Everyone is susceptible to falling. Younger people usually suffer no ill effects or if they do, the injury is minor and causes no long-term harm. Falls among older people, however, are a different story.
Every year, one in three older adults falls but only less than half of them tell their healthcare providers about it. The low number of people who report falling is alarming because falls are the chief cause of fatal and nonfatal injuries in older adults. In fact, more than 90% of hip fractures are caused by falling. The percentage of fractures related to falls is twice as high for older women as it is for older men, and falls among adults over 65 cause the highest number of fatalities.
In 2013, the direct medical costs from falls of older patients amounted to $34 billion. In the same year, about 25,500 older adults died from injuries caused by accidental falls.
Falls among older adults happen for a variety of reasons. Muscle weakness, infections, poor eyesight, issues with walking or balance, and hazards in the home are some of them.
Aside from causing fatal injuries, falls could also lead to nonfatal injuries that range from moderate to severe, such as laceration, hip fractures, and head traumas. In addition to the physical effects of a fall, there are also some psychological consequences, such as developing the fear of falling. Unfortunately, older patients who develop the fear of falling tend to restrict their movements, which makes their strength and flexibility deteriorate. This increases the risk of more falls in the future. Moreover, the same fear could keep them from engaging in social activities that are necessary for their mental and emotional health.
With the assistance of family members or a caregiver, here are what patients can do to prevent falls and reduce their negative consequences:
Eat a balanced diet
Calcium, protein, and essential vitamins are necessary for optimum health and having a balanced diet can help older adults prevent weakness, poor fall recovery, and risk injuries. A diet rich in calcium may also help decrease the negative effects if a fall should occur because calcium makes the bones stronger.
Exercise
Regular physical exercise helps improve balance and leg strength. This is especially important for older patients so the risk of falling will be lessened as they move around the house or other environments. Tai chi, walking, and water workouts are ideal activities as these exercises are usually not too strenuous. However, it’s a good idea to consult a doctor whether you can engage in these workouts. If not, the doctor may suggest other exercises that are better suited to you.
Visit the eye doctor at least once a year
Poor eyesight is a common cause of falling. Patients can sometimes perceive objects as being closer or farther than they are and in some instances, they don’t see objects in their paths altogether. To avoid accidents caused by eye conditions, such as glaucoma and cataracts, get your eyes checked at least once a year and make sure that your eyeglasses are updated so your vision will be maximized.
Take note of your medications
Some medicines or combinations of medicines can cause dizziness and drowsiness, which could increase the risk of falls in elderly patients. If you are taking more than four medications at a time, develop a good medication management plan and ask your doctor or pharmacist to review all the medicines you are taking.
Reduce home hazards
Many things in the home could increase the risk of patient falls. To reduce the risk, rearrange the furniture to make wide and clear paths for walking, get rid of worn or slippery rugs, and make sure that objects are not left lying on the floor. Adequate lighting should be provided in areas where you usually spend your time in and grab rails should be installed in the bathroom, the kitchen, and other places in the house where falls are most likely to occur.
Avoid risk-taking behaviors
The elderly sometimes overestimate their abilities to do certain activities. Standing on unsteady chairs, climbing ladders, or moving without the assistance of prescribed devices are some behaviors that can increase the risk of falls. Although refraining from doing these activities could make your mobility limited, it’s more important to be cautious to avoid accidents that could lead to more complications.
Wear well-fitting shoes
Loose footwear could be the cause of tripping or falling so make sure that you wear shoes that fit you perfectly. Choose shoes that have non-slip, textured soles with good ankle support to help you be balanced and stable on your feet. Avoid wearing slippers or going barefoot.
Use mobility aids
Walking aids, such as a walker or a cane are helpful in the reduction of falls in seniors who have difficulty walking steadily. It is crucial, however, to consult a physiotherapist first before getting a walking aid because the wrong one could actually increase the risk of injuries due to falls.
Get assessed for fall risk
If you are prone to falls or if you want to know how high your risk for falls is, you can visit a falls clinic. There, you will be assessed for risk factors, such as the following:
- Impaired balance, strength, or bearing
- Impaired maneuverability
- Psychological/Cognitive impairment
- Nutritional issues
- Medications
- Neurological issues, such as Parkinson’s diseases and stroke
- Musculoskeletal issues, such as arthritis, foot problems, joint replacement, and deformity
- Chronic illnesses, such as osteoporosis, lung disease, cardiovascular disease, and diabetes
- Previous history of falls
Without a doubt, preventing a fall is better for the patient’s health and well-being than dealing with the results of an accidental fall. However, caregivers may encounter some challenges when proposing the idea of fall prevention to older adults because for them, fall prevention initiatives have a negative implication. Instead of focusing on ways to prevent accidental falls, the best way to deal with resistance from patients is for family members and caregivers to:
Encourage patients to participate in activities that aim to improve their balance and strength
For most patients, fall prevention means making changes in their homes, the use of mobility aids, or the restriction of their activities. This is particularly true among older adults so it is important to educate them in this area in a way that promotes a realistic but positive attitude. To do this, family members and caregivers should emphasize the need for engaging in activities that improve balance, strength, and stability instead of highlighting the need to avoid the risks. For instance, instead of asking patients to avoid climbing the stairs as much as they can, patients should be encouraged to exercise to develop their leg muscles and their ability to maintain their balance during movement. This strategy improves the patients’ view of exercise and allows them to actively participate in the activity to protect themselves from falls.
Emphasize benefits that promote a positive self-image when offering falls prevention initiatives
Older adults are often hesitant to acknowledge falls or to participate in interventions because (1) they are afraid that others will perceive them adversely, (2) they think that falls are part of ageing, or (3) they are ashamed to admit that they are losing control over their own bodies. These concerns are all valid but redirecting their focus to the benefits will make them more likely to participate in the initiatives. Because it’s important for older patients to be in good health, to avoid becoming too dependent on the people around them, and to be sociable and interesting, some of the benefits that you could discuss with your ward are increased confidence, heightened independence, and the improvement in their ability to take a more active role in society.
Design fall prevention initiatives in such a way that they will meet the preferences, capabilities, and needs of the individual patient
Patients come in all shapes, sizes, and dispositions. Some like being in a group while others prefer the one-on-one approach. There are patients who like to keep the company of only people who share the same social standing, religious beliefs, cultural background, ethnicity, and even gender while there are those who have no such preferences. In any case, designing the fall prevention initiatives while taking into account the personality of the patient will go a long way in keeping him or her engaged in the activities.
Encourage patient participation in designing or choosing the type of fall prevention initiative
Adults are more open to participating and adhering to fall prevention initiatives when their participation in the decision-making process is encouraged. Therefore, patients should be involved in creating or selecting the kind of initiative, the different forms of the same initiative, and the goals they want to achieve.
Contrary to what most people think, falls are not inevitable nor do they have to be a natural consequence of ageing. These accidents could be avoided if the patients work together with their family members and caregiver in understanding that they can proactively safeguard themselves from falls. It’s also essential for them to develop a positive attitude about keeping themselves healthy and making changes in their lifestyle and surroundings not only for fall prevention but for their overall well-being and health.
