Falls in older people

Falls are often caused by obstacles and tripping hazards in your home or in the stairwell, garden or entrance to your home. These include things like door thresholds, steps, curled-up edges of rugs and mats, and loose cables on the floor. It is easy to slip on smooth floors or loose rugs, in the shower or bathtub. Wearing loose-fitting slippers or shoes with very smooth soles, and walking in socks, can increase the risk of falls too.

Apart from that, falls are sometimes the result of health problems. Examples include:

• Weak leg muscles
• Sensory problems in the feet and an inability to feel pain and pressure, for instance due to diabetic foot or a neurological (nerve) disease.
• Dementia
• Balance problems
• Low blood pressure
• Dizziness
• Anemia
• Vision problems such as cataracts
• Chronic diseases such as osteoarthritis, osteoporosis, diabetes, Parkinson's and cardiovascular disease.

Some medications may affect your concentration and reflexes, leading to falls. Alcohol can also increase the risk of falls. People who have already had one fall are at higher risk of falling again.

It is estimated that

• 28 out of 100 people over 65, and
• 34 out of 100 people over 85

who live in their own homes fall each year. Women tend to fall somewhat more often than men do. The rate is higher in people who live in nursing homes or residential care, where 50 out of 100 people fall each year. Falls are also more likely in hospitals than at home.

Usually, falls will only result in a bruise or scrape. But about 5 to 10 out of 100 falls at home lead to injuries such as broken bones, gashes or head injuries. In nursing homes and residential care, falls often have more serious consequences. This happens in about 10 to 30 out of 100 people who have a fall there.

If a bone breaks, it is usually a bone in the forearm. Hip or thigh fractures can greatly limit your ability to do everyday activities, and often result in long hospital stays. Especially in old age, falls with serious consequences increase the risk of needing long-term nursing care.

Some of the measures you can take to avoid falls are quite simple. For example, you can go through your home to check for hazards and then take care of them or have someone do it for you. What else might be a good idea depends on your individual circumstances and health. Some useful measures may include

• exercise programs,
• walking aids such as Zimmer (walking) frames and other medical aids,
• treating health problems that can lead to falls,
• getting a new pair of glasses, and
• talking to your doctor about the medications you take.

Occupational therapists can help you to implement various measures, too. For instance, they can go through your home and identify everyday situations that involve a higher risk of falling, then suggest ways to prevent falls.

Although there's so much advice out there about avoiding falls, it's important not to become too frightened in everyday life. As mentioned before, most falls don't lead to serious injury.

Staying active can help prevent falls. Especially in older people, it's important to stay physically active and mobile if possible – that can also help you to stay as independent as possible.