Backdrop:

At old age, one of the biggest risks faced by people is that of “physical falls”. These often happen accidentally and suddenly; before one realizes, one has a fall. The statistics is indeed scary as it is reported that more than one (1) out of four (4) persons above the age of 65 years falls every year but many of these remain unreported. While few falls might not have grave consequences besides minor ones like pain or bruise or scratches, many cause serious injuries like hematoma (blood clotting) or fractures in parts of the body including hip, wrist, humerus, pelvis, face or may even result in traumatic brain injuries (TMIs). Sometimes, there can be multiple fractures and the patient may have to undergo multiple surgeries and bed rest for months. Consequently, life slows down substantially and without proper hospitalization, medication and caregiving, life may prove to be hell. Those who cannot afford professional caregiving because of financial resources, life often comes to standstill and in some cases even may prove to be beginning of the end.

The scarier thing is that psychologically, falls may prove to be disastrous and the patient can go into a shell. And most difficult part of the story is that after a serious fall, it becomes extremely difficult for an elderly person to come to terms with it or regain earlier physical / mental functionality and confidence. One of the main reasons for all this is that even for falls with minor effects, an elderly might need medical care including hospitalization.

Other important psychological aspect with many elders is that that they do not suffer any “falls” but hear or see them happening to some of their close relatives or acquaintances. This forces them to change their lifestyle totally including scanty exercises, little or no movement outside the rooms of their stay or comfort zone. These “deliberate acts of slowing down” sometimes have an adverse impact in terms of making them totally risk averse and more dependent on others (care givers). This takes aways the natural beauties and joys of happy aging. They continue to live in a “world of fear of fall”.

The best way forward is, therefore, to prevent oneself from falls. While falls cannot be total prevented as these are totally accidental, elders must be aware of risks, disastrous consequences and try to take all possible steps to ensure that such accidents are minimized.

Causes of Falls:

While some falls may be totally accidental, there are certain reasons why most of the falls occur. Some of the reasons could be:

• Darkness is one of the major causes. Since eyesight of many seniors may not be strong, they do not see things properly kept in a room where light is dim.

• Tripping is the other cause. It often happens because of slippery floor or things kept in disorganized manner or wearing worn out slippers, and other similar reasons. Tripping also happens suddenly when the person loses concentration for a fraction of second or so causing the trip.

• Getting up from bed in a hurry or rushing to pick ringing telephone do also sometimes cause falls in older people. As physical strength (particularly muscle power) may not be adequate at an advanced age, any physical sudden movement might cause a fall.

• Certain medial conditions are found to have direct relationship with falls. Postural hypertension (increase in blood pressure while shifting posture), hypoglycemia (reduced blood sugar), sudden drop in blood pressure (hypotension), medical conditions like vertigo or balance problems, or onset of mental impairment diseases like Dementia / Alzheimer’s may cause a fall. As we grow older, our reaction time to face an obstacle / hindrance comes down drastically and this is one more reason of falls in elderly.

Strategies to Prevent Falls:

As stated earlier, we cannot foresee the possibility of fall as they happen suddenly and before we realize, there is a fall. We as elders, however, can devise some strategies for ourselves so that possibility of falls is minimized.

Some of these could be:

• Keeping oneself physically and mentally fit and agile facilitating us to be strong to fight the physical / mental weakness and help us not to fall at a small obstacle on the road, etc. Fitness is also key to mental strength to overcome the perennial fear of living in a world of fall.

• Maintaining the living room clean, organized, and dry. This will aid an elder not to face any obstacles or feel slippery while moving inside room.

• At least one (1) light should be kept on in night as well. This will enable the elderly to see things properly while getting up in night. This is important as many elders suffer from nocturia (frequent urination at night).

• If need be, the house particularly living, and bathroom flooring should be changed so that these are not slippery. Similarly, bathroom should be provided with handhold attached to wall near the commode to sit or get up easily.

• Elders must not attempt to try to climb on stools or chairs to keep or remove something. At the same time, they should not try to cross any road in a hurry and wait for their turn.

• Elders should try to slow down their speed: while getting up from bed or walking on road or doing any exercises so that unnecessary stress / pressure is reduced.

• Efforts should be made to ensure that medicines prescribed are taken in time diligently; at the same time, polypharmacy must be avoided.

• At the slightest onset of any physical discomfort like giddiness, etc. all precautions need to be taken including taking rest and seeing a medical practitioner.

Conclusion:

Elders must remember that they do not remain as swift and agile they were in their youth, and they have to accept this reality of life. Better option is then to move in tandem with the aging process and take all precautions so that they do not succumb to any falls. Falls can be dangerous and may be life threatening. Elders, therefore, should remain active while taking all precautions against risks of fall. Excessive youthful or stressful activities must be avoided. Principle of happy aging includes the axiom of “careful physical life”.