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I rarely post openly but I think this subject matter requires it. If you have an older relative/friend or are concerned about ageing then please read on.  If you don't, aren't and are immortal with perfect health then you can stop here.

Unless you have had injuries that cause you to learn to walk again on unsteady joints or an illness that affects your ability to walk, you probably haven't thought about how terrifying it is to fall.  Due to old injuries I still hesitate at stairs and prefer to walk slowly beside the handrail and I am still under 40.  The thought terrifies me and I hate the winter.  I recently started working on the strategic implementation of improvements in Older People's Care in an NHS Trust.  The material I've be working with on falls has been startling.

An elderly person falling and breaking their hip has a 30% chance of being dead within a year and a 10% chance of being dead in a month. Source BMJ 2014 .  The reasons for this are various; you're already frail and small ailments hit you hard, let alone a break and major surgery, you end up in a hospital which is an unfamiliar place where you can catch infections, are surrounded by strangers, possibly fall again, the place frightens you, it's difficult to sleep and the food is not what you are used to and you use a strange and shared bathroom.  The single biggest risk factor for a fall is that you have already fallen.

If you have concerns please consider the following:
Know that most fire services will do free fire safety checks on older people's homes
Check the house for trip hazards (rugs on landings are a nasty one)
Check their shoes/slippers fit properly.
If they are unable to wear shoes recommend socks with rubberised grips (these are standard issue in hospitals)
If they report diziness ensure any medications are checked for any cross-reactions.
Make sure the lighting is adequate for someone perhaps with failing eyesight
Immediately fix any worn carpet on the stairs.
Consider bathroom handrails.
An important but often overlooked one is if you notice they are wearing a long dressing gown or nighty that has perhaps grown to big as they have lost weight or have a dressing gown belt on which trails on the ground - sort it by safety pinning the belt to the loops and offer to buy better fitting night clothes.  Also look for mens trouser hems that trail the ground.
All of these things can help prevent a fall.

Most of all - if you notice that an elderly relative has started to have difficulty walking please do not assume it is part of ageing - ask them to see the doctor and ask for a referral to a Physiotherapist.  They really can help with quite a few problems.  Some tremors of the head can be dealt with through exercises to strengthen muscles.  Showing someone how to get up and down from the floor, especially following a fall can help to minimise or prevent injury.  And the Physio can do some basic gait analysis and look at exercises that counter the under or over use of a particular joint/limb.  Physios also run balance class for people who have fallen which concentrate on gentle exercises to improve balance and are vastly sucessfull - so much so that participants love the classes and won't leave.

If you're interested and want to know more about the subject there is currently an excellent free short course on the OU's Futurelearn platform which I can't recommend strongly enough.  It's through the University of Newcastle and is excellent - you can find it here.

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December 2016

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