Fall Prevention Awareness Week – September 24th – 30th 2018
Nothing in life is more inevitable than the fact that one day we will all be old or in need. When we think of those at falls risk we visualise very frail elderly relatives shuffling around their homes on their own but the reality is that falls impact a much wider population. 30% of all people older than 65 and 50% of all people older than 80 have a fall at least once a year.1
Falls are estimated to cost the NHS over £2.3 billion each year.1 Not only do falls cause pain, immobility and distress to the patient but they also impact on that person’s carer and wider family, which very often are other vulnerable or elderly people.
So, who is at risk?
Risk factors are separated into intrinsic factors, those which are inherent to the person and extrinsic, those which are related to the environment. Intrinsic factors include old age, chronic conditions such as diabetes, dementia and arthritis, previous falls and poor vision or balance. There is very little that can be done about many of the intrinsic factors; good medicine management, correct sight wear and regular testing will all improve someone’s risk of a fall. The extrinsic factors can often be much easier to manage. They include lack of handrails, dim lighting, obstacles or trip hazards and slippery or uneven surfaces. However, is it that simple for a person at falls risk to get handrails fitted or improve the lighting in their home? We all have that odd job that we need to complete at home but very few of us get around to doing it. And how receptive are people at receiving the advice and acting on it. Research suggests many at risk believe it doesn’t apply to them yet or that falling is a part of getting older. Often advice about hazard perception is considered patronising and assumes the person is senile.
The challenge is bigger than first anticipated. So how do we really reduce the risk?
- One of the main elements that must be tacked to reduce the risks associate with falls is balance and exercise. This advice is well received by patients and is most effective when incorporated into every day activity or routines. As well as Tai Chi, Otago and LiFE there are a number of tailored exercise programmes that people can follow which if all over 65’s followed would prevent 7,000 unnecessary deaths a year – from hip fractures alone.1
- Medication review and regular check-ups are vital for reducing risk. Any recent falls should be recorded and the nature and cause discussed. Medication which cause drowsiness, dizziness, low blood pressure or blurred vision should be identified and if possible taken at a time of day that has the least impact.
- Regular sight and hearing tests are simple or organise can both reduce the risk of falls as well as ensuring people can keep their independence and aren’t missing vital information oral and aural.
- Those with a good support network of family are friends are also less at risk as they can share their concerns and ask for help when it is needed. People who are more isolated will take partake in more risky behaviours as they try to manage on their own.
- The final and most obvious activity that reduces risk is to safe check the home. Removing uneven flooring, rugs and trip hazards and fixing hand rails. Good footwear is also essential to ensure a steady footing.
If these 5 elements were tackled the impact would be substantial not only on the wellbeing of those over 65 but also the cost savings for the NHS through reducing the 4 million hospital bed stays each year in England alone. As healthcare professionals, it is our responsibility to educate those at risk of falls and move our attention to prevention rather than treatment.
- Age concern – Stop falling
- NICE Clinical guideline [CG161]
- Age concern- Don’t mention the F-word – 2012