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Falls Awareness

08 Jun

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Falls Awareness Week, 2013

Theme; Healthy Feet 

This week we were sitting in the sun having a nice cup of coffee and the phone rang. My husband answered and it was Burton Alan ( named after his birthplace to indicate which Alan) someone he had come across at the Builder’s  Merchant  when ordering gravel several years ago and they had kept in touch since.  He is now 74 years of age and a few years earlier he had bought some land and single- handedly started  building his own four bedroomed detached house ( having constructed a Wooden chalet to live in whilst it was being built). Considering he had been a Chemical Engineer specialising in water purification  this was no mean feat. He had made great progress,  the roof was completed and he was working on the  interior finishes (nearly finished in his mind but for me there seemed a lot to do). 
Last month one evening he had gone Line Dancing  in the village hall. On leaving, the outer door of the Hall  had slammed back on him and he had fallen. He was helped up, got to the car and drove home. After a restless night he felt he should go to the local hospital as the leg was very painful and paracetamol was not working even with a tot of whiskey! When he got there he had fractured his hip and was admitted to have surgery to have the femur pinned.
 This was why he had phoned as he was now home from hospital and the convalescent clinic after 3 weeks and needed a little job doing. When we had visited him soon after surgery he was not yet walking  but was sitting up in bed drawing his electrical diagrams so we weren’t surprised he was backing ‘home’ in the chalet as he was anxious to get back to his  almost finished house. Now Alan is not the most organised and tidiest of people and when we arrived the land where  the house and chalet stood was a building site and by no means in any order pipes, equipment,plastic buckets etc strewn everywhere and to get to the chalet it was through this detritus and walking through long grass concealing even more hazards. His car was parked at the end of the path for him to use to go to the shop in the next village. As we walked along we cleared visible objects to one side and found him sitting on the veranda surrounded by paperwork, wires,tools various bits of furniture including a new sofa he had recently bought from someone at the Line Dancing group!! We sat down and over a cup of tea tried to talk about the practicalities of staying in this situation but as if he didn’t hear  he merely veered the subject back to how he could finish the house and was working out the amount of voltage the EDF ( electricity board) needed to supply to the house, taking into account the length of the cable and resistance in Ohms it would produce. ( a test on our knowledge of basic physics) The job he wanted my husband to do was to fill in a hole over a pipe in the path through the long grass leading to the house. After  we wandered around looking for a shovel, pick axe to loosen the hardened aggregate  and empty the wheelbarrow full of various tools my husband went off under his supervision to fill in the hole!!!
During this time I tried to discuss other options and discuss falls prevention, probably best managed by staying with relatives. He said the physiotherapist had visited earlier and  he was puzzled as to  why the hospital physiotherapist had recommended walking as much as possible but this domiciliary physiotherapist had recommended doing static exercises and very little walking. No mention of falls assessment !  We did our best to make sensible suggestions but his parting words were ‘thank you for coming over to do that I must take you out for a meal sometime and I’ll be in touch.
 
I wrote this as an extreme example of how difficult it is to make people aware of hazards not only for themselves but for those around them. I remember when I used to take up the rugs in my mothers house knowing full well as soon as I turned my back she would put them down. Do all parents teach their children to put their toys away. A blind friend of mine was obsessional about counting toys in and out of the toy box and also told me her worst nightmare was walking down a street with black bags on the footpath as no way could she see them even the outline ( bear that in mind when you put your bags out)
The irony of this tale is that Line Dancing is a good way of improving balance and strengthening leg muscles! 
 
Hence, falls awareness is for everyone whatever the age and every parent should teach their children this from the word go. I am sure everyone has a tale to tell of a fall that should not have happened.  Do you put salt on the path outside your home  in icy weather? Do you put something to one side or away if it is in the way even if it is not your property or do you just step over it?Do you check your elderly or disabled relatives home for hazards and tactfully remove them? Many people especially in West London have low VitaminD and a high percentage of elderly people  have osteoporosis both conditions indicate a greater risk of fracture and delayed healing. 
Sometimes it is difficult to change someone’s ways but it is worth a try, it may simply be replacing a light bulb, supplying a cordless phone, fitting grab rails in the bathroom  or taking away a mat or tidying an electric cable. 
 
Everyone can be at risk of having a fall, but older adults are more vulnerable than others. This is mainly due to long-term health conditions that can increase the chances of a fall.
Other groups who are particularly at risk are young children and people whose job involves working at heights.
Falls are a common but often overlooked source of injury and sometimes death. In 2009 in England and Wales, there were 3,593 deaths as a result of falls.
Around 30% of adults who are over 65 and living at home will experience at least one fall a year. This rises to 50% of adults over 80 who are either at home or in residential care.
Most falls do not result in serious injury. However, 20% of older adults will require medical attention for a fall and 5% will experience a serious injury, such as a broken bone.
Falls can also have an adverse psychological impact on elderly people. For example, after having a fall a person can lose confidence, become withdrawn and may feel as if they have lost their independence.
 
Falls and accidents seldom “just happen.” But there are many simple things that older people can do to prevent falls, and their potentially devastating consequences aswell as
taking  care of your health by exercising and   making sure that you get enough calcium and vitamin D.
 
How Can I Prevent Falling?
At any age, people can make changes to lower their risk of falling. 
 
Some tips to help prevent falls outdoors are:
Use a walking stick
Wear rubber-soled shoes so you don’t slip
Walk on grass when pavements are uneven or slippery
Put salt or kitty litter on icy paths
 
Some ways to help prevent falls indoors are:
Keep rooms free of clutter, especially on floors
Wear low-heeled shoes
Do not walk in socks, stockings, or slippers
Be sure rugs have skid-proof backs or are tacked to the floor
Be sure stairs are well lit and have rails on both sides
Put grab bars on bathroom walls near bath, shower, and toilet
Use a nonskid bath mat in the shower or bath
Keep a torch  next to your bed
Use a sturdy stepstool with a handrail and wide steps
Add more lights in rooms
Buy a cordless phone so that you don’t have to rush to the phone when it rings and so that you can call for help if you fall.
 
You can also do exercises to improve your balance. While holding the back of a chair, sink, or counter:
Stand on one leg at a time for a minute and then slowly increase the time. Try to balance with your eyes closed or without holding on.
Stand on your toes for a count of 10, and then rock back on your heels for a count of 10.
Make a big circle to the left with your hips, and then to the right. Do not move your shoulders or feet. Repeat five times.
 
 Ealing has been proactive and has a falls clinic and for many years we have therapists who visit the home to carry out a falls assessment and often it is easier for them 
to give advise rather than relatives. If you feel this would be helpful attend the events held in Ealing next week or contact your surgery I you have a concern about yourself or someone you know . Also look out for events and help from ageuk  which supports these events and they originally set up the falls assessment team.?
 
 
 
 
 
 
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posted by Dr Bayer

 

 

 

More information
http://www.niams.nih.gov/Health_Info/Bone/Osteoporosis/Fracture/prevent_falls_ff.asp
http://www.nhs.uk/Conditions/Falls/Pages/Introduction.aspx

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