Fear about falls
We often hear about the huge number of older people who fall and what it means in financial terms. We also hear about the consequences of that fall, which become increasingly more dire as they age. Over 80, half of those who fall will have died within a year.
We don't always stop to think about the way these older people feel about their fall. There is something very humiliating about landing on the ground, especially in front of others. The reaction is to get up as quickly as possible, as if to confirm that we are still in control of our lives. Bystanders rush to help, sensing that lying on the ground is serious, but sometimes doing more damage than good.
One of the after-effects of a fall is an increasing anxiety about falling again. This causes the one who falls to become less active and so weaker and more likely to fall. Balance declines with ageing for a number of reasons, adding to the problem.
WHAT TO DO.
At the time of the fall.
PROLONGED LYING IS SERIOUS and can cause pressure sores or even gangrene. Loss of body heat is also serious leading to hypothermia. Both these factors can be a cause of death and should be made clear to all older people.
They should have a strategy to follow if they are alone. How are they going to call for help? They should shift their weight regularly or even their position. It is good if they have a rug nearby to cover themselves and if possible find something to absorb their urine if need be. It helps to retain dignity.
If you should be with someone if they fall, ensure there are no broken bones or skin. If there are then call 999. Make the person comfortable, try and stop any bleeding and reassure them. Inevitably shock sets in after a while which can be frightening. If severe they must stay on the ground.
If no fractures assist the patient to get up themselves. This is far more dignified and gives confidence that they can manage themselves. If possible get them onto their hands and knees and give support as they get back up on their feet.
Don't lift them up onto their feet.
To prevent falls
Encourage as much activity as possible.
Going for walks or taking part in exercise groups and sport is very beneficial. Balance is improved by doing exercises in the standing position. in.
Ask if they can get up from the ground.
If not, ask them to get in touch with the surgery and request to be shown how to do so.There are staff trained to do just that.
There is a group of exercises which target all the systems essential in maintaining good balance. It is particularly effective in increasing the tone of all the core muscles and so creating central stability. Particular attention should be paid to the mobility of the neck as the proprioception provided by the joints there is essential to maintaining balance.
For those who have had a fall.
Help is at hand to exercise effectively and improve balance. There are evidence-based groups provided by instructors in Otago exercises which strengthen the muscles for movement and balance. Evidence shows that such exercises must be continued in order to provide stability and reduce the risk of falling. For information on such courses contact your GP surgery or local town council. It is essential to ensure that the instructor is Otago trained.
For links to research on Falls see box on the right.