In Singapore, falls are a leading cause of injury in older adults and nearly one-third of senior citizens aged 60 years and above have fallen at least once in their lifetime. While it seems like an innocent mistake, falls can be indicators of poor health and declining function. It’s important to prevent falls, especially in seniors, as they can actually cause a range of physical and even psychological repercussions.
While there are many risk factors that contribute to falling, there are also various ways to prevent this from happening altogether.
How do falls affect the elderly?
Falls, even the most minor ones can cause some serious physical consequences such as fractures that commonly occur in the arm, ankle, hip, and even the spine. They may also cause major head injuries if the impact was felt at the head area. If this happens, the individual should be sent to see a doctor immediately to ensure that they don’t have brain damage or any further complications.
Falls are especially dangerous for seniors with existing osteoporosis, which is a bone condition that causes the bones to become weak or break. Extra precautionary measures to prevent falls should be taken for individuals with osteoporosis.
Where do most falls occur in the elderly?
Falls among the elderly do not happen at random.
While it may seem counterintuitive, most falls actually happen on flat surfaces. In care homes or elderly day care centres, falls commonly occur on the way to or from the bathroom. Even if flat surfaces don’t look like potential hazards, it is critical to still keep an eye out for these.
In Singapore, 63% of falls among the elderly happen at home. This emphasises the importance of senior-proofing your home.
How long does it take for an elderly person to recover from a fall?
While young people can suffer from falls and still get back on their feet quickly and make a speedy recovery, seniors will experience delayed healing after a fall. Depending on the impact, the recovery time will vary between each elderly person. Generally, the older you are in age, the longer it will take for you to recover.
What are the main causes of falls in the elderly?
Poor vision or hearing
As we age, many of us experience age-related eye deterioration caused by conditions such as dry eyes and glaucoma. However, these normal bodily changes can make us more likely to fall. Those with common eye conditions like cataracts and glaucoma may experience difficulty navigating uneven ground and spotting potential hazards.
Seniors who have injured their foot or experience conditions such diabetic neuropathy (nerve damage caused by high blood sugar commonly affecting our legs and feet), sesamoiditis (inflamed tendons) and connective tissue disorders may also be more susceptible to falling. Improper footwear can also contribute to foot pain and fall risk as well. Make sure to only wear shoes that are fitted and comfortable to prevent abrasions.
The surroundings that seniors live in can also be a potential cause for falls. This could be home hazards caused by poorly lit rooms, wet floors, broken stairs or even obstructing furniture and clutter. To prevent falls from occurring, it is important to make necessary modifications to your space and create an age-friendly environment for our loved ones.
Lack of exercise
Lack of exercise can cause weak muscles and decreased balance amongst the elderly. That is why regular exercise is extremely important for seniors to build muscle strength and balance. The longer you are inactive, the more likely your muscles will weaken and eventually deteriorate with time, which may also cause your joints to ache. Make sure to incorporate physical activity in your daily routine to keep your body moving and active.
Side effects of medication
Medication for depression, high blood pressure and sleep problems may also lead to falls due to its side effects. Some common side effects of these medications include drowsiness, dizziness and a loss of balance. Certain medicines for diabetes and heart conditions may also cause you to be unstable on your feet, causing you to lose balance and eventually fall.
What to do if a senior falls?
The first and probably the most critical step when your senior loved one falls is to stay calm and not panic. You are their first person of contact and the last thing you want is to not be able to help them effectively. After which, assess the situation and check for any injuries first, specifically in the head area. Ask them if they are experiencing any pain and where it is located.
If they wish to get up, you may proceed to help them get off the floor slowly only if there are no signs of broken bones or other major injuries. Support your loved one by making sure there are assistive devices or stable furniture for support that they can hold onto like a chair or a grab bar to prop themselves up. If at any point, your loved one gets stuck, is in pain or becomes too tired to get all the way up, stop.
Keep in mind that you should not be lifting their weight. Your loved one should be able to get up on their own, while you keep them steady. If they are unable to get up, call an ambulance.
If you are unsure about what to do or how to help an elderly person up from the floor, it is best to avoid unnecessary actions and call an ambulance right away.
How can we prevent falls in the elderly?
1. Keep moving and stay active
Exercising regularly can go a long way in fall prevention. Gentle exercises and mild activities like walking, water workouts as well as basic strength and balance exercises can significantly reduce the risk of falls by improving your strength, balance, flexibility and coordination.
2. Keep your bones strong
If your bones are weak, they have the tendency to break more easily. By increasing your daily calcium intake and taking vitamins or supplements, you can strengthen your bones and keep them healthy every day. Some examples of calcium-rich foods include milk, cheese, and sardines.
