Fall Prevention in the Elderly
The World Health Organisation has noted that of people over 65, 30% will fall on a yearly basis. In those over 75, the fall percentage is even higher. Of those that fall, 20-30% will suffer major side effects, including reduced independence and mobility, and beyond that, an increased risk of premature death. Resulting injuries often take a long time to heal, depending on the severity of the fall, and the age of the person falling. In 2016, the NIH noted that the elderly population was made up of 617 million people aged 65 and older. Current projections estimate that by 2050, the population of people over 65 will be 17% or 1.6 billion. That will be around 1.6 billion people that are more susceptible to falls then any other subgroup of the population."
As a person ages, the body’s ability to heal wounds and injuries gradually slows down. This means that an initially minor injury can easily develop into a long-term, serious issue. As the body takes longer to heal, there is more time for complications to arise. These complications can range from infection to loss of muscle or movement and unfortunately can even cause a person to become bedridden. Due to this, it is extremely important to take care of our ageing loved ones to ensure fall risk, both inside and outside of the home is minimised.
We have put together a guide to risk factors related to falling and some helpful tips to help you take care of your ageing loved ones.
Fall Risk Factors
Risk is related to the chance of an event occurring. In this case, the risk would be associated with the likelihood of falling, due to a variety of factors. Some of these factors can be minimised or completely removed to help prevent a fall, whilst others simply need to be taken into account and managed.
While preventing falls at a population level hasn’t been officially studied, current published studies identify specific risk factors for falls and subsequent injuries. Therefore, you can look at risk factors for falls by dividing them into three factors: Intrinsic, extrinsic or environmental, and exposure to risk. For the sake of this article, we will look in-depth at those three factors and then how to prevent falls in the future.
Extrinsic and Environmental Factors
Extrinsic or environmental factors are external to the person. They are factors within the surrounding environment that can add to the risk of a fall. This can include anything from wearing the wrong footwear, slipping on loose rugs or carpets or slippery floors, to accidents on stairs or pavements. This can be made worse by the absence of adequately installed support handrails within the home or by uneven footpaths. Inadequate lighting can also increase the risk of falling as tripping hazards may not be seen. Relying on inappropriate walking aids can also lead to a fall, so proper walking aids are necessary.
Studies indicate that between 30-50% of falls are due to environmental factors that affect an individual due to age, while 20% are due to falls that a healthy adult would suffer from. Because older adults lack the balance or right mechanisms for stopping a fall, they are more prone to accidents from extrinsic factors than a healthy, younger adult.
There is a wide range of intrinsic factors that add to fall risk in the elderly from medication to medical conditions. Some of them may be congenital while others may be psychological. This appears to be the largest group of factors.
As previously mentioned, as a person ages, they are more likely to fall. Gender also plays a part in one age. While younger adults’ percentages are nearly evenly matched, older women are far more likely to fall and suffer from fractures, as opposed to their male counterparts.
Certain medications have side effects such as dizziness, which can lead to an increased risk of falling. For instance, benzodiazepine can increase your fall risk by 44%, as well as increasing the likelihood of night falls and hip fractures. The risk of a fall is increased as well, when a person is prescribed more than 4 medicines, regardless of the medicines prescribed.
In addition to this, a number of medical conditions themselves can cause fall risk to be increased. Conditions like arthritis, diabetes, and pulmonary disease, to name a few, all can cause an increased risk of a fall. Dizziness, which is often a side effect of medicine and connected to a variety of medical conditions, is a common reason for elderly adults to fall. Some conditions such as epilepsy or low blood pressure may also cause a person to fall as a symptom of the underlying condition such as fitting or fainting.
While it is not a medical condition, per se, impaired mobility or gait strongly impacts instances of falls. As a person ages, they lose their strength. A loss of core strength will greatly impact overall balance and strength, and it will impact how easily one can slip and fall. Even difficulty getting up from a sitting position impacts one’s likelihood of a fall. Impaired gait, which may require additional aids to walking, makes tripping and falling far more likely. Foot problems, like bunions, ulcers, or deformed nails will impact one’s gait and make the risk of falling even higher.
