Time has made me more aware of safety issues. Maybe my concerns have something to do with survival. I see a tree hanging down, an icy snow storm, garbage laying around, or maybe something I could trip on catches my eye. This month's article focuses on a life-changing event in retrospect about a winter fall. Now it's become a lot more serious topic than I envisioned as a kid.
About a year ago I sustained a fall while walking outside. A two-inch layer of new snow hid the sidewalk and the adjacent grass. Unaware, I stepped on the edge of the sidewalk which was a little higher than the level of the grass and twisted my ankle. I hit the concrete resulting in trauma to my left rotator cuff. Fortunately, there were no head injuries or broken bones but it took quite a while to get over that tumble. I still believe I'm a lucky man.
Sadly, this year will see a lot of older adults encountering fall situations - either outside or inside the home. For the 65+ folks, the rate of fall-related injuries is nine times greater than for those under 65. Studies show that 62% of injury-related hospital admissions for this group related to falls and 5% to 25% of these injuries were serious fractures. Among other adverse consequences, Canadian statistics shows that 20% of those 65 and over will die within a year of sustaining a hip fracture. With these statistics in mind, my fall looked like just one example of a large and costly problem in our society.
The factors contributing to fall injury can be complex and include physiological, psychological, and environmental reasons. Communities, health systems, and clinical teams ought to consider these factors holistically to help create safer environments. Some things for individuals and families to watch for are feelings of weakness, loss of sensation or body awareness. Defects of vision, hearing and depth perception, effects of medications, dizziness, issues around gait, could be classed as potential perils that can lead to falls. Ideally our environments need to be tidy with clutter-free homes, clean bathrooms, clean level sidewalks, salted walkways and well-placed benches. These latter requirements for public spaces need the awareness and cooperation of city planners and governing officials.
Hospitals and nursing homes are careful to measure fall rates and to develop protocols to address fall injuries within their local contexts. For example, medications are reviewed, floors are well-maintained, and safety equipment is installed or provided (such as grab bars).
A good fall prevention program must be sensitive to many human factors including nutrition, hydration, sleep habits, vision and bone health. One of the best things individuals and families can do to prevent falls is to get at least 30 minutes of moderate-intensity exercises, such as walking, every day. Preventing muscle deconditioning it also enhances the health of other body organs/systems (such as the brain, heart, and lungs) to help preserve wellness, independence and quality of life. In the end, all community sectors must contribute to creating as safe an environment as possible for their elderly.©
Thanks to Ken Wong, Physiotherapist and Education Consultant. Regional Geriatric Program of Toronto, for assistance with research and helpful comments.