Elderly people have a high risk of falling. According to the Singapore Health Promotion Board (HPB), about one-third of elderly Singaporeans aged 60 and above have recurring falls.
Falls can lead to several consequences. Physical injuries may occur, from minor scratches and abrasions to more serious harm such as fractures and brain injury. There is also a psychological impact, such as fear of falling, loss of autonomy and confidence, avoidance of social activities, loneliness and ultimately depression from the loss of mobility and pain. Hence, it is important to know the common risk factors and what you can do to lower your risk of falling.
This is a guide on how you can identify whether you are at risk of falling and ways to reduce and prevent falls so that you can age gracefully into your golden years.
Are you at risk of falling?
If you answer
'Yes' to any of the below, you may be at higher risk of falling:
- Have you fallen in the past 12 months?
- Do you avoid going out because you are afraid of falling?
- Do you feel like you are going to fall when standing up or walking?
Source: Health Promotion Board
Conditions that may increase risk of fall
- Hearing/visual impairment
- Poor coordination
- Poor balance and gait disorder
- Weakness
- Numbness of feet
- Arthritis
- Stroke
- Hip surgery
- Dementia
Steps you can take to reduce your risk of falling
1. Fall-proof your home
Most elderly spend a significant amount of their time at home. It is important to fall-proof your home and remove things that can increase your chances of falling at home.
In general
- Keep the house free of clutter and have a clear path for walking.
- Keep the floor dry at all times.
- Bundle up wires and tuck them against the wall. Do not leave wires lying across the floor.
- Ensure adequate lighting at all the areas that you use.
- Ensure your carpets or rugs are non-slip or secured to the floor.
Bathroom
- Install grab bars near toilets and on the inside and outside of your tub and shower.
- Place a non-slip mat on surfaces that may get wet.
- Use a sturdy showering chair if necessary.
Bedroom
- Ensure adequate lighting. Keep a bedside lamp so that you can switch it on easily when you need to get out of bed at night.
- Keep other essentials such as your telephone and flashlight near your bed.
- Ensure the height of your bed is not too high or low. Both your feet should be able to step flatly on the floor when you sit at the edge of the bed.
- Ensure your bed mattress is not too soft that you can still easily get up from the bed.
- Place assistive equipment within reach.
Kitchen
- Place commonly used items on places or shelves that are easily accessible.
- If you need to get an item from a higher place, use a “reach stick” or ask someone for help. Do not climb on a chair.
- Clean up spills immediately.
Singapore citizen can enjoy government subsidies for home improvement items under the EASE programme (Enhancement for Active Seniors).
2. Use proper footwear and walking aid
- Wear well-fitting shoes that have a flat, broad base and non-slip soles. They should also have safety features such as secure and adjustable fastenings such as Velcro or buckles.
- Inappropriate footwear includes crocs, sandals without straps, slippers, high heels and shoes with worn soles.
-
Avoid wearing socks or going barefooted when indoors.
- Use a proper walking aid with the correct height as advised by your doctor or therapist.
3. Check your eyesight and hearing
- Check with your doctor if you have problems with your eyesight or hearing. Wear glasses or a hearing aid if needed.
- Avoid bifocal lens as it can increase the risk of tripping and falling.
4. Exercise regularly
- Stay active, age healthily! Exercise helps to improve balance and build strength, which reduces the risk of falling.
- Aim for 150 minutes of physical activity per week (unless your doctor advised otherwise).
- The Health Promotion Board has come up with seven easy exercises to promote an active lifestyle and aid in ageing gracefully. They are effective in building up muscle strength and improving balance and flexibility. Visit
https://www.healthhub.sg/programmes/71/healthy-ageing-exercise, or speak to your doctor/nurse/therapist to find out more information.
- Try the Otago exercise that is developed to reduce falls in older persons. The Otago exercise programme consists of 17 strength and balance exercises and a walking program, performed three times a week by the older adult in the home, or an outpatient or community setting. You may search “otago exercise fall prevention” on YouTube, or speak to your doctor/nurse/therapist to find out more information.
5. Eat well to keep your bones and muscles strong
- Apart from exercising, what we eat is important. Make sure your daily diet contains sufficient calcium and Vitamin D as well as protein, which are important for our bone and muscle healt
- Adults aged 65 and above require at least 1,000mg of elemental calcium per day. To have sufficient calcium, add one more calcium-rich food to your daily diet (unless your doctor advised otherwise), such as yogurt, cheddar cheese, sardines and spinach.
- Adults aged 65 and above require at least 800 units of Vitamin D per day. The body needs Vitamin D to absorb calcium. We can get our Vitamin D from sunlight and from food rich in vitamin D, such as egg yolks, beef liver and fortified milk.
- Protein is important for muscle formation. Take food rich in protein such as eggs, lean meat, cheese and fish (unless your doctor advised otherwise).
What do you need to do when you fall and are alone?
Fall Recovery Method
Source: Singapore Health Promotion Board
Last but not least, when you are at risk of falling, falling repeatedly and finding yourself with walking or balance issues, we advise you to consult your doctor for further assessment.
Article contributed by Geriatric Medicine, Department of Integrated Care.
