Anyone can fall, but older adults are more at risk than others. Dan Parton reports.

Joan’s story

When Joan went into her bathroom for a wash late last year, she was unprepared for what happened next. As she entered, she slipped and fell on to the bathroom floor.

Joan was found by her daughter some time later, barely conscious and unable to move. She was rushed to hospital where the doctor found massive internal injuries, including fractured and displaced ribs. Joan made a partial recovery in hospital, but was too frail to live independently at home and moved to a care home where it was hoped she would make a full recovery. She died four days later.

At the inquest, coroner Anne said Joan had some of the worst injuries she’d seen of any fall casualty, comparing them to those of car crash victims.

Unfortunately, Joan’s case, although severe, is far from an isolated incident. In Britain, falls are a silent killer, largely unreported in the media. And the statistics are shocking: it is estimated that one elderly person dies from a fall every five hours. Falls are considered less important than strokes and dementia, yet every year almost 2,000 pensioners die as a result of a trip, often alone and in agony with no help at hand.

What causes falls?

On average, some 30% of people over 65 years old will suffer a fall each year, with 12% of those falling more than once. So why does this happen?

  • Poor vision, hearing, slower decision making or muscle weakness (what doctors refer to as motor, cognitive and sensory functions). As we age, these limit our spatial awareness and cause problems with balance
  • Health conditions like heart disease, dementia or low blood pressure (what doctors call hypotension, the opposite of hypertension). All can cause dizziness and short term blackouts which result in a fall
  • Disabilities such as labyrinthitis (inflammation of delicate structure called the labyrinth inside the ear) also affect balance
  • Some drugs taken for other conditions can impact the elements highlighted in the first point above too

The combination of one or a number of factors listed above plus everyday life obstacles like wet or recently polished walking surfaces, rugs, stairs or climbing ladders etc are the causes of most falls.

Hormonal change during the menopause causes osteoporosis (thinning and therefore weakening of bones) and therefore falls can be more problematic for women.

The effects of a fall

3,600 deaths in 2009 in England and Wales were attributed to some sort of fall. Although all falls aren’t deadly, many do result in permanent injury. Fractured wrists and broken arms are the most common injuries, and although not life-threatening they still lead to a huge loss of confidence, depression and isolation.

For those who have already suffered a fall, regaining confidence quickly is paramount if they are to recover fully. Those dealing with the aftermath of a fall can become inactive very quickly, fearful of another fall. Unfortunately, this perpetuates the problem; bones and muscle strength will continue to deteriorate as they remain unused.  Therefore  the old adage of ‘use it or lose it’ is paramount if joints, muscles and bones are to remain healthy. This in turn will better prepare the body for the shock of a fall.

Preventatives steps

Unfortunately, falls are always going to happen, but you can do several things to minimise the risks. These include:

  • Staying active. Inactivity – particularly inactivity associated with conditions like osteoporosis – and aching joints can make it painful to move, which needs to be avoided. Continued inactivity will result in severe muscle and bone deterioration.
  • Taking up a new exercise. Tai-chi is an excellent way in which to improve balance, reflex and build confidence, and any weight-bearing exercise is beneficial to bone strength.
  • Removing clutter. Clearing the floors of obstacles, electric leads and loose rugs will make the floor safer.
  • Using non-slip mats and hand rails in bathrooms with linoleum or tiled floors.
  • Clearing up any spillages quickly and otherwise avoiding wet floors.
  • Visiting the optician. Regular appointments with an optician will help to keep sight healthy, and ensure any problems can be discovered and treated quickly.
  • Getting a medication review with your GP if what you taking causing dizziness as a side effect.
  • Try to be realistic and get help lifting or moving heavier items or reach.