How to Prevent Falls in Older People. Part 4.
Some Important Fall Prevention Measures.
Before you read any further, it is important to state that as long as somebody is moving around, there is always the slight chance that may fall. There are no 100% guarantees that falling can be prevented unless somebody choses to lay flat on the floor and not move; this is the only place from which there is nowhere left to fall. Obviously nobody is going to do that, so the plan is to reduce the risk as far as possible, while still maintaining an acceptable quality of life.
It is important to strike a balance between maintaining safety and still being able to enjoy life. As long as somebody understands the risks they are taking, then it's their decision to make their own decisions about what is an acceptable risk and what is not. You cannot and should not, attempt to impose your decisions on somebody else. It just won't work.
It is important at this point to mention the use of restraint. The facts are quite simple. The use of restraint is an ineffective, dangerous and an ethically very questionable measure to take. Restraint is out-dated. Never even consider using it to prevent falls, in any circumstances.
Nutrition - A well balanced diet that provides sufficient energy to move around, sufficient Vitamin D and calcium to maintain bone strength and enough protein to maintain muscle condition is important. Sunlight gives us Vitamin D but in less sunny climes and for housebound people, Vitamin D enriched milk will supplement their needs. Enough fluids should also be taken as dehydration can lead to confusion. Aim for the ideal weight as underweight people have less 'padding' to protect bones should a fall occur and overwieght people have less agility and will have more difficulty in moving around.
Alcohol - Should be taken in moderation as too much will affect stability. Ideally alcohol should be taken only in the company of others so that help is available should it be required.
Excercise- Excercise can help maintain overall fitness levels, improve muscle strength, improve balance and co-ordination and may help to prevent osteoporosis. That's a great package and the even better news is that activities such as housework, gardening, walking, swimming and gentle excercise routines all work. However, if you are not used to such activity, check with your doctor for advice before you start to take on any new excercise regime.
Surveillance- We are not talking about undercover police operations here. Surveillance just means 'close observation'. Surveillance will not necessarily prevent falls from happening but it will ensure that help is close at hand should a fall occur. It will increase confidence in somebody at risk if they know that help is close by.
Surveillance could be maintained by somebody calling in a few times a day, by phone, by getting a neighbour or a delivery person to watch for signals such as curtains being drawn back by a certain time and by alarms. Be inventive and devise a mix and match option that suits the individual concerned. Remember to agree everything with all concerned and that an invasion of privacy will not be welcomed.
What to do Should a Fall Occur - Stay calm. Lie still and gather your thoughts for a few moments. If there is somebody else in the house, or if you have a phone or alarm nearby, call for help.
If there is nobody around, first check for any injuries. Slowly and gently start to move your arms and legs. Notice if there is any pain in your limbs, neck or back. If you have severe pain try to stay still until help arrives.
If you have no means of calling for help, see if you can gently pull yourself towards a telephone and dial the emergency services. If you cannot reach a phone and you have no severe pain, slowly roll onto your stomach, gradually get onto your hands and knees and crawl to a chair. Put your hands on the seat of the chair and raising one leg at a time, slowly ease yourself into a sitting position on the chair. Then check again for injuries, especially head injuries. Then call for help. You will need to be checked out for injuries that may be delayed or that you may not feel due to 'shock'.
If you are unable to get up, try to manoeuvre yourself onto a soft, warm surface like a carpet. If you can reach something to cover yourself with then use it because you can become cold very quickly when lying on the ground. If you have to wait for help to arrive, try to shift your position slightly every hour because this will help to prevent pressure sores from developing.
If there is some sort of surveillance in place, you know that help will eventually arrive. This is why surveillance is so important.
The next and final instalment will tell you where you can get further help and advice. Should you have any questions, I'd be happy to answer them for you if I can.
This hub is a synopsis from a chapter in my forthcoming book 'Fall Prevention for Older People - A Survival Guide'.