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Sen. Leahy's fall is an all too common occurrence among older Vermonters

Senate Defense.jpeg
Amanda Andrade-Rhoades
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Associated Press
Sen. Patrick Leahy is recovering after surgery for a broken hip. The 82-year-old fell at his home in northern Virginia last week.

Sen. Patrick Leahy broke his hip last week during a fall at his home in northern Virginia.

According to his office, the 82-year-old is recovering after hip replacement surgery. In Vermont, data from the Centers for Disease Control and Prevention shows, each year, one out of every three people in Vermont will report falling.

Experts say the consequences can be serious. In fact, falls are the leading cause of injury-related death for people over the age of 65, and they’re especially problematic for folks over the age of 80 like Leahy.

'Solid Recovery'

After his fall, Leahy was transported to a Washington, D.C.-area hospital where he underwent hip replacement surgery last Thursday, June 30.

According to his office, the senator is making a “solid recovery” at this time. His staff says he was moved from the in-patient care facility at the hospital to the facility's rehab center.

David Carle, Leahy's communications director, said in an interview with Vermont Public earlier this week that it's too early to know when the senator will be able to return to work.

“The doctors will have a very strong role in making that decision, but again they think he’s making good progress," Carle said. "It’s early. The Senate is still not in session and they’re just seeing what the daily progress will be.”

Role in the U.S. Senate

Detailed information on where Leahy is being cared for and when he'll return is hard to come by, which may be by design.

Leahy is the President Pro Tem of the Senate, which makes him third in the line of presidential succession.

In the case something happens to the president, Vice President Kamala Harris would be the first tapped to lead, then House Speaker Nancy Pelosi, and then Leahy.

Because of that, he has special security protection, and Carle sais Leahy's exact location is not public knowledge.

More from Vermont Edition: A conversation with Vt. Sen. Patrick Leahy & his wife, Marcelle Leahy

“He’s still in the same Washington-area hospital and to physically where he will be I think we’ll leave that unclear right now," Carle said.

Leahy's recovery has been closely followed by national media because the Senate is evenly divided. Unlike the U.S. House, the Senate does not allow lawmakers to vote remotely, or what's known as proxy voting. Leahy’s Democratic colleagues are paying close attention to where he’ll be.

Matt Dickinson, a political science professor at Middlebury College, said the Democrats have been in this situation before, in the early years of the Obama administration. When the party was trying to get the Affordable Care Act passed, they often wheeled 92-year-old Sen. Robert Byrd of West Virginia into the chamber for votes, he said.

"Because every vote counted in order to pass 'Obamacare,' and any time a crucial vote was necessary the Senate Democratic leadership would delay that vote until they could get Robert Byrd on the floor," he said.

Dickinson said Democrats may do the same thing with Leahy.

Danger of falls

Leahy’s fall highlights an issue that a lot of older Vermonters grapple with — falling.

The CDC tracks how many falls are reported every year in each state and Vermont ranks high because the state's population skews older.

According to CDC data, each year, one out of every three people in Vermont will report falling and the consequences can be serious.

In fact falls are the leading cause of injury-related death for people over 65 and they’re especially problematic for folks over 80, like Leahy.

Dr. Eric Marsh, a surgeon at the Vermont Orthopedic Clinic in Rutland, said falls are more dangerous in older adults because as we age our bones are less strong.

"Osteoporosis is more common and we lose muscle mass, we lose strength," Marsh said. "So we lose the ability to kind of catch ourselves when we stumble, and maybe not have it turn into a fall. And also those muscles help us, you know, when we hit the ground, kind of can help break the fall a little bit.” 

And so as our vision starts to fail, as our hearing starts to fail, as our strength decreases, as our nerves stop working — all of those things contribute to increasing the risk of falling down as we get older.
Dr. Eric Marsh, surgeon at the Vermont Orthopedic Clinic in Rutland

As we age, we may notice our hearing and vision gets worse. That too can play a role in falls since our sensory perception helps us maintain our balance.

"If you try and stand on one leg with your eyes closed, you know how difficult that is," Marsh said. "Your vision matters, so do the tiny bones and the lining of your inner ear."

We also rely on the nerve endings in our feet to send signals to our brain about where are bodies are in space. Marsh said as we age, those nerves don’t transmit signals as well.

"And so as our vision starts to fail, as our hearing starts to fail, as our strength decreases, as our nerves stop working — all of those things contribute to increasing the risk of falling down as we get older," he said.

And often it's not the fall, but what caused the fall that you need to worry about.

Marsh said falling is often a sign of other serious underlying problems. For instance, you may have fallen because you had a small stroke. Or you may have tripped on your carpet because a heart arrhythmia caused you to feel dizzy.

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Falls can leave you in pain and stuck in bed. You may not be able to drive or get around which can lead to isolation or depression.

It's why even with very frail and elderly patients, Marsh said doctors will often be very aggressive when it comes to doing surgical repairs after a fall because it's so important to get people back on their feet and moving.

"We know if we don't treat them surgically, and they're stuck in bed, or stuck in a wheelchair, their risk of pneumonia, bedsore, urinary tract infection, blood clot, all those things goes way up," he said.

And if you’re fragile to begin with, Marsh said those complications can be the beginning of the end.

Data from the National Institutes of Health show with typical care, the one year mortality rate after a hip fracture for patients 65 and older ranges from 14-58%. And among elderly patients, the risk of dying after a hip fracture increases 4% per year.

Marsh and other experts say you can improve your chances by avoiding getting fragile as long as possible. Take walks, go to Bone Builders classes and make time for strength building exercises.

Improving your balance is also key, Marsh said, but you have to work at it.

"What I tell my parents and my patients is when you're standing in front of the bathroom or kitchen sink, practice standing on one foot. You've got the sink or counter to hold onto so you won't fall down," he said." You can make your balance better if you work on it."

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One in five Vermonters is considered elderly. But what does being elderly even mean — and what do Vermonters need to know as they age? I’m looking into how aging in Vermont impacts living essentials such as jobs, health care and housing. And also how aging impacts the stuff of life: marriage, loss, dating and sex.
Bob Kinzel has been covering the Vermont Statehouse since 1981 — longer than any continuously serving member of the Legislature. With his wealth of institutional knowledge, he answers your questions on our series, "Ask Bob."
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