The World Health Organisation defines a fall as “an unexpected event in which the participant comes to rest on the ground, floor, or lower level”. Some people extend this definition, qualifying it with: “(a fall)… other than as a consequence of a sudden onset of paralysis, epileptic seizure, or overwhelming external force”
Falls are common in the elderly.
Each year, approximately one third of people over the age of 65 will fall. This increases to one half of people aged over 80.
1in 6 falls will result in a hospital admission.
Considering these facts, we can see that falls are highly prevalent. This is important for those who may feel isolated or embarrassed post a fall.
There are over 400 reasons why people have fallen.
Some risk factors may seem fairly obvious to some people
- Poor vision and poor lighting
- Poor gait (the way in which we walk)
- Poor balance
- Weak of stiff legs and feet
- Ill-fitting shoes and slippers
- Loose rugs
- missing a step
Some risk factors are not so obvious
- Fear of falling or low confidence
- Taking four or more medicines (regardless of what they are)
- Using a walking stick or frame (often because it is the wrong size)
- Depression or poor memory
- Being incontinent of urine
- Damage to nerves, particularly in the feet and joints
- Problems regulating blood pressure
Steps to take if you have had a fall:
- Keep a falls diary. This helps get over the problem of forgetting falls, but also helps doctors and therapists to explore the cause behind falls. Sometimes the frequency and timing of falls can provide vital clues.
- See your GP to review your medication.
- See an optometrist to check your vision.
- See your physio to assess you balance, muscle strength and joint flexibility. The can advise on how to improve your mobility.They can also do a home visit to check your home environment and make suggestions of how to make things easier and less risk.
- Being active and exercising is a very good way to prevent falls. Speak to your physiotherapist about what you can do to prevent falls. The Otago exercise program has been designed to help prevent falls.
Things to do at home:
- remove loose carpets
- make sure steps are clear- mark with a different colour tape the edge of the step, or change in eveness of the ground. In this article some of the video clips show how things are perceived when your vision is impaired. Marking the edge of steps in a different colour of the shower step with a different colour can make a big difference.
- make sure you have grab rails in the shower and bathroom.
- install railing next to steps.
- Make use of anti slip mats in the bathroom.
- Consider the use of a chair in the shower if feeling unsteady.
- Keeping as active as possible as you age- an exercise program should work on your cardiovascular fitness, your strength and your balance.
You can follow the home check list to assess you own environment.
What to expect from a physio assessment:
Your physio session will involve of detailed assessment of any falls you had, the physio will ask about medication you are taking, find out about what you do on a day to day basis. From there they may do a some tests to assess where you are. These tests help assess strength of you muscles, your ability to move etc. Many of these tests have age appropriate norms, so even if you have not fallen, the tests can be done to assess you risk of a fall. The good thing about tests is they can be used to track your progress.
An assessment of where you are at is a good start. A physio assessment is a good start.
- The CDC website has a wealth of information for both patients and their families to prevent a fall. Look at their STEADI program: Stop Elderly Accidents and Deaths and Injuries
- Bracing for the fall of an aging nation New York Times
- A tiny stumble, a life upended New York Times
- Steps to Avoid an Accident New York Times
- What you can do to prevent falls
- A home fall prevention checklist for older adults
- Stay Independent- Learn more bout fall prevention
- World Health Organisation- aging and falls prevention
- Otago Fall prevention exercise program