Fall is the main cause of accidents in the elderly, as about 30% of people over 65 fall at least once a year, and the chances increase even more after the age of 70 and as age increases.
The occurrence of a fall can only be an accident, however, it can also indicate problems related to the health of the elderly, in addition to causing very negative consequences, such as reduced functions, the need for hospitalization or institutionalization, which is living in nursing homes. rest or nursing homes.
In addition, if the elderly person has had previous falls, the risk of having new falls is greater, so it is very important that prevention begins before this type of accident happens, adopting a healthy lifestyle, with practice physical activities to maintain muscle mass and bone calcium, balanced nutrition, and control of chronic diseases with medical follow-up.
The main risk factors for falls in the elderly include:
1. Sedentary lifestyle
The lack of physical activities leads to loss of muscle strength, balance and flexibility of the joints, which worsens physical performance measured by gait speed or agility to sit and stand, and leaves the elderly more fragile and at greater risk of falls .
Sedentary lifestyle is very common in old age, as the practice of exercise is not encouraged among the elderly, which is a mistake, because the less the body moves, the greater the decline in physical conditions and capacities. The good news is that in many cases this loss can be recovered, in whole or in part, although it is not easy. Learn how to prevent muscle loss in the elderly and how it is possible to recover.
2. Dementia or mental confusion
Cognitive decline is usually caused by illnesses such as dementia by Alzheimer's or Parkinson's, for example. This situation leads to the risk of falls as it causes impairment of posture, perception of the body, the reaction of the limbs during movement, in addition to leading to less muscle strength, reducing balance.
In addition, in cases of advanced dementia, it is common for the elderly to present episodes of agitation and lowered mental states.
3. Excessive use of medications
The use of many medications, especially when 5 or more, is a situation known as polypharmacy, and if it is not well monitored it can cause side effects or combinations of drug effects. Thus, the consequences may be the existence of symptoms such as dizziness, drowsiness and drop in pressure, which can cause falls.
Some of the drugs most related to these effects are antihypertensives, diuretics, sedatives or sedatives for sleeping, some antidepressants, antipsychotics and opioids, for example.
4. Home environment
An environment without proper adaptation for the elderly's locomotion, with slippery surfaces, poor lighting, absence of handrails for support and with many carpets or steps is one of the main risk factors for falls. Observing this situation is very important, as it is much more common for the fall to occur at home than in the external environment.
The use of inappropriate shoes, such as flip-flops, such as Hawaiian shoes, or shoes with slippery soles, is also a cause of falls and should be avoided.
5. Impaired balance
The balance can worsen for several situations, mainly for orthopedic diseases or that cause dizziness, such as labyrinthitis, postural hypotension, cardiovascular, neurological or psychiatric diseases, endocrine alterations, as well as the use of medicines.
In addition, changes in the perception of the environment caused by visual difficulties, such as presbyopia, cataracts or glaucoma, or by hearing impairments are important causes of loss of balance. This perception can also be impaired by loss of skin sensitivity, caused by diabetes, for example.
6. Diseases
The presence of both chronic diseases, citing arthritis, osteoarthrosis, osteoporosis, cardiovascular diseases, lung diseases, depression or insomnia, as well as acute ones, such as infections, cardiac arrhythmia, stroke or, even, after undergoing surgery, for example, are associated greater ease of falls in the elderly, both due to impaired mobility and causing greater fragility and dependence.
The greater the number of diseases, or the more severe, the greater the limitation to exercise day-to-day activities, therefore, it is important that each disease is detected and treated properly, based on regular medical monitoring.
7. Incontinence
Incontinence, both urinary and fecal, makes the elderly feel the need to quickly go to the bathroom, which causes the risk of falling. It is common for the incontinent elderly person to experience episodes of falls at night, as they may try to get around while it is still dark or because they feel dizzy when they get up.
8. Malnutrition
Inadequate nutrition leads to an increased risk of disease, in addition to favoring the loss of muscle mass, fragility and damage to physical performance. Elderly people who have diseases that make it difficult to swallow food, especially if they use probes, or who have difficulty getting around and preparing their food are at greater risk, and caregivers should pay special attention to the provision of food in the appropriate quantity and quality.
Health consequences of falls
Falls can have serious physical and psychological consequences for the elderly, and bone fractures, especially ankle, knee, femur, hip and forearm, in addition to joint injuries and head trauma, can be very limiting and be responsible for the need to be bedridden for a long time and cause a great deal of dependency and reduced quality of life.
As a result, the elderly may become more limited, with worsening activity levels and functionality, the need for hospital admissions more frequently and, in some cases, this may lead to the need for daily care by a caregiver or institutionalization.
The psychological consequences include shame, loss of self-confidence, anxiety and depression. Another serious consequence is the post-fall syndrome, a situation in which the elderly person has a fear of falling again and loss of security to move around, and this makes them want to move less and avoid walking, bringing serious effects related to sedentary lifestyle, which include frailty, muscle atrophy and increased dependence on daily activities.
How to prevent falls
About 70% of falls happen indoors, in their various environments, such as bathroom, kitchen, living room, stairs and garden, so it is very important that the entire space where the elderly walks is well adapted for their mobility and for avoid accidents. Thus, it is very important to follow some guidelines, such as:
- Perform physical activities, such as tai-chi, swimming, walking or weight training, for example, as a way to maintain or recover muscle strength, balance, joint flexibility and stimulate bone health. Check out some excellent exercises that are suitable for the elderly;
- Physiotherapy, especially when movement is limited, important for training gait, posture, balance and flexibility, as well as instructions on how to lift and carry out room transfers;
- Have a good medical follow-up, preferably with a geriatrician, to perform an appropriate screening and treatment of diseases that can alter the elderly's ability to move around, provide guidance to the family, in addition to limiting the use of medicines to only those that are essential, if overuse of medications, a situation called polypharmacy;
- Treat possible changes in vision and hearing, with the ophthalmologist and otolaryngologist, to improve the senses and balance;
- Keep the house environment well lit and adapted, with non-slip floors, adapt handrails to allow easier mobility, especially in bathrooms, corridors or near the bed, avoid carpets, objects along the way and steps along the house. It is also recommended to avoid beds that are too low or too high. Learn more about adapting the home for the elderly;
- Wear well-fitting footwear for the elderly, which is comfortable and well attached to the foot, preferring an orthopedic shoe, sneakers or sandals with adjustable velcro straps, avoiding open slippers, such as Hawaiian shoes, or shoes with heels. It is also important that it is non-slip, with a rubberized sole;
- Using a support, such as a cane or a walker, may be necessary to avoid falls in the elderly who have some limitations in walking, which can generate more confidence and security;
- Have a balanced diet, rich in proteins, milk and dairy products, vegetables, whole grains and 6 to 8 glasses of water a day, so that good nutrition and hydration is guaranteed.
If the elderly need to go to the bathroom in the middle of the night, it is recommended that it is as close as possible, easily accessible and that the environment can be lit easily. Otherwise, it is preferable to consider the need for diapers or a potty at night, avoiding a fall in the attempt to get to the toilet. Check out other tips on how to prevent falls in the elderly.
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