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Most falls occur to people who are over 65 years old; you have a one in three chance of falling this year. For people aged 80 and over, the risk increases to one in two.

Falls mostly occur when you have:

  • Poor balance 
  • Weak muscles 
  • Low blood pressure 
  • Poor vision 
  • Medical conditions (e.g. Parkinson’s disease, stroke)

A client may also be at risk of falling if you are not active, or take multiple medications. Older people fall most often at home, leading to injuries such as cuts and bruises, broken bones, or worse. As a result, many people require admission to a hospital or residential care facility.

What can you do to prevent falls?

Even if a client has had a minor fall that didn’t cause an injury, it may affect their confidence. You should encourage the client to tell their doctor and ask for a health assessment. Often falls can be prevented by taking relatively minor steps, such as changing medication dosage, altering glasses or taking some exercise.

Avoid unnecessary risks

There are steps a client can take right now to reduce the risk of falling. They can make their home as safe as possible. When you are out and about with a client, take notice of their surroundings and keep an eye out for any potential hazards that may cause them to slip, trip or fall such as uneven pavements or loose rugs.

Have a health assessment

The doctor can advise about any falls a client may have had and they can check:

  • Strength and balance 
  • Sight 
  • Medications 
  • Cardiovascular status (heart rate, heart rhythm and blood pressure) 
  • Current exercise or activities.

The doctor can advise if anything needs to be changed, and if suitable, refer the client to an exercise programme.

Consider an exercise programme

Falls are often prevented by undertaking a regular form of exercise that improves your muscle strength, balance and fitness. This checklist will help you take the steps to make your home a safer place to live. Any number of factors from genetics to illness to medications including the mismanagement of prescription drugs may affect balance, which can lead to falls. According to research, people with severe white matter changes in their brains were twice as likely to score poorly on walking and balance tests, affecting how well they get around and keep their balance.

Causes of Falls

Causes of falls can be broken into three main groups physical, psychological, and medication related.

Physical

This could be something in the environment or the client’s physical abilities - examples of physical causes include:

  • Poor foot wear, no grip on shoes
  • Low blood pressure
  • Inner ear disorders – often called vestibular disorders – is another cause of dizziness in older adults, which can lead to imbalance and place seniors at a higher risk of falls, according to research. 
  • Poor lighting or poor vision
  • Clutter 
  • Conditions that cause drowsiness, balance problems or dizziness
  • Limb weakness
  • Restraints

Psychological

  • Wandering or unsafe behaviour
  • Depression/anxiety
  • History of falls
  • Refusing to use walking aides

Medication

  • Side effects from a range of medications that cause balance to be changed
  • Medication interactions and reactions including improper use of prescription drugs

Seniors should complete a physical examination and make sure they ask about ear and hearing issues or balance problems that they might be experiencing. If a senor is unsafe at home, having a caregiver/companion with him, even a few hours a day could help put both at ease.

Finally, sedatives and the mismanagement of prescription medications are other likely culprits when it comes to balance problems that could lead to falls. According to an analysis of previous studies reported in a recent issue of the Archives of Internal Medicine, older adults who take several types of psychotropic medications such as antidepressants or sedatives appear more likely to experience falls.

Fall Prevention Checklist

This checklist will help you take the steps to make your home a safer place to live:

Physical Changes

  • Are pathways and footpaths outside the home even and free from uneven cracks?
  • Are the walkways free from clutter?
  • Are rugs and carpets secured with non-skid tape?
  • Are there hand rails or grab bars installed beside the stairs or in the bathroom next to the toilet and bath?
  • Are non skid mats placed in the bath tub?
  • Is the kitchen floor free from liquid, grease or any other slippery substance?
  • Have wheels been removed from all items of furniture?
  • Is there a nightlight to keep the bedroom lit at night time?
  • Are light switches placed at each end of the stairway?
  • Are steps visible?
  • Are all spills cleaned up?

Personal changes

  • Keep hydrated
  • Wear flat non slip shoes
  • Medication reviews to ensure smallest risks to falls
  • Ensure client is wearing glasses and ensure visits to optometrist are kept

You can download the ACC's Falls Prevention Checklist.

Physical and social impacts of a fall

Physical

  • Fractures
  • Broken Bones
  • Skin tears
  • Head injuries
  • Reduced mobility

Social

One of the consequences of falls is fear which has a number of social implications. Loss of confidence and restriction of activities in order not to put themselves in the position of risking further falls. The person may seriously restrict outings, hobbies, and activities such as attending religious services. This can lead to social isolation, loneliness, and immobility which will further reduce strength and muscle tone and stiffer joints. Because of a limitation of lifestyle and being confined to the home a client can become very depressed and withdrawn.

What to do if a client falls

  • Remain calm and reassure the client that help is on the way. 
  • Make the client comfortable and call for help immediately. Do not attempt to lift or treat injuries unless trained to do so. If the client has an emergency response system the “panic” button on the bracelet/pendant/phone equipment can be used to call emergency services. 
  • Call 111
  • In the event of them being transported to hospital, organise for their purse or wallet to go with them and any important medications.

Reference:   Ministry of Health (MOH) - 2015