Falls

Every year, many old people suffer from falls. These falls in older adults are a significant cause of morbidity and mortality and can have a serious after effect due to the fall. The risk of falling increases with age and is greater for women than for men. According to stats, two-thirds of those who experience a fall may fall again within six months. A decrease in bone density contributes to falls and resultant injuries.

Falls can be caused by many reasons and often the cause is multi-factorial, and requires a multi-disciplinary approach to treat any injuries sustained during the fall and to prevent any future falls. Some people believe that falls are a normal part of aging, and as such are not preventable. Lack of knowledge leads to lack of preventive action, resulting in falls.

SymptomsCausesDiagnosisPrevention
  • Soft tissue injuries
  • Inflammation of joints
  • Hypotension
  • Auditory and visual abnormalities
  • Trauma
  • Tremor
  • Illness
  • Fractures or dislocations
  1. Physical Exercise

Physical strength is particularly important to stay mobile and prevent falls and injury. Exercise is good for heart and circulation as well as for bones, muscles and balance. It also helps to maintain a healthy weight and mental well being. Include balance and exercises as a part of regular exercise routine. For older people, walking groups, exercise and dancing groups are recommended. Group exercises makes the session interesting and active. Plan the physical activity with a health professional before beginning an exercise program.

  1. Healthy Nutrition

Eat or drink sufficient calcium. Postmenopausal women need 1,500 mg of calcium daily. Calcium-rich foods include milk, yogurt, cheese, fish and shellfish, selected vegetables such as broccoli, soybeans, collards and turnip greens, tofu and almonds. It’s also important to keep hydrating the body with water or fluids.

  1. Better Vision

Have regular checkups by an ophthalmologist to discern the extent of age-related eye diseases such as cataracts and glaucoma. Keep the glasses handy at all times. Avoid wearing reading glasses when walking. Use colour and contrast to define balance-aiding objects at home (e.g., grab bars and handrails). Reduce the outdoor glare by wearing a hat or sunglasses and eliminate glare inside the house by using light shades curtains.

  1. Keeping Track of Medication

Know the common side effects of all medications taken. Talk with the physician about ways to reduce the chances of falling by using the lowest effective dosage, regularly assessing the need for continued medication, and the need for walking aids while taking medications that affect balance. Limit intake of alcohol as it may interfere with the medications.

  1. Personal care

Get sufficient vitamin D in order to enhance the absorption of calcium into the bloodstream. Vitamin D is formed naturally in the body after exposure to sunlight, but some older adults may need a supplement. However, do not get exposed to direct sun for long duration.

Fear of falling or loss of confidence sometimes occurs after a fall, this may lead to vicious cycle stopping activities, which in turn reduces muscle mass and strength. If there is a fear of falling, discuss that with family members and health professionals and take necessary steps for fall prevention.

If alone at home, use personal alarm or cordless, personal alarms can be worn as pendants around the neck. Hip protectors are protective shields and can be effective in reducing the hip fractures. Ill fitting footwear and foot wear with worn soles increase the risk of fall. Foot problems like in-grown nails, fallen arches, badly-shaped toes and decreased sensation with age or from diabetes can also contribute to falls.

Garments that hang below ankle level are trip hazards. Wear walking shoes for daily activities and make sure the shoes are firm and supportive around the heels and the instep of feet. Shoes should provide enough room for toes. Shoes with Velcro fasteners are best. Do not wear socks without shoes. Avoid slip on shoes and unsupportive slippers.

Having short term illness like UTI, diarrhea and chest infection can increase the risk of falls.

  1. Environment

Few modifications in the home environment can significantly reduce the risk of falls:

Stairs:

  • Well lit, free of clutter and non skid surface
  • Edges should be marked with contrasting colored non skid tape

Kitchen:

  • Place the frequently used and heavy items in an easy to reach location
  • Use stable step stool with side rails for reaching high places
  • Wipe the spills immediately
  • Living room
  • Should be clutter free, non glaring light, non slip surfaces

Bedroom:

  • Light switch should be at the entrance
  • Place a cordless phone and lamp near bed
  • Use night lights in the halls, bathroom in order to avoid darkness while getting up in the middle of the night
  • Take a few moments to sit at the bedside before standing up after resting or before getting up in the morning

Bathroom:

  • Use grab bars inside the bathroom
  • Keep the absorbent towel handy to wipe up moisture or spills immediately
  • Talk to the health care professional about the correct placement of assistive devices
  • Always maintain the assistive devices in good condition. For example, check for the worn out rubber bushes and handles.
  • Always use the assistive devices of appropriate height suitable for the patient

Outdoors:

  • Always use foot paths, avoid damaged footpaths or rough ground with loose or uneven surfaces
  • Be aware of curbs, changing levels and slopes, especially at entrances to buildings
  • Take time and cross the road slowly
  • When using public transport take time and keep one hand free to hold the rail and always look at the step while getting up and down

After the treatment of injuries, the person is assessed to identify the reason for falling and risk factors to avoid future falls and fall-related injuries. The diagnosis of fall is usually dependent on the reason for the fall. An ECG or X-Ray could be taken in case of serious injuries.

