What does the word “fall” mean to you?
Understanding exactly what a fall is, and what it means, is an important step in treating and preventing falls. Distinguishing between different situations such as falls, slips, trips, faints and stumbles is important as it leads to different treatment and prevention strategies.
The World Health Organization definition of fall:
“An event which results in a person coming to rest inadvertently on the ground or floor or other lower level.”
The difficulty describing dizziness
Dizziness is an important consideration when thinking about falls. It may provide clues to the underlying reason behind falls and improve diagnosis and treatment, thereby preventing falls. However, there are many different words to describe it: dizziness, vertigo, light-headed, funny turn, woozy, off-balance, giddy, disequilibrium. They all mean different things to different people.
Maintaining balance is hugely important in preventing falls. But even if we have a problem with our balance, our brains can adjust and maintain our balance through re-training. Our ability to adapt is fascinating. Even in advanced years, if we have a problem with our balance, our brain can be encouraged to adapt and balance can be restored through physiotherapy.
What is Fall Prevention?
Preventing falls can be important to any aging individual. We can help you to succeed in preventing falls.
At first this may seem quite simple; someone has a fall, remembers it, and reports it to a family member or a doctor, but some people may not report that they have had a fall for several reasons:
- Some people may hide their falls as they do not want to be seen as old or frail.
- Some people think it is normal to fall as we grow older and that nothing can be done.
- Some people may be embarrassed by the circumstances, such as rushing to the bathroom.
- Some people worry they will be put into a care home.
- One in three people who have had a recent fall do not remember it.
Bearing this in mind, falls may be even more common than we think, because falls are often unreported.
It is important to remember:
- That young people fall too; falling does not mean frailty.
- Falls are not an inevitable part of ageing and we can treat and prevent falls.
- Falls are not a reason to put someone into care.
Unfortunately, as we get older we have further to fall down and our bodies are less resilient. Each year, approximately one third of people over 65 will fall, this increases to one half of people aged over 80. Considering these facts, we can see that falls are highly prevalent. This is important for those who may feel isolated or embarrassed. Remember, falls are very common.
The consequences of falls
Falls have consequences for individuals, family and social circles, society and the economy. While we will touch on each of these, our focus will be on the personal impact of falls. The most obvious injuries which result from falls include bruises, cuts and grazes and these will occur for almost everybody who has a fall. They become more obvious as we get older as our skin and blood vessels become more fragile. Broken bones or fractures occur in 6% of older people who fall, with 1% of people who fall breaking their hip bone.
Fear of falling is non-physical injury. About 50% of people who fall become frightened of falling again. This fear can lead to avoiding some activities, or limiting oneself to staying in the house. Unfortunately, fear of falling itself can increase the risk of having further falls.
Impact On Family and Friends
• Reduced contact with family or friends
• Increased concern from family, sometimes reducing your independence
• Reduced support to your family and friends if you help care for grandchildren for example
• Reduced attendance at social events or classes
Impact on Health Services
The annual cost of treating seniors in Canada who fall and hurt themselves is 2 billion dollar. Therefore, the impact of falls is both personal and far-reaching. Preventing falls can help keep people independent and injury free.
Some risk factors may seem fairly obvious to some people:
- Poor vision or poor lighting
- Poor gait (the way in which we walk)
- Poor balance
- Weak or stiff legs and feet
- Ill fitting shoes and slippers
- Loose rugs
But some risk factors may not be obvious:
- Fear of falling or low confidence
- Taking four or more medicines (regardless of what they are)
- Using a walking stick or frame (often because it is the wrong size)
- Depression or poor memory
- Being incontinent of urine
- Damage to nerves, particularly in the feet and joints
- Problems regulating blood pressure