Falls have been cited as one of the most common reasons people over 65 are admitted to hospital, affecting more than 40% of over 65s according to recent national statistics. This appears to worsen as age advances to over 80 years, with more than 50% of over 80s having one or more falls per year (Office for National Statistics, 2015). Falls cause fractures, head injuries and, in worse cases, deaths on a yearly basis.
There is a saying that “age does not come alone”, unfortunately. Falls occur as result of multiple factors and the most common cause of falls is general frailty, which is associated with ageing. Deconditioning and disuse (sarcopenia) muscle loss associated with ageing is a common feature in the elderly population, as are low blood pressure, confusion and acute infection, such as urinary tract infections (UTIs), acute kidney infection/injury (AKI) and dehydration. Medications have also been cited as a predisposing factor, especially in individuals taking more than four different medications at the same time.
Falls can be detrimental to an individual’s confidence and quality of life as the fear of falling predisposes individuals, especially in advanced age, to loneliness/social isolation and a reluctance to participate in society. It can also result in a fear of walking/moving.
Poor nutrition has also been cited as a cause of frailty, particularly among those with memory problems, which is especially relevant to those affected by Alzheimer’s disease and dementia, both of which have increased in the recent past.
These two conditions have also contributed to increased falls risk due to the additional pressure they have put on healthcare and social services in terms of the level of inpatient and community-based care needs for these groups.
Some of these falls are preventable in a community setting, and the Royal College of Nursing and other organisations in England, Wales, Scotland & Northern Ireland have come up with frameworks to tackle the problem.
One of the most commonly used early intervention methods is a comprehensive assessment of risk of each individual’s risk of falling, which is followed by engaging them through various pathways of management. Some of these include community-based service prescriptions and supervision of exercises aimed at strengthening, body awareness, balance and coordination. This gives the individual not only a sense of confidence but also the ability to regain their independence and participate socially, reducing loneliness.
I have worked with these groups both in a community setting and with inpatients in the South of England for Sussex, Surrey, Kent, Maidstone & Tonbridge Trusts in rehabilitation wards, A&E and in falls prevention assessments, all with outstanding feedback.
At David Physio & Sports Clinic, we provide a comprehensive assessment of each patient over 75 or with a history of falling in order to tailor the rehabilitation accordingly to restore motivation, confidence in walking, balance and to improve their independence and quality of life. We do also offer home visit services, but terms and conditions apply.