Elderly patients are questioned about falls on a periodic basis because there are high chances of recurring falls. The risk of getting injured by a fall depends on the likeliness of a person and other environmental hazards.

Below is a list of drugs that may increase the risk of falling:

  • Sedative-hypnotic and anxiolytic drugs
  • Tricyclic antidepressants
  • Major tranquilizers
  • Antihypertensive drugs
  • Cardiac medications
  1. Physical Exercise

Physical strength is particularly important to stay mobile and prevent falls and injury. Exercise is good for heart and circulation as well as for bones, muscles and balance. It also helps to maintain a healthy weight and mental well being. Include balance and exercises as a part of regular exercise routine. For older people, walking groups, exercise and dancing groups are recommended. Group exercises makes the session interesting and active. Plan the physical activity with a health professional before beginning an exercise program.

  1. Healthy Nutrition

Eat or drink sufficient calcium. Postmenopausal women need 1,500 mg of calcium daily. Calcium-rich foods include milk, yogurt, cheese, fish and shellfish, selected vegetables such as broccoli, soybeans, collards and turnip greens, tofu and almonds. It’s also important to keep hydrating the body with water or fluids.

  1. Better Vision

Have regular checkups by an ophthalmologist to discern the extent of age-related eye diseases such as cataracts and glaucoma. Keep the glasses handy at all times. Avoid wearing reading glasses when walking. Use colour and contrast to define balance-aiding objects at home (e.g., grab bars and handrails). Reduce the outdoor glare by wearing a hat or sunglasses and eliminate glare inside the house by using light shades curtains.

  1. Keeping Track of Medication

Know the common side effects of all medications taken. Talk with the physician about ways to reduce the chances of falling by using the lowest effective dosage, regularly assessing the need for continued medication, and the need for walking aids while taking medications that affect balance. Limit intake of alcohol as it may interfere with the medications.

  1. Personal care

Get sufficient vitamin D in order to enhance the absorption of calcium into the bloodstream. Vitamin D is formed naturally in the body after exposure to sunlight, but some older adults may need a supplement. However, do not get exposed to direct sun for long duration.

Fear of falling or loss of confidence sometimes occurs after a fall, this may lead to vicious cycle stopping activities, which in turn reduces muscle mass and strength. If there is a fear of falling, discuss that with family members and health professionals and take necessary steps for fall prevention.

If alone at home, use personal alarm or cordless, personal alarms can be worn as pendants around the neck. Hip protectors are protective shields and can be effective in reducing the hip fractures. Ill fitting footwear and foot wear with worn soles increase the risk of fall. Foot problems like in-grown nails, fallen arches, badly-shaped toes and decreased sensation with age or from diabetes can also contribute to falls.

Garments that hang below ankle level are trip hazards. Wear walking shoes for daily activities and make sure the shoes are firm and supportive around the heels and the instep of feet. Shoes should provide enough room for toes. Shoes with Velcro fasteners are best. Do not wear socks without shoes. Avoid slip on shoes and unsupportive slippers.

Having short term illness like UTI, diarrhea and chest infection can increase the risk of falls.

  1. Environment

Few modifications in the home environment can significantly reduce the risk of falls:

Stairs:-

  • Well lit, free of clutter and non skid surface
  • Edges should be marked with contrasting colored non skid tape

Kitchen:-

  • Place the frequently used and heavy items in an easy to reach location
  • Use stable step stool with side rails for reaching high places
  • Wipe the spills immediately
  • Living room
  • Should be clutter free, non glaring light, non slip surfaces

Bedroom:-

  • Light switch should be at the entrance
  • Place a cordless phone and lamp near bed
  • Use night lights in the halls, bathroom in order to avoid darkness while getting up in the middle of the night
  • Take a few moments to sit at the bedside before standing up after resting or before getting up in the morning

Bathroom:-

  • Use grab bars inside the bathroom
  • Keep the absorbent towel handy to wipe up moisture or spills immediately
  • Talk to the health care professional about the correct placement of assistive devices
  • Always maintain the assistive devices in good condition. For example, check for the worn out rubber bushes and handles.
  • Always use the assistive devices of appropriate height suitable for the patient

Outdoors:-

  • Always use foot paths, avoid damaged footpaths or rough ground with loose or uneven surfaces
  • Be aware of curbs, changing levels and slopes, especially at entrances to buildings
  • Take time and cross the road slowly

When using public transport take time and keep one hand free to hold the rail and always look at the step while getting up and down

Current Category: Falls
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