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 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.
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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.
Magnitude of the problem Studies in UK shows that about 50 per cent of patients who live independently before sustaining a hip fracture are unable to do so afterwards.
About five to 10 per cent of patients die within one month, whilst around 20-30 per cent die within one year.
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The elderly 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 over medicated. There are cases where they mistakenly take same medicines under different brand names.
5. They have Diabetis Mellitus that causes neuropathy and visual problems
6. They are suffering from conditions like Parkinson’s disease that leads 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 risk of fall and subsequent fractures using simple but well validated tools. These are inexpensive non invasive screening tools that can be done in the out patient settings. Let the doctors and physiotherapist evaluate and recommend measures to reduce the risk of fall and subsequent fracture.
- 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 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 programme. Lack of exercises can make your muscle 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 Clinical Gerontologist and Wellness Consultant and Regional Medical Director Grand World Elder Care, Coimbatore