Key messages on prevention of falls in the elderly

 

Falls occur frequently and are the most common injury among the elderly. In China, injuries resulting from falls are the top cause of death for those aged 65 and above. Falls are also the top cause of traumatic fracture in the elderly as well as the most commonly cited reason that they seek treatment at medical institutions.

 

Falls can cause bone fracture and head injury in the elderly, which seriously affects their health and life quality and causes pains to them and their family members. As people grow older, the risks of falls and the injuries or death resulting from them gradually increase. The older people grow, the more attention they should pay to preventing falls. 

 

 

A fall is usually not the result of a single factor, but is connected with body functions, health conditions, behaviors, medications, and styles of dress.

 

Aging can lead to weakening of balance and muscles, which is the key physiological factor that causes the elderly to fall.

 

The risk of falls increases if seniors wear slippery shoes, high heels or ill-fitting clothes, or if they move too fast and engage in unsuitable sports.

 

Common environmental factors that cause falls in seniors include slippery floors, areas with barriers and insufficient lighting, lack of support when getting up and furniture that is too high, too low or improperly placed.

 

The risk of falls also increases if old people take multiple medications at the same time, such as medicine for nervous system diseases, cardiovascular diseases, eye disease and so on.

 

The awareness of fall prevention in the elderly can be raised with relevant knowledge and mastering of basic skills for fall prevention.

 

Seniors who have had falls before are at a high risk of falling again and should pay extra attention to the risk.

 

Aging is a normal physiological process, resulting in the changes in physiological function and morphology of the human body. It is a universal experience that everyone experiences, although there are individual differences.

 

Old people should actively accept and gradually adapt to this natural process, adjusting their behaviors and habits accordingly. In daily life, the elderly should take it slow in turning round, standing up, opening doors, picking up the telephone and going to the toilet. Those with reduced mobility should proactively use assistive devices. They should not stand when putting on trousers, climb to get things or take strenuous exercise.

 

Sports can reduce and delay the effect of aging of body functions and decrease the risk of falls in older people. There are some sports that can help older people to comprehensively exercise body functions, including Tai Chi (Chinese shadow boxing), Ba Duan Jin, five-animal exercise (imitating the movements of a tiger, deer, bear, ape, and bird), yoga and fitness dancing. In particular, seniors should enhance exercises on the muscles of their lower limbs. Endurance can be improved through aerobic exercises such as brisk walking and fitness dancing.

 

Old people should choose suitable sports and levels of intensity. They should take warm-up exercise before doing sports and relaxation exercise after doing sports. They are advised to not take exercise when they feel uncomfortable and to reduce outdoor activities during bad weather. 

 

It is quite normal to have concerns about falls. Seniors should not stop exercising out of an excessive fear of falls. Stopping exercise will accelerate the aging of the body, further increasing the risk of falls.

 

Older people should wear well-fitting clothes that are not too long, too tight or too loose and can keep them warm without affecting their physical activities.

 

Wearing well-fitting and safe shoes is important in maintaining the balance of the body. The shoe soles should be slip-resistant and supportive for the feet. The heels should not be too high and the material should be soft and good for keeping the wearer warm with good air circulation. It is better to wear shoes with a buckle design and if a senior wears lace-up shoes they should make sure the shoelaces cannot easily loosen.

 

 

Older people should choose and use suitable assistive devices under the guidance of professional staff. The most used assistive devices include walking sticks, walking aids, wheelchairs, squatting pans, bath chairs, nursing beds, vision compensation facilities and hearing aids. 

 

Walking sticks can not only support old people to walk, but are also convenient and effective for preventing falls. Seniors with decreased walking capacity should proactively use walking sticks. The handle of a walking stick should be crooked, the stick should be solid and durable, its length should be not too long or too short and its bottom should feature non-slip rubber pads. 

 

The elderly should pay attention to the outdoor environment and the risk factors that may cause falls in public places, trying to choose barrier-free, non-slippery routes with good lighting. They should stand steadily and move slowly when walking up and down stairs, standing up, taking public transportation or using escalators. The elderly should take a rest according to the body’s conditions in order to avoid falls when they do exercise or go out. They should reduce outdoor activities when it is snowing, raining or windy. When going out, they should carry with them emergency cards and mobile phones and avoid travelling at night.

 

The elderly fall most frequently at home. An aging-friendly home environment helps to prevent falls. The floor should be slip-resistant and dry. Bathrooms and kitchens should use non-slip mats.

 

The rooms should have appropriate lighting. They should adopt multi-light source lighting and avoid using reflective materials in large areas. The lamp switch should be within easy reach.

 

Set a bedside table for the convenience of older people to get things. Common items should be placed within easy reach. Beds and chairs should be of an appropriate height and not too soft. Furniture placement and room layout should be reasonable to keep the space barrier-free. Shower rooms, toilets, stairs, beds and chairs should be equipped with handrails. 

 

Osteoporosis is a common systemic bone disease in the elderly, and increases the risk of bone fracture after falls. 

Older people should have a balanced diet that includes low-salt foods rich in protein and calcium, such as dairy products, bean products, nuts, eggs and lean meat. They should avoid smoking and excessive drinking and take medicines that affect bone metabolism with caution. They should get sunlight for at least 20 minutes a day if the weather conditions permit.

 

Take appropriate exercises to prevent osteoporosis. 

 

Old people should periodically assess osteoporosis risk and take bone mineral density tests for early detection of osteoporosis.

 

Once diagnosed with osteoporosis, old people should take standard and proactive treatment under the guidance of medical staff and pay attention to fall prevention. 

 

Taking multiple medications simultaneously may increase the risk of falls in the elderly.

 

Older people should tell the doctor what medicines they have taken when they seek medical advice. If the doctor prescribes a new medicine, they should ask if it increases the risk of falls. 

 

If you fall, do not panic. Do not hurry to get up before judging for yourself whether there is injury, the location of the injury, the severity, and whether you can stand up by yourself.

 

If you cannot stand up by yourself, you can seek help by shouting loudly, making telephone calls, knocking on doors, floors and plumbing pipes. Use cushions, clothes and bed sheets to keep warm when waiting for help.

 

If you can stand up by yourself, you should get up slowly with a support around you. After getting up, take a short rest and seek help after your physical strength has partially recovered.

 

Whether you are injured or not after the fall, you should inform your family members and medical staff and have a checkup. 

 

 

If older people fall, the rescuers should confirm the safety of the surrounding environment. When carrying out the rescue work, the rescuers should first judge their awareness, breath and other body conditions. Avoid aggravating the injury by blindly propping up the injured. Do not violently shake them; keep them warm.

 

If the fallen person is unconscious or seriously injured, please help by making emergency calls immediately. If they are conscious, please give comfort and psychological support.

 

If the rescuers have some first-aid skills, they can give the fallen preliminary treatment. If not, they can seek other people's help.

 

Family members and caregivers of seniors should learn fall prevention skills and share them with the elderly.

 

Family members and caregivers should encourage and accompany older people to take fall risk assessment at medical institutions. They should have more communication with the elderly to help them to correctly understand and actively deal with aging as well as encourage them to take exercises scientifically.

 

Caregivers should provide walking sticks, non-slip mats, senior-friendly toilets and bath chairs for the elderly in need and construct a safe home environment for them. 

 

 

 

Falls may threaten every senior's health. Prevention of falls is related to the family of every senior citizen and involves all places where they live. Therefore, it requires the participation of the whole society, which should care for the elderly, publicize fall prevention in seniors and build an elder-friendly environment.