Falls And The Elderly
As the world’s population surpasses 7 billion people, health care services are facing a multitude of different challenges to deal with their ageing inhabitants and the effects that coincide with the ageing process. By 2035 it is projected that those aged 65 and over will account for 23% of the total population in the UK, an increase from 17% in 2010. Within this population, falls represent the most frequent and severe cause of injury. The World Health Organisation (WHO) defines a fall as “inadvertently coming to rest on the ground, floor or other lower level”. Falling is considered a “geriatric giant” as a fall has the potential to cause considerable reduced functioning, morbidity and even mortality. Falls in the ageing population have become a modern medical nightmare as they put a large burden on the health care services. Falls that result in a hip fracture alone cost the NHS and social care an estimated £6m per day or £2.3bn per year yet the causes of most falls are preventable and injury from them can be minimised. Despite this, approximately 30% of over 65 year olds living in the community will fall each year, which increases to 42 % in the over 75 age group. There is growing evidence that suggests falls prevention strategies reduce the number of people that fall, the rate of falls and the severity of injury should one occur.
As the ageing demographic forecast becomes a reality, the challenge is to implement strategies that aid with the social and economic burden that falls place on the health-care services. One such strategy that is currently utilised by Physiotherapists is the use of exercise prescription, with progressive strength and balance training to improve patient outcomes.
Age-related deterioration in balance exerts a significant impact on the ability to perform functional activities safely, and therefore reduces an individual’s quality of life. This is because falls can often result in disability, restriction of activity, fear of falling and institutionalisation. In doing so, economic strain is placed on the health care services by providing long-term care to patients who experience a fall. However, adequate intervention can improve patient’s quality of life, and save money at the same time. It is extremely important therefore, to commence falls prevention strategies for people who are approaching retirement age to reduce the risk of injurious falls. The best strategy for reducing falls is a course of strength and balance exercises alongside regular aerobic exercise.
Tips for preventing falls in the home
Six out of every 10 falls occur at home, where we spend much of our personal time and tend to move around without thinking about our safety. Many falls could be prevented by making simple changes in your living areas, as well as personal and lifestyle changes, these include:
- removing clutter, trailing wires and frayed carpet
- using non-slip mats and rugs
- improving lighting
- immediately mopping up spillages
- not walking on slippery floors in socks or tights
- not wearing loose-fitting, trailing clothes that might trip you up
- wearing well-fitting shoes that are in good condition and support the ankle
Review Your Medication
If you’re taking medication for long term health conditions, your GP should review your medicines at least once a year to make sure they’re still right for you. It’s particularly vital that your medicines are re-assessed if you’re taking four or more medicines a day. Your Doctor may recommend alternative medication or lower doses if they feel the side effects increase your chances of suffering injurious falls. In some cases, it may be possible for the medication to be stopped entirely! See your general practitioner if you haven’t had your medicines reviewed for more than a year, or if you’re concerned that the medications you or a relative are taking may be causing or increasing the risk of falling.
Falls Prevention Exercises
Completing regular strength, balance and aerobic exercises can massively reduce your risk of having a fall. This can take the form of simple activities such as walking and dancing, or tailored exercise programmes prescribed by professionals. Many community centres and local gyms offer specialist assessments and training programmes for older people, however the exercises detailed below can be carried out at home. Be sure to ask your GP about any programmes or classes in your area that you’re able to get involved in.
Non-slip socks are a fantastic tool for anyone who is unsteady on their feet and live in properties that have hardwood or tile floors. These slippery surfaces pose a huge risk to adults of falling however wearing grippy surfaced socks or slippers will reduce this risk greatly.
Check out favourite grippy socks here!
Falls Prevention Exercises
A fantastic exercise that is often advised throughout our site! Squats will help to strengthen all lower limb muscles and will progress your ability to perform daily activities such as standing up from a chair and going up and down stairs with ease.
How to do it:
- Stand up with something stable (like a kitchen counter) in front of you for support.
- Slowly bend your hips and knees as if you were sitting down. Stop half way, before pushing yourself back upright.
Repeat 10 reps, 3 sets, twice a day.
2) Hip Abductions
Hip abductions or “sideway leg lifts” are perfect for overall lower limb strengthening but specifically work the glutes which give the hip it’s stability. How to do it:
- Rest your hands on the back of a chair for stability.
- Raise your left leg to the side as far as is comfortable, keeping your back and hips straight. Avoid tilting to the right.
- Return to the starting position.
- Now raise your right leg to the side as far as possible.
Raise and lower each leg five times.
3) Heel Raises
A great exercise for calf and ankle strengthening. Ensure you have something sturdy to hold on to for support if you are unbalanced. How to do it:
- Rest your hands on the back of a chair or counter for stability.
- Lift both heels off the floor as far as is comfortable. The movement should be slow and controlled.
- Repeat five times. For more difficulty, perform this exercise without support or with weights.
4) Wall Press Ups
Its also a great idea to focus on upper limb strength. Although it won’t directly affect your standing balance, having strong arms will help with a whole host of daily activities such as cleaning, carrying or simply standing up from a seated position. How to do it:
- Stand at arm’s length from the wall. Place your hands flat against the wall, at chest level, with fingers pointing upwards.
- With your back straight, slowly bend your arms, keeping elbows by your side. Aim to close the gap between you and the wall as much as you can.
- Slowly push yourself back to the start.
Attempt three sets of 10 repetitions. Progress by standing further away from the wall.
5) Stalk Stand
Also known as single leg stands, an easy exercise to improve strength and balance one leg at a time. How to do it:
- Start by standing facing the wall, with arms outstretched and your fingertips touching the wall.
- Lift your left leg, keep your hips level and keep a slight bend in the opposite leg.
- Gently place your foot back on the floor.
- Hold the lift for five to 10 seconds and perform three on each side.
6) Tandem Stance
Tandem walking or stance is a very difficult exercise for those who suffer with balance issues, be sure to only complete this exercise with adequate support around you, or even with supervision of a Physical Therapist/another person whilst you get the hang of it.
How to do it:
- Standing upright, place your right heel on the floor directly in front of your left toe (pretend you are walking along a tight rope).
- Hold position for 10 seconds
- Then do the same with your left heel. Make sure you keep looking forwards at all times. If necessary, put your fingers against a wall for stability.
- Try to perform at least five steps. As you progress, move away from the wall