What can you or I do to stop a fall?
This question has never been more relevant. Due to the COVID-19 Pandemic many people are reporting a deterioration in their physical and mental health, meaning more people have a higher risk of falling. Reported increases in the rate of falls (per 1000 bed days), during the pandemic period, also reflect this.
While this period has mainly been categorised by challenges due to hypoxia-related confusion and post-ICU delirium, the effects of deconditioning are among the upmost concerns.
Research has shown raising awareness in patients and those who care for them can help to reduce falls by up to 60% [Vonnes C, Wolf D. Fall risk and prevention agreement: engaging patients and families with a partnership for patient safety. BMJ Open Quality 2017]. However, as the provision of care is often built up around multiple parties i.e. healthcare professionals, carers, family and friends, it is important that everyone has an awareness and access to education campaigns so that they know what to do to reduce the risk.
Let’s make Falls Awareness Week 2021 bigger, better and bolder!
- Falls Awareness Week Bingo Card
- Falls Awareness Week Campaign Poster
- Falls Awareness Week - Top Tips From the Team
- Falls Awareness Week - What 3 Things Will You Do To Stay Safe?
- Falls Awareness Week - What 3 Things Will You Do Today to Keep Your Patients Safe?
- Falls Awareness Week - How Will You Raise Awareness and Reduce the Risk of Falls?
As you age your risk of a fall increases; it is a huge cause of hospital admissions and can also result in serious injury and long term complications. Falling may also leave you with a loss of independence and confidence.
By understanding the risk factors associated with falls you can take preventative actions. if you have previously sustained a fall you are more likely to fall again and therefore it is even more important that the steps listed on this information page are taken.
So take a look at the topics to the left to find out the many positive and easy steps you can take to reduce your risk of falls.
We cannot stop the ageing process, but we can offset some of its effects making small changes to your lifestyle.
After suffering a fall you are more likely to fall again: guidelines suggest that if you have fallen you should ensure that you are reviewed by your health professional, if this has not been done automatically speak to your GP.
See below to find out how you can make changes.
Our balance reaction times reduce as we age as do our reflexes; making it harder to regain balance, particularly when moving quickly e.g. turning. Balance is vital in ensuring you stay upright when over reaching for items or if you trip up this can be improved with regular exercise.
As you age your bones will naturally become more brittle making the possibility of fractures significantly more likely if you do fall. Weight – bearing activities are great in maintaining healthy strong bones as well as a healthy diet ensuring that sufficient calcium is taken to maintain bone strength. Vitamin D will help you absorb calcium and can be obtained through sunlight (NO BURNING) and from some foods.
Muscle Strength and Joints
Between the age of 50 years and 70 years 30% of muscle strength is lost; again by taking regular strengthening exercise whatever your age you may begin to feel stronger and more stable. It is recommended that you exercise for 30 minutes five times a week.
Medication reviews can be arranged with your GP surgery and should occur every 12 months.
Psychotropic drugs are clearly implicated in falls especially Tricyclic antidepressants, antipsychotics and benzodiazepines.
Benzodiazepines and other hypnotics increase the risk of falling in a dose dependent way. Hypotension is recognised as a key contributing factor to falls.
The risk of having a fall or recurrent falls increase with the number of associated intrinsic risk factors below:
- Balance disorders
- Visual impairment
- Previous fall
- Hearing impairment
- Cognitive impairment
- Polypharmacy ie 4 or more medicines
- Psychotropic drug use
- Orthostatic hypotension
- Alcohol more than 1 unit a day
- Poor mobility / gait
High risk drugs that can contribute to falls:
- Anti-psychotic (including atypical)
- Benzodiazepine and Hypnotics
- Dopaminergic drugs used for Parkinson’s disease
Moderate risk drugs that can contribute to falls:
- ACE inhibitors/ARB’s
- Opiate analgesics
Low risk drugs that can contribute to falls:
- Calcium - channel blocker
- Oral anti-diabetic drugs
- Proton pump inhibitors and H2 Receptor Antagonist
Shoes or slippers that are poorly fitting and poor foot health may contribute to risks of falling. Research suggests that older people are more likely to fall at home if they wear footwear that is ill-fitting. A substantial number of older people fall every year due to ill-fitting or worn down footwear.
While falls sustained at home are a major cause of disability and in some cases death, many may have been prevented by taking quite simple actions. By purchasing new, properly fitted slippers, you can reduce one of the biggest extrinsic risk factors known to cause people to fall.
Practice good foot care. Check your feet regularly.
If you feel you require a Chiropody Service please speak with your GP who can refer you to the appropriate service providing you meet the criteria.
It is not just ‘old age long sight’ that can contribute to vision impairments. As you age sensitivity to contrast decreases - making it more difficult to see the edge of kerbs; along with that your depth perception changes and may cause disturbances within your visual field, all of which will increase your risk of falls.
Having an eye examination yearly even of you believe your eyesight is fine will be of great benefit for yourself; as the Optician will check for glaucoma, cataracts, macular degeneration and diabetic retinopathy.
If you struggle to visit your Optician they may be able to visit you at home!
6/10 falls will happen within your home environment; not surprising as homes get old too: clutter builds up, carpets get worn and maintenance becomes more difficult.
As you age you will need 3 times more light – consult a trusted electrician to discuss your options i.e branch lighting to increase light without suffering from glare. Try to reduce your risk of falls from trailing wires from lamps. Contemplate having two way switches on the hall/landing area. Bedside touch lamps are useful should you need to get up in the night so that you can see your path more clearly (never walk around in the dark).
To reduce your trip / falls risk ensure that all rugs have a non-slip underlay and that you replace any worn ones. Cables tidies will allow you to organise jumbled cables b your TV / Computer or Stereo. Ensure that your walk ways are free from clutter especially in hall/landing/ stairs and doorways. Pets have a habit of staying close to us and people do at times fall over them consider purchasing a brightly coloured collar or a bell to alert you of their location / presence.
Kitchen / Bathroom
Reduce your risk over losing your balance through over-reaching by rearranging your cupboards so that items you require more frequently are within easy reach. Try to clear up any spillages immediately. Consider purchasing a non-slip mat in the bath/shower and installing grab rails.
Ensure that your front and back doors and garage are well lit and clutter free to avoiding trip/ falls. Keep pathways free from moss/leaves and repair any cracks in your paving slabs.
Impaired strength and balance contribute to most falls and therefore improving upon your strength and balance will require a commitment to a specific and safe exercise programme.
Exercise needs to be regular, 30 minutes a day for 5 days a week as able. Ensure that you exercise in a safe environment:
- Use a sturdy and stable, knee height chair for seated exercise
- Wear comfortable clothes and supportive footwear
- While exercising, if you experience chest pain, dizziness or severe shortness of breath, stop immediately and contact your GP
- If you experience pain in your joints or muscles, stop, check your position and try again. If the pain persists, contact the person who issued you these exercises
Maintaining Good Posture
- Ensure you sit or stand up tall with relaxed your shoulders.
- Ensure you do not arch your back too much.
- Sit away from the back of your chair and keep feet flat on the floor.
- When standing engage your abdominal muscles to maintain stability at the trunk.
The National Institute for Health and Care Excellence (NICE) has published the following guidance on the subject of fall in older people: