Effects of falls

Falls are not only more likely to happen in older people but they are also more likely to result in serious injury. Elderly people are not as well able to save themselves from a fall as younger people. They are less stable with slower reflexes and are therefore less effective in preventing falls.

Injury

Approximately one in ten falls results in serious injury and 10% of visits to hospital emergency are as a consequence of falls. The most common fractures are fractured hip or femur (thigh bone) and Colles fracture (involving the end of the forearm) but other serious injuries can occur such as skull fracture, head injury, sub-dural haematoma, (bleeding on the brain following a head injury) other fractures and soft- tissue injuries. Burns can be sustained if he/she falls against a radiator and is then unable to move.

Fracture of the femur is an example of a very serious complication of a fall as it involves hospitalisation, surgery and a convalescent period. The treatment can itself be complicated by an adverse reaction to the anaesthetic, infection of the wound, post- operative pneumonia, immobility and pressure sores, slow and delayed recovery, pain and stiffness of the hip joint and reduction of future activity for fear of further falls.

The consequences of the fall itself may be made more serious by a delay in discovery when the person stays on the floor or ground for a long time and this can lead to hypothermia (especially in the winter) or dehydration from lack of fluids. The time from injury to discovery may be the difference between life and death.

Immobility, mental and social

The average person of 70 to 80 years is now much fitter than ever before. Continuing activity and exercise helps maintain muscular strength, balance, joint position sense and the strength of bones.

However, a hidden and often under-recognised consequence of falls is fear, loss of confidence and restriction of activities in order not to put themselves in the position of risking further falls. The person may seriously restrict outings, hobbies and activities such as attending religious services. This can lead to detrimental effects such as social isolation, loneliness and immobility leading to further reduced strength and muscle tone and stiffer joints. Because of a limitation of lifestyle and being confined to the home, the person can become very depressed and withdrawn.

Frequent falls and the fear of further incidents may cause the elderly person to be admitted into long-term care. This may not be the ideal solution as the environment may well have its own hazards (polished floors, unfamiliar bathrooms, rugs, steps and stairs) with which the person will not be familiar leading to an increased risk of falls and the loss of independence. This change of circumstances (including distance from important relatives) may lead to serious depression, decline and ultimately death.

Effects of falling

Other useful links

• Ageing
• Frailty