Skilled Nursing & Wound Care | Physical, Speech & Occupational Therapy

FALLS IN THE ELDERLY: CAUSES AND PREVENTION

No matter how old we are, whenever we have health issues, we are more likely to experience falls. However, falls of elderly people can result in severe injuries and fractures. Such cases often end in disability, loss of the ability to move, and even death. The most dangerous are traumatic brain injuries, hip fractures, dislocations of joints, spinal injuries, etc.

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Aging causes many health issues and thus, it may result in falls. For example, neurological and somatic pathologies are among the diseases that may be accompanied by falls. And, what’s even more challenging, falls can be a psychological problem. How?

The elderly are often more attentive to their health and thus are scared of it. And this psychological issue leads to a passive lifestyle and weakening. Which, consequently results in falls.

General causes of falls in elderly

All causes of falls in the elderly can be divided into two groups: external and internal.

The first category is linked to inadequate mobility organization: uncomfortable shoes, bad spectacles, and a lack of supplementary transportation such as walkers. Changes in the musculoskeletal system, eyesight, and cardiovascular system are the second category.

Broadly said, external factors include:

bad weather as heavy rain, snow, heat
uncomfortable clothes and shoes- tight clothes, slippery soles, etc.
house design that affects the daily activities such as bathroom grab bars, non-skid flooring, sharp corners, etc.
and, of course, the light level of a room and apartment.

As for internal factors of fall, aging itself is a great cause. With age, a lot of changes occur in the body that disrupts the normal functioning of all functions, including those responsible for the coordination of movements and the position of the body in space. That is, maintaining balance when walking, as well as standing and sitting. Visual acuity worsens, contrast, depth of perception, and speed of adaptation decrease with a sharp change in lighting. There are changes in muscle tone, structure, and muscles and their ability to develop the necessary effort and speed of movement. It also affects coordination and the ability to maintain balance under external influences (for example, stability during a push, or if a person bumps into something, stumbles over a ledge).

Hence, as a rule, it is the low muscle tone that causes more falls. Health disorders due to acute and chronic diseases, taking medications are important factors that increase the likelihood of loss of coordination. The number of medications taken especially plays a role. Among the drugs that most often increase the likelihood of falling and injury, psychotropic drugs are in the first place.

Situational factors

Among the fall factors, situational factors play a big role. That is, some activities or individual actions increase the likelihood of falls and related injuries. For example, you can perform several tasks at once, be distracted by conversations and at this time not react to the appearance of an external danger (not to notice the curb during a walk), or you can sneak to the bathroom at night without fully waking up and stumble upon a piece of furniture, rush to the ringing phone and touch something. Of course, all these lead to falls and damages.

Complications after the fall of an elderly person

Human falls, especially those repeated several times, increase the likelihood of injury, further hospitalization, and even death. In particular, this applies to elderly people with diseases of the bone system (osteoporosis) or reduced vital signs in their daily lifestyle (urinary incontinence).

If we consider the problem in the long term, there is a risk of complications in the form of a decrease in motor activity, the occurrence of phobias associated with falls, and even changes in the usual behavior pattern. If we rely on background information, in 40 cases of hospitalization of patients out of 100, this happens due to loss of coordination.

Every second fall of an elderly person is associated with subsequent injury, but not always serious. Most often these are minor abrasions and bruises. However, 5% of patients aged 65 and over are admitted to medical institutions with injuries resulting from loss of coordination. 5 cases out of 100 lead to fractures of the bones of the shoulder, wrist, or pelvis. In 2 cases out of 100, the fall breaks the neck of the hip.

Loss of coordination can lead to a significant decrease in the quality and comfort of life: approximately half of all patients with a hip fracture do not restore their previous mobility and mobility. An old man who has fallen once may have a fear of repeating this situation, followed by uncertainty and decreased motor activity. Some even stop performing the usual tasks, such as shopping or tidying up the house. Low human activity can lead to ossification, the appearance of weakness in the muscles, and a further decrease in mobility against this background.

What can be done to prevent falls in the elderly?

Fall prevention requires individual solutions. However, there may be some tips and tricks that can help you out in preventing falls and being cautious. For example, the house lighting level should be comfortable, but not too bright.

The order of household items also highly matters. Equipping the toilet seat, making it higher, and adding some more handrails are good ways of preventing falls. On the walls along the corridors, at the entrance, in the bathroom and restroom, you can install special handrails that will make it easier for an elderly person to move around the house. To do this, you can install a special alarm system at home, and put a bracelet on the hand of a person in need of care, with which you can give a sign for help.

If there are not enough funds for such a device, you can purchase an easy-to-learn mobile phone with large keys, explain to an elderly person how to use it, and ask them to carry it with them at all times. So that an elderly patient does not have to make his way to the toilet through the whole house at night, a special toilet chair can be placed next to his bed. It is necessary to provide an old man in need of care with comfortable clothes and comfortable shoes. After all, many people fall at home because they wear soft but slippery flip-flops or wool slippers. Such shoes are very comfortable, but extremely unsafe.

The list of preventive measures also includes therapeutic physical exercises – with an increase in the strength of ligaments and muscle strength, a person stands more confidently on his feet and the probability of loss of coordination decreases. The fact is that it is impossible to predict at what point an elderly person with dementia will fall – often such people overestimate their strength, are unable to seek help, can make chaotic movements without observing minimum safety rules.

And first and foremost you need to prevent the psychological disorder of the elderly as they tend to overthink and worsen their mental health. All the elderly need is our attention and care!