Kate Tohm has a history of falling.
In August, she tripped over an antique shoe shine kit that sits next to her bed. She fell forward, hit the windowsill and passed out.
"It took about two months to completely heal. I was completely bruised from my face all the way down on my arm and into my neck,” Tohm recalled.
Tohm is 74 and lives alone in El Cajon. She said one of her constant fears is falling and having no one around to help her.
This last fall sent her to the emergency room. It crushed her confidence.
"I don't get out as much as I used to, simply because I just don't want to put myself in a position where I can injure myself," she said.
Falls are the leading cause of injury among older adults in the U.S. according to the Centers for Disease Control and Prevention. In San Diego County data show 1 in 4 adults over 65 experiences a fall each year. They are a major reason for nursing home admissions.
For older adults, the fear of falling goes beyond the immediate pain of a stumble. It’s about the potential for serious injury, long recovery, and sometimes, the loss of independence. At the Challenge Center, a La Mesa physical therapy nonprofit, seniors are learning how to fall safely in "Age-ility" classes.
"This class is what we call total fall management. So it's not simply fall prevention, but we also teach seniors how to get up from the floor," said Jaime Casey, a physical therapist and fall prevention specialist who leads the five-week class.
"There is a real fear for a lot of people of having a fall in not being able to get up again. And we also teach techniques for how to fall safely to avoid a serious injury should a fall occur," she said.
More than 38,000 seniors died from falls in 2021, according to the CDC. And nearly 3 million ended up in the emergency room for fall-related injuries.
Tohm said the class is a lifeline. She’s learning how to fall in ways that lessen the impact and protect vulnerable areas. These are crucial skills for older adults whose bones may be more fragile.
The classes also address the emotional toll of falling.
"They are developing a real serious fear of falling and then end up isolating, staying at home, not going out with friends. And unfortunately, what happens is the less you do, the more physical decline you actually experience," Casey said.
Research shows that once a senior falls, their chances of falling again doubles.
Aging can diminish our sense of balance, said UC San Diego Health geriatrician Ian Neel.
"We start to lose something called proprioception, the position sense in our feet, and that can affect our balance. It reduces somewhat our sense of where our feet are in reality, and so that can make it that we've become off balance a little bit more easily," Neel said.
He said even everyday factors like footwear choice can increase fall risk.
"Really thick, foamy shoes. They're good for helping kind of keep our feet comfortable, but at the same time it also reduces our sensation of kind of where our feet are in space," he said.
Medications can also play a role.
"If we are on certain blood pressure medications, certain psychiatric medications, those are associated with higher fall risk. If we are on sleep medications, those linger in our body the next day, and so that can make us a little bit more fatigued, a little bit more off as we're walking."
Tohm said she is also learning from others in the class.
"I might not have thought to do something one way, and see somebody else do it a different way, then try that — and make sure that it works for me. I’ve made wonderful friends there. They're so nice,” she said.
In a recent class the group worked on strengthening their balance, improving their agility and learning techniques to roll safely in the event of a fall. Tohm said the class has been a vital step in regaining her confidence.
"I just hope to maintain my balance, not fall any more, but have the knowledge that if I do, I know what to do, and I can help myself and not depend on somebody else to come and help me.”
