PSA: Learning from actress Ann Bradford Davis’ deadly fall

by 1389 on June 7, 2014

in 1389 (blog admin), brain, PSA

Kathleen Kozak has the story at Civil Beat:

Ann B. Davis
Ann B. Davis [source]

Ann Davis, the actress who played “The Brady Bunch” maid, died from an avoidable danger.

Ann B. Davis, the woman who stole our hearts playing Alice, the spunky housekeeper on “The Brady Bunch,” died this week after falling down.

The 88-year-old actress developed a traumatic acute subdural hematoma, which is a serious and, in this case, lethal complication of head trauma.

She never awoke from her fall and, unfortunately, never lived to explain how it happened.

Falls can happen to anyone, including here in Hawaii. But in these sorts of cases, the elderly are particularly vulnerable.

According to the CDC, one in three adults over the age of 65 will suffer a major fall.

In older adults, falls are the most common injuries, resulting in more than 2 million emergency room visits and costing more than $30 billion dollars.

Statistics from the Hawaii Department of Health’s Emergency Medical Services and Injury Prevention Department reveal that, on average, an elderly resident in Hawaii is injured every five hours in a fall so severe that he or she needs medical attention.

Eighty-five deaths occur each year from falls in the islands.

Such statistics are staggering, and yet some easy things can be done to reduce the risk of falling, both inside the home and out in the community.

Dr. Robert Sloan — who is a fellow in the Academy of Physical Medicine and Rehabilitation, the head of the Concussion Care Center at Castle Medical Center and president-elect of the Hawaii Medical Association — notes that people of any age group can have serious falls.

“Whether it’s from climbing up the mango tree, to trying to fix the roof, to just tripping and falling at home, the risk might be greatest in the elderly, but it’s still there at any age,” he said.

Some falls result in concussions, others in fractures of the spine and hip, and still others in major brain trauma.

So what are the warning signs of a serious head injury after a fall?

Dr. Sloan says, “headaches, dizziness, loss of consciousness, changes in memory, worsening balance problems are just a few. Be wary of the lucid interval, and be vigilant in monitoring someone who has suffered a fall.”

The lucid interval occurs in one-third to one-half of all serious falls and can make someone falsely feel like they are okay, which can lead them to delay getting medical care.

In some cases, such as that of the actress Natasha Richardson, this can lead to death when everyone assumes there is no need to seek out medical care that turns out to be crucial.

To understand brain trauma, let’s review the layers of the brain and skull.

The brain has three outer membrane layers, called the dura. A subdural hematoma is the most common type of injury and consists of a collection of blood that accumulates in the confined space of the skull between the brain and the outermost layer of the dura.

This is usually the result of brain trauma with a sudden force that tears blood vessels in the brain, some of which may already be stretched by the aging process. This is the type of brain injury that happened to “our” housekeeper, Alice. She had a subdural hematoma and didn’t wake up.

An epidural bleed in the brain can be just as lethal. This occurs when the injury results in a rupture of blood vessels that are on top of the outer membranes of the brain.

Both of these injuries can lead to a progressive increase in pressure in the skull, squeezing the brain into a smaller space, blocking off the blood flow and subsequently leading to death.

Statistically, the chances of dying from a serious brain bleed ranges from 40 percent to 80 percent, depending on the age of the individual and the amount of time it takes to get medical evaluation and treatment. Younger people tend to do better and have a greater chance of recovery than the elderly.

Luckily, falls are preventable. And, as Hawaii’s Executive Office on Aging reported in their state sponsored Hawaii Injury Prevention Plan for 2012-2018, public awareness is key, along with a comprehensive approach that includes mobilizing patients, family, doctors and the community to reduce the risk of falls.

Dennis Ka’aihue, a physical therapist at Kaiser Permanente teaches the elderly about their risk of falls and provides easy strategies to help reduce such dangers, as well as the best way to get back up off the ground.

“The key is to focus on leg strength and balance. Simple exercises can be incorporated into daily living and don’t take a lot of time. Knee lifts while doing the dishes or brushing your teeth can help. Lifting forward, sideways, and balancing on one leg at a time can help.”

“Remove power cords from the floor, get rid of loose rugs that can get caught while walking, have good lighting, eliminate the clutter around and have grab bars in the bathroom.”

Sloan adds that anyone who has fallen should talk to their doctor and look at their medications, since many have the unfortunate side effect of causing dizziness, which increases the risk for falls.

Making sure to get your vision checked and corrected is another way to prevent falls, both in the home and outside in the world.

Ka’aihue suggests that people stay alert to their surroundings and keep active, even after a fall, because inactivity leads to further muscle deconditioning, which increases the risk of more falls.

Public awareness is key and anyone who has an elderly loved one can do them a service by helping to keep an eye on their balance and assisting in making their home a safer place.

We may never know what caused Ann Davis’ fall, but suffice to say, if Alice was around, she’d have a lesson to teach the Brady kids — one all of us can still learn today.

From Wikipedia:

subdural hematoma (American spelling) or subdural haematoma (British spelling), also known as a subdural haemorrhage(SDH), is a type of hematoma, usually associated with traumatic brain injuryBlood gathers between the dura mater, and the brain. Usually resulting from tears in bridging veins which cross the subdural space, subdural hemorrhages may cause an increase inintracranial pressure (ICP), which can cause compression of and damage to delicate brain tissue. Subdural hematomas are often life-threatening when acute. Chronic subdural hematomas, however, have better prognosis if properly managed.
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