Trying not to fall Prevention of falls in the elderly

As a consequence of the increase in life expectancy, the risk of falling and presenting sequelae also increases, especially in those elderly who suffer from greater frailty or health problems.

Falls, frequent

30% of those over 65 and 50% of those over 80 fall at least once a year; and those that fall are two to three times more likely to fall again in the following year. Falls and can generate from the decrease in the quality of life of the elderly, disabilities that impede their independence in daily life, even their death, with the corresponding impact on their families and caregivers.

Age and other causes

The main predisposing factor to falls is age. However, mobility disorders (,, lack of muscle, balance disorders), nutritional problems (due to dental or digestive disorders, financial problems, etc.), and the type of home are also relevant.

In fact, half of the falls in the elderly are at home, although it is residents of long-term care centers who fall the most and suffer the worst consequences.

Main risk factors

There are two types of risk factors for falls: individual and environmental.

Individual risk factors

History of previous falls

• Age
• Female gender
• Living alone
• Taking Psychopharmaceuticals (sedatives, antidepressants, etc.)
• Multiple medications (more than four)
• Chronic illness (especially respiratory, depression and arthritis)
• Impaired mobility and gait (, instability, lack of movement)
• Fear of falling
• Nutritional deficiencies
• Cognitive impairment, dementia
• Visual disorders (cataracts, glaucoma, etc.)
• Foot problems and deformities (bunions, calluses, claw toes, ulcers, etc.)
• History of cerebral infarction,
• Acute infections and illnesses (urinary tract infections, flu, etc.)

Environmental or Extinct Risk Factors

• Environmental hazards (poor lighting, slippery floors, uneven surfaces, etc.)
• Inappropriate footwear and clothing (for example, shoes that do not support the foot well)
• Inappropriate walking aids or assistive devices
• Save different heights (stairs, curbs, entering and exiting vehicles, etc.)

General measures to reduce the risk of falls

Reducing the rate of falls and its consequences can improve the quality of life in older people, and reduce the functional, emotional and economic impact that its consequences entail. To do this, it is important to take into account the following tips:

In the bathroom…

Keep the floor dry after showering. A mat can be placed, but must be secured firmly to reduce the chance of tripping.

• Install safety rails.
• The towel rail, soap holder, shelves or holders for toilet paper must be attached to the wall, so that they do not fail when used as support points.
• Add non-slip strips to the floor of the bathtub and shower.
• In case of instability or balance problems, or to stay on your feet, use a shower chair and a handheld shower attachment (a so-called “telephone”).
• Do not close the bathroom door, if you fall inside, they will take longer to attend to you.
• Take the mobile phone to the bathroom, or if you are a user of a telecare system, shower with the alarm on.

And in the rest of the house?

• Get up carefully and, little by little, after sitting or lying down. Sit on the edge of the bed or chair until you are sure you do not get dizzy.
• The height of the bed must be such that you can get out of it and lie down without having to make efforts.
• Avoid rugs; In case of use, make sure that it is firmly attached to the ground and that there are no irregularities, wrinkles or folds that facilitate tripping.
• Wear footwear that supports the foot well, with non-slippery soles (rubber ones are adequate and must be checked for wear). High and thin heels should be avoided, as well as clogs or flip-flops, even for slippers at home.
• Improve the lighting of the bedroom and passageways. Turn on the lights when they get up at night.
• Put bulbs that give enough light (at least 60 watts or equivalent). Use screens to reduce glare and to make room lighting even. Use light shades to avoid glare from outside light, without over-darkening.
• The floor must be kept dry and free from irregularities (eg broken or moving tiles).
• Organize clothes and other objects so they can be easily picked up (especially important in the kitchen); Avoid bending over too much, standing on tiptoe, or climbing stairs or stools. Always keep the wardrobe drawers closed to avoid tripping over them.
• Do not wear clothing that is too long or too loose, as you may trip over or step on it.
• On stairs, it is a good idea to put a contrasting color at the top of the edge of all the rungs so that you can see the stairs better. For example, if they are made of dark wood, use a light color.
• Remove things you can trip over (such as papers, books, packages, power lines, and other electrical appliances) from walkways. Simplify the routes of these transit areas.
• Place fixed handrails on both sides of the stairs. When going up, it is advisable to keep at least one hand on the railing and focus on what you are doing. Also, never carry any package that prevents you from seeing the next step.
• Having a phone that they can easily reach, the best are simple mobile phones, which they can always carry with them. They must have the emergency and most used numbers (family members, emergency services, etc.) programmed.
• Assess the usefulness of telecare services, which offer portable announcers (they are usually like medals with an activating button).

These tips, while numerous, are not exhaustive. We must apply common sense to facilitate mobility in a safe way and avoid risky situations. The most difficult thing is to understand that actions such as getting up, getting dressed, taking a shower or the way of dressing have to be done in a different way than usual years ago. For many people, the need for these changes is the first confirmation of old age; But since we are not going to be able to avoid it, let us try to live it safely and fully.