Kamala, a 70-year-old observed a gradual change in her gait over a few years. A sociable lady, she frequently visited her children in Bangalore and Pune.
Since her husband died a few years ago, she found solace and relief from loneliness in travel. Though she had a couple of falls before, she did not think too much about it and never thought it significant enough to discuss them with her doctor.
One night, she took a fall on the way to the toilet and broke her hip. She was operated upon but couldn’t walk again. She is today bed-bound and miserable. The fall changed her life.
Falls are common in elders. It is known as one of the Geriatric Giants- a terminology indicating the drastic effect it can have on the quality of life of the elder.
Studies shows that 1 in 3 elders above the age of 60 years fall down every year. The numbers go up as age advances.
Falls account for the majority of hip fractures in the elderly.
More than half of falls in the elderly happens when they are walking. A third of falls happen while elders take bath.
40 percent of falls happen at home. At Home, the majority of falls happen either in the restroom or in pathway between bedroom restroom .
More than half of the falls in the elderly happen during morning time.
Slips followed by trips are the most common cause for falls. Elder usually slips over wet floors and trip over cluttered objects on the floor.
Fear of falls is a major contributor to increased dependence and lower mobility in elders. Elders often restrict their activities following a fall which leads to social isolation.
Reason for fall
As our body ages, muscles undergo deconditioning as part of lesser mobility and loss of protein mass.
Impairment in vision contributes to trips and slips
Medications especially sleeping aids, antidepressants, Blood pressure-lowering medications and anti-seizure medicines contribute to falls
Neuropathy especially in elders with conditions like diabetes causes impairment in the judgement of ground level and contributes to falling.
Movement disorders like Parkinson’s disease causes impairment in coordination and balance contributing to falls.
Urge incontinence- the urgency to pass urine and inability to control the urge, often leads to falls.
Pain especially of the knees contributes to knees giving away while walking and falls.
How to prevent falls
Keep your home clutter-free and make sure pathways are always clear and lighted.
Have your medications reviewed by your physician. Various drugs and drug interactions contribute to falls. It is better to have a single prescription of all your medicines.
Use walkers and canes as per recommendations from a medical team. Unnecessary use of walking aides also contributes to falls.
Walking is the best exercise to strengthen your muscles and improve balance. Consult a physiotherapist to assess your gait and recommend specific exercises
Modify your home to suit your body needs. Handrails and grabs are recommended to keep you safe at home. Simple modifications like overhead lights, commode raiser, and handheld shower reduce risk of falls.
Keep floors and tiles dry.
· Incontinence can be managed with trainable bladder habits, use of diapers and medications. Consult your physician.
Balance exercises like yoga and Tai Chi improves your balance and coordination
Check your vision regularly. Always wear glass when walking
Wear appropriate footwear. It is recommended that you use appropriate footwear inside the home too.
Dr Rahul Padmanabhan is a consultant in Geriatrics and Gerontology with a decade of experience in elder care. He specializes in home and community based geriatrics and is currently medical director of Dr Rahul’s Elder Care, Coimbatore.
Dr Rahul's Elder Care is top geriatric Care service providers in Coimbatore.