Falls are one of the most serious threats to an older person’s quality of life. In adults 65 and over, one out of every three fall in a year, and of those, 20-30 % have falls that cause moderate to severe injuries, such s fractured hips which will radically alter the course of life. Estimates of ability to return to previous levels of functioning after a fracture range from 45-65%. Whatever the “true” number is, a significant number of people do not. Falls are a leading cause of admission to hospitals and nursing homes, and a predictor of death within one year of up to 25% of people who have a fracture.
There are a number of causes of falls which are preventable, although some are not. Many falls are due to spontaneous fractures that are the result of osteoporosis, cancer, or other diseases. Many are the result of decreased cognitive functioning which comes with a dementia, such as Alzheimer’s, or vascular (stroke related) dementia, or Parkinson’s. For some of the factors which lead to falls, all one can do is help the older adult stay in good physical and emotional health, regularly see a good doctor who is truly interested in the health of their elderly patients. Common sense and preventative actions can lower risks.
Here are some causes of falls and suggestions as to the precautions you can take to avoid them.
Click here to save a PDF version of the table.
As can be seen in the PDF chart, many of the causes of falls are preventable by assessing a person’s physical and emotional health, by assessing and modifying their environment, or meeting needs. Seniors should have regular assessments by their physicians, and reviews of their medications, preferably by a pharmacist.
It is important to work with the older person in helping to modify homes and make decisions regarding safety, walking aides, and other issues. Making changes in habits is not easy for any of us; when it is imposed we all may become resistive. Changes due to aging and frailty can cause grief and denial as people struggle to maintain their sense of independence, self worth and dignity.
If a fall does occur, try to get or remember as much detail as possible. Where, when, how. What else was going on? What was the person doing? What had they just done—medication, or bath, etc.? Ask what they were feeling, or if they felt anything. Talk to a physician, and if there is more than one fall, begin to keep a record so that you can recognize a pattern, if there is one.
If and when a fall happens, you can ask them to slowly move and see if there is pain. Call an ambulance if the person appears to be in or describes pain. The ambulance people will want some basic information about the person. Fill out and keep updated and handy the Diamond Geriatrics Emergency Information Document. View it at http://diamondgeriatrics.com/pdf/EmergencyInformationDocument.pdf
Peter S. Silin, MSW
(Statistics from the U.S. Centre for Disease Control)