Categories: Geriatrics

If your elderly loved one has a fall it’s important to report to a doctor

Health Regulatory and Health Monitoring agencies around the world have published enough data on a common condition that affects senior citizens – falls, or falling incidents! Every year, millions of people over 65 years of age fall, around the world. In fact, more than one out of four people in this age-group fall every year.

Falls may appear like a minor problem but they are not. Every year, falls contribute to several hip fractures and deaths due to brain injuries. Elders who have fallen once are at the risk of falling again. Most importantly, the fall may just be a symptom or consequence of a larger condition. So ignoring the fall means, the underlying condition may not be addressed in time. This can be risky to the elder, in the long run.

Risk Factors for falling

So why do elders fall so often? What are the reasons or health conditions that cause falls?

The risk factors can be divided into 4 groups:

Health-based risks. Elders can suffer from balance problems, skeletomuscular weakness which results in weakened legs or lower-body weakness, chronic illness such as dehydration, Urinary Tract Infection (UTI), arthritis, osteoporosis, anemia, pneumonia, heart conditions such as Atrial Fibrillation, strokes which cause weakness in one side of the body, Parkinson’s disease, Lyme disease, hormonal disorders, Vitamin D deficiency, vision problems, foot pain due to arthritis or plantar fasciitis, etc. The side-effects of medications such as sedatives, tranquilizers, opiate pain-killers, anti-cholinergics, diabetes and blood-pressure medicines can also cause falls. These risks are unique to each elder.
Lifestyle-based risks: Regular consumption of alcohol, use of psychedelic drugs, and vigorous exercise can cause the elder to lose balance once in a while.
Environmental risks. These pertain to hazards at home, or outdoors, such as carpets and rugs that are loose, icy sidewalks, narrow or steep steps, wet floors, steep ramps, and risky footwear such as high heels. So also, improper use of a walker, cane or crutch can also cause falls.

Also Read: How to Create a Safe Environment for Seniors?

Unexpected Triggers: These are sudden or occasional eventualities that cause the elder to lose balance. These could be – a strong dog pulling on the leash, a cat that suddenly darts across, a diabetic suddenly experiencing low blood sugar, or sudden bouts of low BP.

Why do elders hide fall incidents?

Its alarming to note that although more than one in 4 elders over 65 years of age may experience a fall, less than half of them report this to a doctor or family member. This could be due to:

Not wanting changes in the daily routine after the fall
Not wanting the family to go through financial stress
Not wanting to be physically dependent on family members
Not wanting to be moved in to an assisted-care facility
Fear of discovering the underlying cause behind the fall

Why report to a doctor?

Some elders may justify the above reasons, but it is in their own self-interest to report falling incidents. This is because:

In elders with a weakened skeletomuscular system, falls can cause fractures in the wrist, ankle, arm and hip. Hip fractures can be serious and in some cases may require a hip-replacement.
Falls are a huge risk-factor for brain damage caused by head injuries. They can trigger a stroke, brain hemorrhage or neurological damage to the brain. And elders who are taking blood-thinners face the risk of increased bleeding subsequent to the fall.
If the underlying condition is not treated immediately, there is a high risk of falling again and again. With each fall, the extent of injuries can get worse due to age-related conditions.
Even if the elder has not been injured after the first fall, he/she may develop a phobia around falling. This can cause the elder to venture outdoors lesser than before. Unfortunately, this has the opposite effect. Lack of enough exercise can weaken the lower-body further, which increases the risk of more falls. In fact, the elder should become more regular with exercise after the first fall.

What steps will the doctor take?

Once the elder along with a caregiver meets a doctor, the latter will conduct a series of tests and examination, and recommend certain measures.

An assessment for all the above mentioned health-based risks. The doctor will ask for symptoms to zero-in on the specific condition.
Blood pressure and pulse readings, when the elder is sitting, and then standing. These can detect balance problems or the risk of dizziness due to various reasons.
Blood tests: These can detect the risk of high or low – BP and blood sugar. Abnormalities in BP and blood-sugar can cause balance issues.
Vitamin D test, to check for Vitamin D deficiency
Review of all medications being taken by the elder in the last 1 year
Evaluating cardiovascular, respiratory and neurological health
Assessment of Gait and balance issues due to a weakened skeletomuscular system. The doctor may recommend a bone-densitometry test if required.
Assessment of vision or podiatry (foot-related) conditions

Outlook

Like with any other health condition, even when it comes to falls, prevention is better than cure. There are many lifestyle-related and environment-related risks that can be pre-empted by careful planning. Earlier, we have published an article on how to keep your home safe for elders.

To know more about preventive measures that can pre-empt falls of your elders, consult a reputed hospital. A team of doctors there will advise you in this matter. Changes made thereafter can minimize the risk of your elder falling and ensure a better quality of life to him/her.

Reviewed by Dr Suresh S Venkita, Group Medical Director, Kauvery Hospitals

Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai, Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.

Chennai – 044 4000 6000 • Trichy – Cantonment – 0431 4077777 • Trichy – Heartcity – 0431 4003500 • Trichy – Tennur – 0431 4022555 • Hosur – 04344 272727 • Salem – 0427 2677777 • Tirunelveli – 0462 4006000 • Bengaluru – 080 6801 6801