The ending to this classic line from a 1980’s television commercial is well known. While the commercial tried to depict the serious and frightening situation of an older person who is home alone after experiencing a fall and requiring assistance, its design and the frequency with which it was viewed turned this call for help into a comedy punchline. In reality, falls are a serious threat to seniors’ health and independence. According to the National Institutes of Health, on an annual basis more than 1.6 million older adults visit emergency departments due to injuries related to a fall. Falls are the primary cause of fractures, hospital admissions for trauma, loss of mobility and independence, and deaths resulting from injury in older adults.
The potential for injury from the fall itself is not the only concern in this situation. While some falls are simply accidents, others may be a symptom of an underlying medical problem. If an acute injury doesn’t result from the fall, an older person may insist that he/she is “fine” and refuse medical evaluation because of fears of hospitalization or placement in a care facility. However, a delay in diagnosing and treating a medical condition may eventually lead to hospitalization and long-term consequences that could otherwise have been prevented. For some individuals, a fall can trigger a general mental and physical decline, even though the symptoms of the decline may not appear to be directly related to the fall. Even without a fall, just the fear of falling can have an adverse impact on the quality of life for older adults. They may reduce their activity levels to try to prevent falls, which in turn can lead to increased isolation, depression, muscle weakness (thus increasing their risk of a fall), and other physical ramifications.
The risk for complications from a fall increases with the length of time that an individual spends lying on the floor waiting for help. Although a sprain or fracture may not be present, older persons may be too weak to get themselves up after a fall. An extended period of time on the floor can result in pneumonia, pressure sores, blood clots, dehydration, hypothermia, and/or rhabdomyolysis. Rhabdomyolysis is a condition in which injured muscles release a certain type of enzyme. Abnormally high levels of this enzyme can result in kidney failure. Any of these complications may prove fatal for an older person, so it is easy to see why falls are a major concern for the older population.
Not all falls can be prevented, although there are some steps which can be taken to reduce the risk of falls. Remaining as active as possible will help keep muscles stronger. Activities which involve strength, balance, and flexibility should be considered. The old adage “use it or lose it” is not an exaggeration. We all lose muscle mass as we age, but older adults lose it faster than younger ones, and inactive people faster than active ones. Of course, a physician should be consulted prior to beginning an exercise program.
Multiple other components impact fall risk as well. Diet (both food and fluid intake) affects one’s overall physical condition. A review of one’s medications can help identify the potential for side effects (such as dizziness) which may cause falls. A visit to the eye doctor may be in order to determine if vision changes are a potential risk factor. On the environmental side, footwear can be a contributing factor to falls (slippers and other loose fitting footwear without non-skid soles are culprits), as can uneven surfaces (think throw rugs!) and household clutter. Don’t let pride bring you down, either. If your health care provider suggests that you utilize a physical aid (such as a cane) to walk, then follow that advice. Asking for help with tasks that may be too much to handle shows intelligence, not weakness. Stop, think, and stay on your feet!
Since the elderly woman in the commercial had already fallen, what happened next? The advertised solution to her need for help was a personal emergency response system. These systems can provide a critical link to the safety and security of seniors. Next week’s article will cover the who, what, when, and how much for these types of services.
Karen Kaslow, RN, BSN