Contrary to assumption, falls don’t ‘just happen’, and are not always to be brushed aside as being common in the elderly. Here’s why they may occur, what you can do to prevent them, and what to do in case you, or someone you know, has a fall.
The World Health Organisation recently updated its Fact Sheet on Falls and Slippage as a cause of concern. 4 Facts you should know:
- Falls are the second leading cause of accidental or unintentional injury deaths worldwide.
- Over 3.7 crore falls occur each year that are severe enough to require medical attention.
- Each year an estimated 6,46,000 individuals die from falls globally of which over 80% are in low- and middle-income countries especially from Southern Asia, including India.
- Adults older than 65 years of age suffer the greatest number of fatal falls.
WHAT CAN CAUSE A FALL?
The causes of falls can be broadly grouped into 3 categories:
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Situational reasons, like rushing to the bathroom, or to answer the telephone,
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Environmental reasons, like slippery surfaces, unsafe footwear or steep steps, and
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Intrinsic reasons. These include:
- Impaired balance and gait, as in Parkinson’s Disease, neuromuscular diseases, Arthritis, Vertigo, weakened muscles, or following a Stroke.
- Visual impairment, as in simply not wearing your glasses, having Glaucoma, Retinopathy (often seen in uncontrolled diabetes), Macular Degeneration, or having bifocal or trifocal lenses
- Dementia and confusion
- Cardiovascular problems, like Postural Hypotension (where your BP drops suddenly as you go from a sitting/lying down to standing position), Postprandial Hypotension (a fall in BP roughly 1 hour after eating), Arrhythmias, Vasovagal Syncope (fainting), or valvular heart diseases.
- Medication, such as sedatives, or certain cardiac drugs.
WHAT CAN I DO TO PREVENT ONE?
If you or anyone in your family have any of the above-mentioned conditions, make sure you get them evaluated by a doctor at the earliest, who can also help suggest measures to prevent falls specific to that condition.
Aside from that, it’s important to realize that a majority of falls occur at home. The following measures will help make falls less likely:
- Clean up. Remove any objects that you are likely to trip over, such as phone cords, small furniture or clutter
- Make sure you have sufficient lighting. Brighten your lights, and turn on a night light/bathroom light to illuminate the way in the night. In addition to these, keep a flashlight next to your bed
- Mop up spills as soon as possible. If your floors are slippery, you can install friction strips that will aid you.
- Wear sturdy footwear at all times. Try avoiding slippery shoes, or ones that do not have straps at the back.
- Install strong handrails on the stairs, preferably on both sides. Also, consider adding handrails near the toilet or the shower
- Keep commonly used items within easy reach, so you needn’t go out of your way.
- Buy a walking stick or a walker after consulting your doctor, if you do not feel steady.
- If you have rugs or carpets, tape them securely to the floor, or remove them
- If possible, ensure that you are not alone when you venture outside.
Other than these, make sure you get your eyes checked at least once a year, or as often as your doctor suggests. Exercising, even if it is just a daily walk, will help improve your strength and balance.
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Stay with the patient and call for help. Assess their breathing and pulse. If either of these is absent, call an ambulance immediately, and begin with CPR if you know how to.
- If the patient is confused, disoriented, in pain or dizzy, stay with them and do not move their neck. Check for any noticeable bruises, cuts or bleeding. Call for an ambulance, and let the medical staff who arrive assess for spinal cord injury.
- If they attempt to get back up and seem to be able to do so, assist them with another person to help. Do not assist them alone. However, in case you suspect a fracture (especially common in elderly people with osteoporosis), or they complain of excruciating pain, call an ambulance.
- If you have witnessed an elderly person falling, accompany them to the hospital to provide an eyewitness account. This is often useful in diagnosing why the person has fallen and is essential in taking care of cognitively impaired adults who may not be able to recall the details of the fall themselves. Try to notice or remember if they took an extended period of time to react (i.e., their reflexes were slow), and if they attempted to stop their fall by stretching out their arms.
- If possible, ensure that you have a complete list of their medication, and be sure to report a history of any previous falls, their frequency, and consequences.
By Dharini Prasad
Guest Author & Student of Medicine
Bibliography
Falls in the Elderly, MSD MANUAL | 6 Steps for Preventing Falls Among Your Older Loved Ones, NCOA
Dick
May 10, 2019
A significant cause of falls may be fainting. Elderly men may be susceptible to micturition syncope. This is fainting while urinating, and usually occurs when an elderly man wakes up and moves rapidly to the toilet to urinate. This may not allow the body’s blood pressure to adjust quickly enough from a prone sleeping position to a standing position. Women, of course, usually urinate in a sitting or squatting position and so are less vulnerable. It would be interesting to know if micturition syncope is less common in men from cultures where it is usual for men to squat when urinating.