Tag Archives: falls

A fall broke her leg but not her spirit

December 9, 2013
Susan-Ryan-headshot

Susan Ryan, the federal Age Discrimination Commissioner, was feeling happy after her meeting with Sydney’s gay and lesbian community. She’d been discussing the efforts underway – which later proved successful – to make it unlawful for church-based aged care facilities to discriminate against gays. You could say she had a spring in her step as she walked to the corner of Pitt and Bridge Streets in the heart of the city. But when the lights at the crosswalk changed and she stepped off the kerb, she fell into the gutter. “The next thing I’m in the most excruciating agony with blood everywhere,” she told me.

More than five months later, she still doesn’t know what happened. She was wearing flat shoes. Perhaps she slipped on something. But when she looked at her legs, she felt shock – her left foot was facing the wrong way. This is how the nation’s chief advocate for the elderly became one of the 84,000 or so older Australians who end up in hospital each year as a result of a fall. “I’m 71 and I’d never broken a bone before,” she said. “And this was a compound fracture, two bones in the ankle broken – one had gone through the skin – and the tendons torn.”

It doesn’t necessarily take personal experience to sensitize you to the travails of others. But sometimes it can be a short-cut to deeper understanding. For Ms Ryan her experience has proven an eye-opener about the potentially calamitous consequences of a simple fall, and about the urgent need for age-friendly cities, communities, houses and apartment buildings.

“Falls in the elderly” is a topic entirely deficient in sex appeal. It lacks the newsworthiness of, say, bringing to heel remnant churches intent on banishing gays from their nursing homes. But it’s a deadly issue. Data from the Australian Bureau of Statistics shows that 1530 people aged 75 and over died as a result of falls in 2011. That’s higher than the national road toll – vehicles claimed 1290 people of all ages that year.

Since her appointment in 2011, Ms Ryan, a former minister in the Hawke government, has been a tireless advocate for older Australians. She’s worked to improve policy, laws and public awareness about “active ageing.” Engagement and independence have been her themes. And suddenly she was an invalid; ten days in hospital, three steel pins in her ankle; a fibre glass cast up to her knee for eight weeks; a wheel chair for three months, and finally a walking stick. Without her partner, Rory, she couldn’t have stayed in her flat. Even with him as a strong and willing helper, it was hard to get inside the apartment building.“There was one step that was too high to get the wheelchair up,” she said. The buzzer in her flat to allow people into the building was out of reach from the wheelchair. The step onto the balcony was too steep. She couldn’t have a shower, and needed community nurses in. She wasn’t able to cook – and cooking wasn’t Rory’s thing.

Physical recovery took its time as it does with complex breaks. But the psychological aftermath was also a factor. “I’d lie in bed thinking ‘Will I be able to walk again?’” she said. “I feared I wouldn’t get the use of my ankle back. I’m no athlete but I’ve been pretty active. I fly around Australia. I go overseas.” Perhaps the worst fear was whether the fall signalled the start of a decline. “Was this the beginning of going downhill? I had intimations of dependency,” Ms Ryan said. “I didn’t want to be someone who couldn’t make herself a cup of tea.”

Working from home helped her recovery. As she was able to get out more, she found herself being “super-cautious” and lacking confidence: “I walked down the street constantly looking at the road, the footpath, the kerbs, looking for a trap.” She started to notice things: the lack of rails on stairs; public buildings, such as the State library, where the lifts shut down at night; broken footpaths, uneven gutters, bumpy asphalt patches on the pavement; obstacles to trip over. “Being in the city is a constant hazard,” she concluded.

Though her jurisdiction is federal she’s now keen to promote greater awareness among local councils of the UN’s age-friendly cities movement. It aims to make communities safe and accessible places for older people but it’s been slow to catch on here. She’s meeting with the City of Sydney and Randwick councils, and she’s taken the matter up with the Commissioner for Senior Victorians, and will do so with the NSW ministerial advisory committee on ageing. Human error and human frailty can play their part in falls. And for many, it’s the home, not the street, that’s full of hazards. Even so, Ms Ryan says, “Those entrusted with the planning and maintenance of our cities and suburbs should be much more conscious of public safety.”

As I write this, my left foot is in a “moon” boot. I, too, broke my ankle a month ago. I was walking fast and tripped on a subsided, broken piece of pavement. My break was simple compared to Ms Ryan’s. But it’s been a tough time none-the-less. This is a huge hidden health problem incurring ballooning health costs yet our national response to falls prevention has been patchy. Medical experts tell me more can be done. I’ve no doubt Susan Ryan will be a passionate advocate. Once it happens to you, you don’t forget.

Has it happened to you or someone you know? Any ideas? Please Comment.

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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.

What’s your experience? (Click on comment)

Coming of Age is updated every Monday