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Fall in Older Adults and Prevention

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Balance problems and falls are common in older adults. The consequences of falling can lead to illness, fractures, disabilities, loss of independence, and even death.

Risk factors for falls can be divided into two main categories:
  1. Internal Risk Factors: These are factors resulting from changes in the body:
    1. Changes in vision: Such as presbyopia or blurred vision.
    2. Changes in the musculoskeletal system: The degeneration of joints and ligaments can lead to limited mobility.
    3. Changes in the urinary system: Frequent urination at night, which can increase the risk of falling.
    4. Factors caused by illness, for example:
  • Cardiovascular and circulatory diseases: Such as low blood pressure when standing up from sitting or lying down, leading to dizziness or fainting.
  • Neurological conditions: Such as dementia, Parkinson’s disease, or cerebrovascular diseases (stroke), which can lead to weakness in the limbs, affecting movement and balance.
  • Other physical conditions: Hospitalization or acute illness requiring extended recovery time.
    1. Side effects from medications: Such as blood pressure medications, sedatives, or antidepressants.
  1. External Risk Factors: These include environmental factors inside and outside the home, such as slippery floors, uneven surfaces, inadequate lighting, lack of handrails, disorganized surroundings, inappropriate use of household appliances, and wearing shoes that do not fit properly.
  1. Fractures: Common fractures in older adults occur in the hip, spine, and wrist.
  2. Head injuries: These can lead to bleeding in the brain or under the meninges.
  3. Immobility: Prolonged bed rest due to immobility can increase the risk of urinary tract infections, pneumonia, and pressure sores.
  4. Fear of Falling: This can cause older adults to avoid walking or leaving the house, leading to a loss of confidence, depression, and potentially resulting in functional decline.

 
There are several risk factors contributing to falls in older adults, involving various body systems. Therefore, preventing falls is essential and can be achieved through the following measures:
  1. Assess and address fall risk factors: Identify potential risks and take corrective actions. For example, the bedroom should be on the ground floor to avoid the need to climb stairs. It should also be positioned for easy access to the bathroom. The bathroom floor should have a rough texture, and grab bars should be installed for safety to prevent slipping. Adequate lighting should be provided throughout the house and along hallways.
  2. Promote health through exercise: Encourage physical activity, particularly exercises that strengthen leg muscles and improve balance, such as Tai Chi.
  3. Evaluate medication use: Medications such as sedatives, anti-anxiety drugs, antihistamines, and painkillers can cause side effects like dizziness, drowsiness, and confusion, increasing the risk of falls. Medications should be used cautiously in older adults and under medical supervision.
  4. Wear appropriate footwear: Choose comfortable shoes that reduce the risk of falling, such as:
  • Low heels and rounded edges: The soles should have a rubber tread to enhance grip and prevent slipping.
  • Closed-back shoes: The heel and ankle area should be sufficiently firm to provide ankle support and improve balance.
  • Wide-toe shoes: These shoes have a broader toe box, allowing the toes to move freely and comfortably.
  • Slightly raised toe area: The front of the shoe should have a slight upward curve to help with stability and prevent tripping.
  • Adjustable shoes: Shoes such as sneakers or those with straps allow for size adjustments to ensure a proper fit for older adults.
  1. Use assistive walking devices: These devices help provide stability and improve mobility, reducing the risk of falls, especially for older adults who have difficulty with balance, muscle weakness, or walking problems. Examples of assistive devices include canes, walkers, walkers with front wheels, or walkers with a seat.
Last modify: January 08, 2025

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