As person ages, vision may become impaired, making it difficult to identify possible tripping hazards. Visual impairments and the added use of bifocal lenses increase the likelihood of falls. For that reason, many doctors may recommend using single lenses whilst moving around the house, especially around stairs or tripping hazards and set the bifocals aside for reading.
Cognitive impairments in the elderly, like dementia and Alzheimer’s impact one’s chances of falling. An American study that focused on nursing homes in Maryland determined that those with dementia fall twice as often as those without. While most falls may not result in an injury, the correspondence between cognitive impairment and falling is vital to note.
If an elderly person has fallen before, they’re more likely to fall again. They’re also more likely to fall if they have a fear of falling. Fear of falling may be due to age or it may be due to health side effects, like stroke or surgery. Whatever the reason, psychological fear of falling is seen in 70% of people who have suffered recent falls. A fear of falling has a variety of other side effects that play into the overall cause of falling, like decreased mobility which leads to weakness and lack of core strength. Fear of falling greatly impacts the overall health and mindset of an individual, and may even cause one to stop socialising, or exercising, which leads to an overall decrease in physical and mental health.
Because of fear of falling or because of their advanced age, elderly people are more inclined to be sedentary, which can also impact their likelihood of a fall. A Canadian study noted that even a person who cuts back on exercise or basic activity for two weeks due to a health reason, is more inclined to fall, simply due to sedentary behaviour.
Exposure to Risk
The final category of people more likely to fall is those who are exposed to risk. Whether it is intentional or not, people who are more exposed to risks that could cause them to fall, will. Some people fall on walks, others fall in increased physical activity due to unsafe conditions, but as a general rule, the pros of the activity outweigh the cons. Overall, the relationship to activity and falling is multifaceted and difficult to categorise, but activity is so vital to physical and mental strength it is strongly encouraged to continue as long as the individual is fit.
Deaths from Falls
Unfortunately, one of the side effects of falling in elderly people is death. An American study from the State of Health noted that in metro areas in 2014 and 2017, deaths in falls were far more common among the elderly. The WHO estimates that 640,000 people die annually from falls and that even those who do not die, maybe at a higher risk of subsequent long term care.
Tips for Fall Prevention in the Elderly
Preventing falls in the elderly is important for their health and well-being. It is essential to take precautions to help protect your elderly loved ones from falls. We have put together a list of helpful tips that can aid you in doing this.
It is vital that your ageing parents and grandparents have a full check up on a routine basis. This is necessary so that any medical conditions can be quickly diagnosed and treated promptly. Regular visits to their GP is necessary to ensure that their body is functioning adequately.
A cross-sectional cohort study of 197 individuals noted there was a correlation between high blood pressure and impaired balance or falling. High blood pressure becomes more common as one age, and this is just one example of an issue that can be diagnosed with regular GP appointments. Additionally, a GP is able to sit down and discuss overall side effects from medications, which is imperative to note, especially if they could contribute to falls.
GP appointments aren’t the only appointments that elderly individuals should attend yearly. Seeing an ophthalmologist is imperative to maintaining good vision. Having poor vision will lead to a higher likelihood of falling, among other side effects, so it is important to maintain regular appointments. Adults who have fallen and injured their heads are at a higher risk of ocular trauma, a major evidence-based fall prevention study indicated, so to prevent further falls, elderly individuals are urged to be seen to confirm no ocular trauma that could impair vision.
Lastly, elderly individuals are encouraged to visit an ENT doctor to check on any dizziness or hearing problems, which could further contribute to falls. Inner ear problems could contribute to dizziness and affect the balance system, making it important to confirm and correct.
As we grow older, our body starts to become stiff, resulting in decreased balance and a lack of coordination. Body strength is also reduced making it essential to incorporate adequate exercise into the daily routine. No matter the age, exercise helps to keep the body fit and flexible and promotes coordination and strength. All of these factors can significantly decrease the chance of falling.
