. But health insurance and Medicaid don't cover the cost of these services.
BARBARA SALISBURY
Brookline
The writer is chief executive of MAB Community Services, formerly the Massachusetts Association for the Blind.
AS A practicing emergency physician, and as chairman of our state's Injury Community Planning Group, I'd like to point out that while the incidence and severity of injuries from falls, including hip fractures, continue to grow in Massachusetts, falls need not be just a fact of life for our aging population.
Falls, like most injuries, are preventable, and strategies exist to help senior citizens remain safe in their homes.
The state Department of Public Health and the Centers for Disease Control and Prevention recommend that seniors talk to their physicians about what they can do to remain healthy, fit, and active.
Regular exercise to promote good balance is crucial, as are regular vision screenings and medication screenings for those seniors who take medicines.
Communities can also take the lead in preventing falls by making sure sidewalks are kept in good repair and that roads and sidewalks are kept clear of ice .
Hip fractures and other unnecessary injuries rob our older citizens of their independence and strain our healthcare system.
As your outstanding series has confirmed, it is a long road back from a fall injury. Perhaps we can save some of our older residents and their families from this heartache by preventing falls before they occur.
Dr. WILLIAM FERNANDEZ
Boston 
