A fall is defined as an event which results in a person coming to rest inadvertently on the ground or floor or other lower level. Falling Injuries may be fatal or non-fatal though most is non-fatal. For example, of children in the People’s Republic of China, for every death due to a fall, there are 4 cases of permanent disability, 13 cases requiring hospitalization for more than 10 days, 24 cases requiring hospitalization for 1–9 days and 690 cases seeking medical care or missing work/school. While all people who fall are at risk of injury, the age, gender and health of the individual can affect the type and severity of injury.
Risk factors of Falling Injuries
Below mentioned are the most common risk factors:-
Age is one of the key risk factors for falls. Older people have the highest risk of death or serious injury arising from a fall and the risk increases with age. For example, in the United States of America, 20–30% of older people who fall suffer moderate to severe injuries such as bruises, hip fractures, or head traumas. This risk level may be in part due to physical, sensory, and cognitive changes associated with ageing, in combination with environments that are not adapted for an aging population.
Another high risk group is children. Childhood falls occur largely as a result of their evolving developmental stages, innate curiosity of their surroundings, and increasing levels of independence that coincide with more challenging behaviors commonly referred to as ‘risk taking’. While inadequate adult supervision is a commonly cited risk factor, the circumstances are often complex, interacting with poverty, sole parenthood, and particularly hazardous environment.
Across all age groups and regions, both genders are at risk of falls. In some countries, it has been noted that males are more likely to die from a fall, while females suffer more non-fatal falls. Older women and younger children are especially prone to falls and increased injury severity. Worldwide, males consistently sustain higher death rates and DAILY’s lost. Possible explanations of the greater burden seen among males may include higher levels of risk-taking behaviors and hazards within occupations.
Other Risk Factors Include
- Occupations at elevated heights or other hazardous working conditions.
- Alcohol or substance use.
- Socioeconomic factors including poverty, overcrowded housing, sole parenthood, young maternal age.
- underlying medical conditions, such as neurological, cardiac or other disabling conditions;
- Side effects of medication, physical inactivity and loss of balance, particularly among older people
- Poor mobility, cognition, and vision, particularly among those living in an institution, such as a nursing home or chronic care facility
- Unsafe environments, particularly for those with poor balance and limited vision.
Diseases That Can Increase the Risk for Falling Injuries
Certain diseases or medical problems can pose an increased risk for falls. It is important that symptoms such as muscle weakness, dizziness, light-headedness, decreased sensation in the arms and legs, and difficulty with walking and balance be evaluated by a physician to determine the cause of the symptoms and initiate or modify existing treatment where possible to address the problem.
The following are some examples of conditions that can increase risk of falls:-
- Parkinson’s disease impacts gait, balance, and coordination.
- Alzheimer’s disease distorts judgment and perceptions of physical limitations. In later stages limited mobility and impaired judgment put individuals at high risk for falls
- Hypotension (low blood pressure), can cause lightheadedness or dizziness especially when changing position (e.g., going from lying to sitting or sitting to standing)
- Strokes can lead to weakness or paralysis and an increased risk of falls.
How to Reduce the Falling Injuries
Evaluate the Risk for a fall
A comprehensive fall prevention effort should consist of an annual medical evaluation that assesses blood pressure, vision, hearing, balance, muscle loss, mental status, and a review of all medications and supplements taken. It should also include a thorough evaluation of the physical environment in which the person is living. If you are concerned for someone who is disabled or an older person who may be at risk for falls, check with your local Area Agency on Aging to determine if they can suggest programs or individuals who can assist with an in-home safety evaluation. Sometimes occupational or physical therapists can come to the home to evaluate the bathrooms and living quarters to suggest safety improvements. Changes could be as simple as adding a railing or installing grab bars in the shower, or could be as complex as building ramps, widening doorways, or remodeling the living area. These modifications can help make the home a safer place and reduce the risk of falls.
Basic steps to Reduce/Prevent Fall
In addition to fall prevention strategies already mentioned, the following steps can help prevent Falling Injuries and are especially important for older adults and others at risk for falls:-
- Avoiding sudden changes in position especially if someone has low blood pressure or is taking medications to lower blood pressure or others that may cause dizziness, balance problems, or light headedness. In the morning, he or she should sit at the edge of the bed for a moment before standing up.
- Wearing supportive footwear with non-slip soles and low heels.
- Not wearing smooth-soled slippers or socks on smooth floors such as wood or linoleum.
- Using caution when walking on thick pile carpets.
- Walking carefully outside, particularly when it is icy or slick.
- Limiting alcohol intake.
- Removing reading glasses when performing other activities.
- Taking medications as prescribed and reporting any side effects as soon as possible.
- Install handrails on both sides of stairways where possible.
- Use non-skid strips in the tub and shower.
- Mark the first and last stair with a strip of bright paint or colored adhesive tape made especially for stairs.
- Avoid slippery surfaces. Clean up spills on the kitchen floor quickly and use a rubber pad in the bath tub to prevent a child from slipping and falling.
- Discourage play near windows and patio doors which could lead to a fall through glass.
- Use foam carpet padding, double-sided tape, or a rubber pad under area rugs to keep them from sliding.
- Never allow a child under age six to sleep in the top bunk of a bunk bed.
- For older children, if a bunk bed is not against a wall, use guardrails on both sides. No matter how old the child is keep guardrails in place on the top bunk as children can roll in their sleep.
- Make phones easily accessible from various rooms in the home, so that you will not have to get up quickly and risk falling when trying to get to the phone.
- Keep daily items easily accessible so you do not have to get up on a stool or ladder or bend over to get them.
You should also ensure you know how to properly use any prescribed assistive devices such as walkers, canes, or wheelchairs and that they are in good working order. If not used properly or not maintained, assistive devices can increase the risk of a fall. Something as simple as a worn down rubber tip on a cane could be a hazard. A physical therapist can help evaluate the appropriate device for a particular individual and provide training in its use.