To counter weakness due to old age, simple, basic exercise is recommended. From walking to Tai Chi, many elderly individuals have noticed an improvement in their core strength and overall balance due to exercise. An evidence-based Brazilian study noted that women who danced Samba had better overall strength, posture, and fitness, and could dance with their eyes closed, thus indicating their strong balance. Swimming or water exercises offer many benefits, including core building strength exercises that will improve one’s posture and strength in and out of the water.
And a set of randomized trials noted that Tai Chi, light to moderate-intensity exercise, in elderly adults improved their balance and helped limit their fear of falling. Many exercises that can help elderly individuals do not require any equipment, thus making them easy to pick up and do either at home or in a group setting.
As mentioned above, certain medications can cause side effects such as unsteadiness or drowsiness. This can lead to a trip or fall. It is for this reason that medicines should be regularly checked and discontinued if they are seen to be interfering with the body’s regular functions. They should also be discontinued if they are no longer needed; only continue medications that the doctor prescribes to you and destroy any excess medication.
Just as you would babyproof your home should you have a new baby in the house, it may be a good idea to fall-proof the homes of ageing relatives. This involves removing all tripping hazards, ensuring rooms and stairs have non-slip treads and lighting is adequate throughout the home. Consider adding mats in the bathroom, where floors can be slippery when wet, and guard rails near the toilet or bath to assist in standing up. Adequate lighting is extremely important in aiding proper vision and preventing falls related to unseen obstacles, so ensure that overhead light or lamps are bright enough.
Along with your home, fall-proof your wardrobe. Consider that clothing isn’t too loose and might impede your balance or vision whilst walking. Items like long, loose, flowy dresses or skirts are easy to trip over or limit one’s vision. Ensure that shoes fit well and aren’t too loose or too tight and that laces are tied neatly. If you wear house shoes, ensure they too fit snugly or purchase a pair of fall prevention slipper socks. Along with clothing, ensure that any accessories like earrings, necklaces, eyewear chains, and more are not distracting enough to throw off balance or cause one to be distracted and trip.
Fall prevention training is important if you care for elderly people. It will have in-depth information on preventing falls in the elderly, and caring for an elderly family member who has fallen in the past.
Invest in Telecare equipment
The advancement of technology within the healthcare industry has not only helped to simplify care but has also made growing older much safer. The major player in doing this has been the wide-spread use of telecare equipment and fall prevention devices. Telecare equipment gives users the ability to call for help should an accident or emergency situation occur. Telecare equipment can be landline or mobile-based, dependent on the needs of the user, and allows the wearer to be connected to a designated contact or monitoring centre at the push of a button.
The SureSafe range of telecare equipment is manufactured with the safety of your elderly loved ones in mind. Our range includes alarms for all needs and requirements; automatic fall alert devices, landline-based alarms and mobile-based alarms. Our wearable monitored personal alarm devices, with automatic fall detection included, use up to date technology to detect falls. If detected, a designated contact, or 24-hour monitoring centre, is immediately alerted and help dispatched if necessary.
Wearers can also manually raise the alarm using their elderly panic button, should they feel at risk in any way. This allows both wearers and their loved one’s peace of mind that they will be quickly looked after should a fall occur. This quick response can dramatically impact the severity of injuries sustained, often preventing prolonged complications or even death.
You can trust SureSafe telecare devices to provide prompt assistance to your loved ones in the event of a fall. Our telecare equipment range is made using cutting-edge technology, making sure that your elderly loved ones remain safe both inside and outside of the home. Our telecare devices are unlike other monitored alarm devices; they are lightweight and discreet and most types can be worn around the wrist or as a pendant.
It is our aim to ensure that every elderly person can live a safe and independent lifestyle for as long as possible. For more information on our fall alert devices or any other type of personal alarm, contact a member of our expert team today. We can offer advice and help to find the perfect solution for your elderly loved ones!