There are simple and easy-to-adopt measures that will minimise the risk of falling in elders in the family, says

Dr. RAHUL PADMANABHAN

Kamala, a 70-year-old observed a gradual change in her gait over a few years. A sociable lady, she frequently visited her children in Bangalore and Pune.

Since her husband died a few years ago, she found solace and relief from loneliness in travel.

Though she had a couple of falls before, she did not think too much about it and never thought it significant enough to discuss them with her doctor.

One night, she took a fall on the way to the toilet and broke her hip. She was operated upon but couldn’t walk again. She is today bed-bound and miserable. The fall changed her life.

The magnitude of the problem

Studies in the UK show that about 50 percent of patients who live independently before sustaining a hip fracture are unable to do so afterward.

About five to 10 percent of patients die within one month, whilst around 20-30 percent die within one year.

The elderly are more likely to fall because:

1. They are likely to have weak bones that can lead to fractures

2. They are on sleep aids, anti-epileptic, anti-psychotic or anti-hypertensive medication that could cause instability

4. They are overmedicated. There are cases where they mistakenly take the same medicines under different brand names.

5. They have diabetes mellitus that causes neuropathy and visual problems

6. They are suffering from conditions like Parkinson’s disease that lead to balance and coordination problems.

7. They may have urinary incontinence which results in them waking up frequently at night.

8. They wear inappropriate footwear

9. They can’t see too well

10. They are depressed

11. Their muscles are weak

12. Their living area has poor lighting, is cluttered room, has no handrails and supports in toilets, etc.

Prevention:

Elder care specialists can assess the risk of falls and subsequent fractures using simple but well-validated tools. These are inexpensive noninvasive screening tools that can be done in outpatient settings. Let the doctors and physiotherapists evaluate and recommend measures to reduce the risk of falls and subsequent fractures.

– The patient’s medicines should be regularly reviewed by the doctors. Sometimes medicines on their own or when combined with other medication can cause drowsiness and therefore precipitate falls.

– Medications can help with incontinence. (Simple measures like scheduled voiding at regular intervals and avoiding fluid intake after 4 PM can help).

– A physiotherapist should evaluate the footwear

– There should be a regular eye check-up

– Begin a regular exercise program. Lack of exercise can make your muscles weak and increase your chances of falls

– Make your home safer by removing things you can trip over (like rugs, papers, books, clothes, and shoes) around areas where you walk.

Dr Rahul Padmanabhan is a consultant in Geriatrics and Gerontology with a decade of experience in elder care. He specializes in home and community-based geriatrics and is currently the medical director of Dr Rahul’s Elder Care, Coimbatore.

Dr Rahul’s Elder Care is a top geriatric Care service provider in Coimbatore.