Vitamin D is also essential for your bone strength as it absorbs the calcium from the food we consume. This can be found in foods like eggs and fatty fish such as tuna and salmon. You can also choose to supplement your diet with cod liver oil vitamins that can improve overall bone health and reduce joint pain as well.
3. Go for regular eye checkups
To maintain healthy vision as you age, adults aged 18 to 60 are advised to go for regular eye checkups and examinations every two years. However, “at risk” adults and seniors need to make those appointments more frequent. Elderly persons aged 61 years and above should be having annual examinations and nothing less.
By doing so, this allows your doctor to update your prescription if it is outdated or detect if you are suffering from eye conditions that could impair your vision and increase the risk of falls.
4. Always stand up slowly
When we stand up from a seated or lying position, it is common for most people to experience a sensation called head rush. It is a sudden drop in your blood pressure that causes you to feel lightheaded and unbalanced for a brief moment.
To avoid potential falls, make it a habit to stand up slowly from your previous position and take some time to get your bearings before moving. Using walking devices like canes and walkers can provide you with the support you need when moving and walking significantly longer distances.
5. Monitor your medications
Certain types of medicines like antidepressants and hypnosedative drugs can affect your balance and coordination and even cause dizziness and drowsiness, ultimately increasing the risk of falls. In a study conducted by the Therapeutic Advances in Drug Safety, falls in older patients have been linked to drug and medication implications.
More often than not, you also become generally more prone to falls if your medication intake is high. To aid in fall prevention, do consult your doctor to review your existing medication and ask if you can be prescribed with alternative ones instead.
6. Wear proper non-slip footwear
Backless, heeled and loose-fitting shoes are a major risk factor when it comes to falls in the elderly. However, this problem can be fixed rather quickly.
The National Institute on Aging recommends wearing footwear that have rubber soles, low heels, and are non-skid. These shoes provide you with greater traction and friction, which can prevent slips and falls.
7. Light up your living space
Did you know that environmental factors such as dim lighting in your home are one of the most common ways to fall for elderly persons? Research from the Journal of Physical Therapy Science states that ‘insufficient information due to low lighting can increase the risk of falling due to unseen obstacles or reduced body stability in daily living’. With that, ensure that your homes are brightly lit if you are living with an elderly person.
8. Remove excess furniture
Create clear pathways in your space by removing excess furniture that can also be potential environmental hazards for seniors when trying to move around their home. Some examples of easy home modifications you can make to your space include keeping away wires and loose cords on the floor; cleaning spills right away to dry the area; and laying non-slip mats on bathroom floors to prevent slipping.
9. Install assistive devices
Adding to the list of home modifications, using assistive devices are highly encouraged if you are staying with a senior. Some assistive devices that you can consider installing are handrails for stairways; grab bars for different areas in the bathroom; and raised toilet seats with armrests. This allows seniors to still feel independent and perform their activities of daily living with ease.
You may browse and purchase a variety of assistive devices online on sites like Active Ageing and our Homage Store. Subsidies for home modification are also available via the Enhancement for Active Seniors (EASE) programme.
10. Visit a Falls Specialist
Many people may not know this but there are actually clinics that specialise in falls in the elderly. The process at a Falls Assessment Clinic typically begins with a consultation with a geriatrician followed by a review from a physiotherapist on your muscle strength, balance, walking, and posture. A brief check-up with a nurse will then be conducted to assess your blood pressure, vision, and memory as well. Finally, the nurse will discuss your history of falls, if any, and educate you on fall precaution.
Fall Prevention & Recovery
Senior fall prevention is definitely better than cure. Falls can have grave consequences amongst seniors and can result in serious complications from not being able to walk, expensive surgeries, and even affecting your independence. Ageing is a normal part of life, but falling sure is not. Don’t let falls affect you and stay equipped with the necessary tools and information to remain active and safe.
While fall prevention does go a long way, it is inevitable that some seniors may still experience a fall at some point. Should this happen to you or a family member, be sure to consult with your doctor to analyse the severity and impact of the fall to receive the necessary care they need.
The mobility of a senior may be limited after a fall, and it can be tricky to travel to and fro medical appointments or even perform activities of daily living at home. In such situations, consider having an experienced and professional medical escort bring them to and fro. Home care can also be a convenient option that not only supports seniors with activities of daily living but also helps them regain strength, alleviate pain and recover from any injury sustained from the fall.
An additional benefit of engaging home care is that trained caregivers are able to assess your home environment, pinpoint potential fall hazards, and advise you on home modifications you can make, which is especially important in fall prevention since falls most commonly occur at home.
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- Drug-related falls in older patients: Implicated drugs, consequences, and possible prevention strategies – Marlies R. de jong,
- Maarten van Der Elst, Klaas A. Hartholt, 2013. (2013, May 20). SAGE Journals. https://journals.sagepub.com/doi/full/10.1177/2042098613486829
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