Not waving, falling…

March 25, 2013
Fear-Of-Falling google

About two years ago I fell down the stairs in my house – the stairs I race up and down a dozen times a day; actually I flew off them in spectacular fashion, landed spread-eagled on the floorboards, and broke my wrist. It was excruciating. I’ve never viewed the stairs in the same casual way since, nor torn down them in the old heedless manner, nor worn the floppy slippers I blame for tripping me up. A fall can do that to you. It can shake you up and shake your confidence.

Imagine what it’s like for our parents or other elderly people to fall. I was shocked to read in new data from the Australian Bureau of Statistics that 1530 people aged over 75 died from falls in 2011. That’s higher than the national road toll. Vehicle accidents claimed 1290 people of all ages in that year. When you take into account falls are the single biggest reason for admission to hospitals by people aged 65 and over, and tens of thousands are hospitalised by them each year, you begin to see the dimension of a huge, hidden national health problem.

But who takes falling over seriously? Who thinks falls in the elderly are like car crashes?  Federal and state governments sort of take it seriously, aware of the ballooning health costs involved. National falls prevention guidelines were issued by the Australian health ministers in 2009. But the message isn’t getting through. ”It’s fallen off the agenda,” Dr Frances Batchelor, a research fellow at the National Ageing Research Institute, told me. “We need a road safety approach to reduce falls amongst the elderly.”

I certainly didn’t take falls seriously. As a newspaper reporter, my eyes used to glaze over the studies on “falls prevention” that occasionally crossed my desk. Boring, trivial…… not like the binge drinking epidemic, or the obesity tsunami or even the Alzheimer’s crisis. But then my father-in-law fell over. Yes, he was 91 but he was still healthy enough and mentally alert. He was at a shopping centre when he tripped and cracked his head. The head mended but he never did, not really. It was the trigger for his sad, 18-month decline.  More recently I saw an elderly man in his 80s fall right in front of me on a jagged bit of footpath. He crashed down heavily, face-forward. He was a big man and was badly shaken. As we talked, I learnt he was single, lonely and on an outing to our local cinema. I wondered whether the fall would undermine his confidence in venturing out again. Fear of falling, the experts say, can be as debilitating as a fall itself. Physically, he was lucky. If an elderly person breaks a hip in a fall, 15 per cent will die as a result and one-third won’t survive a year.  And falls are a huge problem in aged care residences.

Yet falls are preventable. Those of us in our 50s and 60s would be wise to start now to help ourselves avoid them. And the best advice?  Exercise; you just can’t get around it. It comes from one of the key experts, associate professor Jacqueline Close, director of the falls and injury prevention group at Neuroscience Research Australia. Exercise for strength and balance is top priority for baby boomers and for our parents. “Better to get the older people on an exercise program so they don’t need a walking stick,” she said.

At a personal level we can fall-proof the homes of our parents. I’ve known people to trip over electric cords and rugs, and floppy slippers are a hazard. As a nation there are gaping holes in our approach to falls prevention. Research shows for elderly people, especially those in aged care residences, Vitamin D supplements are highly effective in preventing falls and their serious consequences. But it’s low priority here. On the other hand, more elderly people need help to wean themselves off sleeping tablets which are contributors to falls. Professor Close said hospitals are often woeful in following up people with fractures to ensure they’re treated for osteoporosis if necessary. Treatment would greatly reduce the chance of further fractures. And bi-focal and multi-focal glasses are not a good idea in the elderly. “I’ve seen two hip fractures this week which I put down to bi-focals,” she said.

Around 84,000 elderly people hospitalised and 1530 dead from falls in a year – it’s a worsening national health problem and not trivial at all.

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