Falls in older people – reducing the risk

Falls are a common and serious health issue for older Australians. Around 1 in 3 people over the age of 65 will experience at least one fall per year, with 2 in 3 of them suffering an injury. The recent deaths following a fall of two prominent Australians, Barry Humphries and Carla Zampatti, has highlighted the tragedy that can follow this all-too-common occurrence as we age.

The good news is that falls are not an inevitable consequence of aging and there are steps we can take to reduce the risk. In this article we look at why falls can be so serious, preventative actions you can take now to reduce the risk of falling and what to do if you or an older person you care for fall.

Why are falls such a concern?
Anyone can experience a fall, but in older people they are more common and more likely to result in serious injury and long-term consequences. Around 30% of people over the age of 65 experience at least one fall each year, with two thirds of them suffering an injury and around 1 in 5 ending up in hospital. About 10-15% of the injuries are serious and include head trauma and fractures.

Hip fractures are one of the most serious injuries sustained in a fall. Older people tend to recover slowly and are more likely to experience post-operative and bed rest complications. Some don’t recover at all – 25% of people who fracture their hip die within 12 months of their injury and of those who survive, between 30-50% never regain full mobility. 

Injuries aren’t the only consequence of a fall, it can be a confidence-buster as well – nearly 48% of older people who fall say they have a fear of falling again and many seriously curtail their activities, leading to a reduction in quality of life and a snowball effect of decreasing mobility (which increases the risk of further falls) and loss of independence.

So what’s the good news??
The good news is that falling is NOT an inevitable result of the ageing process; most falls are preventable with some simple interventions. 

Stay active
Ask most GPs for their top 3 tips to reduce the risk of falls and their answer will invariably be: exercise, exercise and exercise! Gradually losing muscle condition and fitness is the number one reason falls are more common as we age but is certainly not inevitable. It’s NEVER too late to start or increase your levels of physical activity; even small changes (at any age) can make a big difference.

The experts recommend:

• 30 minutes of moderate physical activity a day, most days of the week. Examples include brisk walking, golf, swimming or group classes.
• Activities to improve balance, most days of the week. Examples include Tai Chi, yoga, home or group exercises and dancing.
• Muscle strengthening exercises at least twice a week. These can be done at home or with the help of a physiotherapist or exercise physiologist. There are many free programs available online too.

Healthy eating

• Eating a healthy and balanced diet pays big dividends for health, keeps muscles and bones strong and energy levels up so we feel motivated to move more.
• Stay hydrated. Aim for around 6 glasses of fluid a day (preferably water) and watch your alcohol intake.
• Boost your vitamin D levels to help keep bones strong with a daily dose of sunlight. Your GP can advise whether a calcium and/or vitamin D supplement may be helpful. 

Medication review

• Taking multiple medications is a risk factor for falls – see your GP for a medication review every 6 to 12 months so we can check if they are still necessary, the dose and for side-effects such as dizziness or drowsiness.
• Common culprits are medicines causing a drop in blood pressure when you stand-up and sleeping tablets.
• Check over the counter medicines too, such as antihistamines.

Health check

• Many health conditions can affect your ability to move around or make you unsteady on your feet, including arthritis, diabetes, heart problems, breathing problems, depression, dementia and Parkinson’s disease.
• Whilst many of them have no “cure” per se, optimal management can reduce falls risk.
• Have regular hearing and vision checks and consider seeing a podiatrist to assess your feet and footwear.

Home safety check-up

About two thirds of falls happen in the home, so it’s just as important to give your home a safety check-up as it is to get your own check-up!

• Walk through each room with a checklist to identify any “threats”; they are usually fairly easily remedied.
• Your GP can help arrange an occupational therapist to come and do a home assessment and you may qualify for assistance in making modifications through My Aged Care.
• Look at lighting, trip hazards like rugs and uneven surfaces, installing railings for stairs or in bathrooms, clearing away clutter and taming electrical cords.
• See HERE for a home safety checklist.

Know your risk

Knowing your risk of falling is an important step to addressing many of these treatable or preventable factors – your GP can help determine your risk and there are some good online assessment tools that can give you a score and suggest what actions to take.

What to do if you fall

It’s good to have an emergency plan in place just in case you do have a fall. Your plan should include:

• Knowing who to call for help, have the numbers of nearby family or friends in your phone (or near the phone if it’s a landline)
• Keeping the phone on a low table so it’s easy to reach
• Consider a personal alarm that you wear 
• Make sure there is a way to get into the house for family/friends or an ambulance if you can’t get to the door.

One of the big risks of falling comes from what’s known as the “long lie” – being stuck on the floor unable to get up for an hour or more. Even without an injury from the fall, this can cause a number of problems itself, like muscle weakness, dehydration or pneumonia. Consider familiarising yourself with, even practicing, the technique for getting up from a fall (provided you aren’t injured). See HERE for a step-by-step guide.

Even if you have a “minor” fall or stumble and are uninjured, it’s important to see your GP reasonably quickly so we can work through the possible causes.

Whilst falls are a serious health concern for older people, the really good news is that most are preventable. By staying active, getting regular check-ups and modifications to improve the safety of your home, you can reduce the risk of falls or serious injury significantly. Having an emergency plan in place and knowing what to do if you (or an older person you care for) does have a fall is another proactive step you can take. Your GP is best placed to work with you to help reduce your risk, you can book an appointment HERE.