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Prevention of Falls
 
 

Understanding how to prevent falls

Falling is part of growing up, as they say. Unfortunately, when we reach the age of 65 years old and above, falling may lead to injuries such as fractures, which could affect and disrupt our normal activities.

As we grow older, our bodily functions change or deteriorate. For example,

  • Sense of balance reduces
  • Slow reaction or response
  • Weakening of muscles
  • Poor vision

Medical conditions which may increase the risk of falls are:

  • Stroke and Parkinson's disease that cause balance and walking disorders
  • Heart and lung diseases
  • Joint disorders, like arthritis
  • Bladder conditions
  • Depression
  • Dementia

Medications can also be a risk of falls. Diuretics, sedatives or anti-hypertensive medications can affect you as you grow older.

Reducing the risk of falls at home

The elderly generally tend to fall easily at home. This usually happens to those who are left alone at home or have walking disorders. Here are some tips you can follow to reduce the risks of falling at home:

  • Maintain an active lifestyle. This could include early morning Tai-chi exercises at your void decks or community centres, or doing your regular grocery shopping or housework.
  • Scan your environment to identify potential areas that may be dangerous.
  • Be aware of fall hazards and risks, especially in the home.
  • Below is a list of guidelines you can adhere to reduce such risks.
    Living Room:
    • Ensure wires and cords are untangled and kept safely.
    • Arrange your furniture in a manner that is easy and safe to move around.
    Kitchen:
    • Use a stool if you need to reach a high shelf.
    • Move items to a lower shelf for an easier reach.
    • Ensure that wires and cords are safely-tucked away.
    Bathroom:
    • Install grab rails on walls beside the toilet.
    • Use non-skid mats.
    • Consider shower chair and portable shower head.
    Bedroom:
    • Place light switches within reach.
    • Install night lights between bathroom and bedroom.
    • Get out of bed slowly to avoid dizziness.
    Stairways:
    • Keep path free of clutter and ensure that the stairways are well-lit.
    • Install handrails on either or both sides of the stairs if possible.
    Self-care:
    • Wear rubber-soled shoes at home to prevent any slipping.
    • Use walking aids if necessary.
    • Ensure regular check-ups and consume medication as prescribed.
    • Be aware of the side-effects of the medication prescribed.
    • Ensure that spills are cleaned at once.
    Proper Hand Rail Design:
    • Wall clearance = 9 cm
    • Height from stairs = 94 cm from edge of step
    • Shape for grip = 38 mm in diameter
    • Surface for adequate friction = matte varnish. Avoid chrome.
    • Hand rail must be securely mounted

Following these instructions does not guarantee that you will not fall again. However, it helps you to be aware of measures you can implement to reduce accidents. More importantly, exercising regularly is key to preventing falls. Exercising on a daily basis helps one to remain physically active, keep fit, improve muscle strength, and maintain good postural balance.

Resources

Find out more information from:

Singapore Health Services
Health Promotion Board
Aetna
Centers for Disease Control and Prevention

FAQs

1. What is syncope?

Syncope is the medical term for fainting. It is a sudden, brief loss of consciousness caused by inadequate blood supply to the brain. It is usually preceded by lightheadedness. The person usually recovers spontaneously. Similar to a fall, syncope is a symptom, not a disease. It is a common problem with many causes. These include:

  • Cardiac diseases such as a heart attack
  • Low blood pressure, fluid loss (for example, vomiting and diarrhoea), infections and drug complication.
  • Abnormal blood composition such as low levels of blood sugar or blood oxygen
  • Brain diseases such as seizures and strokes

Syncope can cause falls, fractures, brain haemorrhage and loss of independent function. You should visit a doctor if you have had an episode of syncope.

2. Should a single fall be of concern?

A fall is a symptom, not a disease. Although falls are more common in older people, they should not be accepted as a part of normal ageing. There is no acceptable number of falls and a single fall can cause serious injuries. It is therefore important that you consult a doctor even if you only had a single fall.

It is also important for patients to have regular follow-up consultations with their doctor. This will help him to manage and detect any new risk factors for falls earlier. It is also necessary to keep track of any deterioration in your health that may require changes or modifications to your environment.

3. Is there a way to prevent falls?

Falls can be prevented by simple measures, such as adjusting the dose of your medication or getting new eyeglasses. Your doctor may advise on the following:

  • Modify or adjust the dose of your medications
  • Recommend an exercise programme with balance training
  • Recommend gait training (that is, proper walking technique) and training for proper use of walking aids, such as canes
  • Correct any hazards in your home that could contribute to a fall, such as loose carpets or poor lighting
  • Treat any cardiovascular disorders, such as heart-rhythm abnormalities and low blood pressure

4. How to help people at risk of falls?

Some elderly may require a fall evaluation. It is important that the healthcare professional has the appropriate skills and experience in managing falls. This may require a referral to a geriatrician (a doctor who specialises in the care of older adults).

Your doctor will:

  • Review your history of falls
  • Review your medication
  • Evaluate your gait (that is, the way you walk) and sense of balance
  • Test your vision
  • Determine the status of your cardiovascular health, including your heart rate, heart rhythm and blood pressure
  • Review your need to use walking aids, such as canes and walkers
  • Refer you to a physiotherapist for training and balancing

It may also be necessary to have a physiotherapist or occupational therapist visit your home and assess your needs more accurately.

5. What is the role of exercise and balance training?

Older people who experience recurring falls should participate in regular exercise and balance training. The physiotherapist will be able to help you develop a programme to reduce your risk of falling. Research has shown that:

  • Training a patient's sense of balance is most beneficial.
  • Exercise needs to be sustained for patients to continue receiving the benefits.
  • Tai chi is a good form of exercise which concentrates on a person's balance and therefore helps to reduce the frequency of falls.

This article is reproduced with the permission from Agency for Integrated Care (AIC) and Singapore Sliver Pages.

For more information, please visit http://www.aic.sg/silverpages.

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