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Fall Prevention in Older People

Fall prevention in older people

Falls are the leading cause of death, injury and hospital admission in older people. Not only is the eventuality of falling more common in older people than any other age group; the chances of suffering a fall-related injury such as trauma or a broken hip also increase in old age. That makes it essential to know what factors can endanger an older person’s stability and balance, along with what precautions can be taken to reduce the likelihood of an older person suffering a fall.

Falls in older people: statistics

1. One in three people aged 65 and over will suffer a fall every year. This figure rises to more than one in two people aged 80 and over.

2. Two out of three elderly people who suffer a fall are likely to do so again within six months.

3. Falls are responsible for seven out of every eight fractures in senior citizens.

4. The average hospital stay of an elderly person who has fallen is twice as long as the average hospital stay of elderly patients admitted for any other reason.

5. 10% of falls in people aged 85 and over result in hip fractures.

6. One in four senior citizens who fractures their hips after a fall will die within six months of contracting the injury.

7. 47% of senior citizens who suffer a fall will no longer be able to get up without assistance.
Sources: National Council on Aging / Mayo Clinic

Hip fracture

What causes older people to fall?

1. Many adults become less active as they get older and their balance, flexibility and co-ordination is likely to diminish. Also, the presence of chronic health conditions such as diabetes or arthritis increases the risk of falling due to inactivity, sharp pain or loss of function.

2. It’s also likely that their eyesight could worsen (in elder years, less light reaches the retina), which makes it more difficult for them to judge their steps and to spot fall hazards such as puddles, uneven surfaces and items on the ground.

3. Some prescriptions and over-the-counter medications could have side effects which contribute to falling, such as drowsiness, dizziness and low blood pressure. Sedatives, antidepressants, opioids and some cardiovascular drugs are the most likely medications to spark these problems.

4. Older adults might inhabit a home where fall hazards such as poor lighting, damaged floors or stairs, loose carpets or slippery floors are present but go unnoticed or aren’t acted upon.

5. Surgical procedures such as hip replacements can cause extreme discomfort in older people and make them weaker and less mobile.

6. The level of activity in which an older person engages could affect their likelihood of suffering a fall.

Dangers of older people falling

If an older person falls, they could suffer injuries ranging from hip fractures to traumatic brain injury, depending on how they land. Broken bones and soft tissue injuries are the most likely consequences of a fall.

Even minor trauma from a fall can have lasting repercussions for older people, with a strong chance of them being hospitalised and unable to ever get back the functionality and self-confidence they had prior to falling.

Older people are less likely to recover from fall injuries due to their bodies’ fraility and pre-existing medical conditions. Even relatively minor injuries such as broken bones often require complicated surgical procedures which could involve sedation and further trauma, both of which impact negatively on an older person’s life.

Even if an older person survives a fall and does not suffer any great physical injury initially, they may still require an extended hospital stay which could leave them open to the risk of contracting hospital-acquired infections such as pneumonia, sepsis and urinary tract infection.

This video outlines a few ways in which the risk of older people falling can be greatly reduced.

How to prevent falls in older people

Eliminate fall hazards

1. Keep floors as clear as possible. Do not leave objects strewn around the home and keep wires and cables well clear of areas where people are likely to walk.

2. Wipe up any liquid stains on floors straight away, although be careful not to leave the floor too damp or someone could slip on it.

3. Secure any carpets or rugs to the ground.

4. Ensure that any staircases or steps have firm handrails. Also, it’s a good idea to indicate step edges by covering them with clearly visible tape.

5. Install grab bars alongside showers, bathtubs and toilets to allow for greater stability when standing or sitting.

Choose the right footwear

1. Discourage elderly relatives from wearing shoes or slippers that are worn out, impractical or do not fit them comfortably.

2. Discourage elderly relatives from walking around the house in socks or backless slippers, as these won’t provide a firm grip.

3. Ensure that they have low-heeled shoes with plenty of support and a non-slip sole.

Try to keep active

1. The more physical activity an elderly person can get, the better their balance will be.

2. People lose muscle mass and tone as they get older, leading to decreased strength and coordination and consequently making them more susceptible to falling.

3. Speak with their doctor or physical therapist, who can recommend an activity routine that is ideally suited to the elderly person and will improve their stability.

Use prescribed mobility aids

1. Encourage elderly relatives to use mobility aids if they’re needed. Even if they seem reluctant to use them, try to point out the benefits of having them and the risks of neglecting them.

2. Ensure not only that they’re using prescribed mobility aids but that they’re using them correctly.

3. Speak with a physical therapist for advice on the right type of mobility aid to use and ask them to teach elderly relatives how to use it.

Get their eyesight tested regularly

1. Encourage elderly relatives to wear glasses if their eyesight isn’t clear.

2. Ensure that they go for regular eye tests so that they have the correct prescription and can get their glasses changed if their sight has worsened since their last test.

3. Encourage elderly relatives to take great care with new glasses while they are getting used to them, e.g. bifocal or trifocal lenses can change their depth perception, potentially increasing their risk of falling.