Falls are the most frequent and serious type of accident for people aged 65+ and the main cause of disability and death from injury among people aged over 75. Falls can lead to a loss of confidence, reduced independence, increased isolation and can cause long-term health problems.
Most fractures in older people occur as a result of falls from a standing height and commonly affect the pelvis, wrist, upper arm or hip. Almost half of all women and one in six men experience a painful and disabling fracture in later life.
Falls and fractures among people aged 65 and over account for more than four million hospital bed days each year in England alone. The associated healthcare costs are estimated at £2 billion per annum. Falls resulting in injury are the leading cause of accident-related mortality among older people. After a fall, an older person has a 50 per cent chance of having seriously impaired mobility and a 10% chance of dying within a year.
What should you do if you have a fall?
1. Firstly, don't panic.
2. Assess the situation to see if you are injured or in pain.
3. Try to attract attention before considering trying to move.
4. If you are alone and feel able to stand, try to crawl or shuffle to a piece of stable furniture to help you pull yourself up. Then sit for a while before standing.
5. If you cannot get up, try banging on a wall or floor to attract attention, crawl to a telephone to call for help or use your personal alarm if have one.
6. If you can, try to find a blanket or something to keep you warm. Tense your leg and arm muscles regularly to produce heat and maintain circulation.
Access to Falls Care Service
A new falls service has been launched in Surrey Downs CCG with the aim of easing the pressure on the urgent care system. The Integrated Falls Team commenced in October 2017 and is being delivered by CSH Surrey. The service will provide a triage function and support for non-injured fallers aged 65 and over within their own home or a care home, thereby supporting people to stay safely in their home. The service will also accept referrals from those patients at risk of falls who are under 65 years, in line with NICE guidelines.
The main aims of the service are:
- Improve patient experience and outcomes by assessing patients, reducing the risk and providing advice, treatment and support
- Reduce unplanned hospital admissions due to falls, thereby cutting pressures on emergency and acute unplanned care services
- Reduce the number of patients conveyed to hospital in an ambulance who could have been more effectively supported in their own homes
The service has been developed as part of the CCG's Falls Care Pathway, initially as a one-year pilot for those who are aged 65 and over and registered with a GP practice in the Surrey Downs catchment area.
The service can be accessed by GP practices as well as any other health or social care professional in the system. Referrals will be triaged within two hours, subject to an initial assessment to establish if the situation is suitable.
This telephone assessment will be carried out by trained registered clinicians employed by CSH Surrey who are capable of making sound judgements through a structured telephone triage process with the patient, their carer or another healthcare professional.
After initial triage and work from the Multi-Disciplinary Hub, patients may then be referred to the urgent or non-urgent falls service depending on their assessed need. The services offered to patients may include 1:1 therapy-led assessment plans with defined goals, equipment aids and adaptations, on-ward referrals for additional patient and carer support, home hazard assessments and balance/exercise classes. CSH Surrey will then provide a falls assessment to identify and address potential causes of avoidable harm.
Remember: Always tell your GP and someone close to you if you have had a fall, even if you have not been injured.
If you have injured yourself or hit your head
You or someone who cares for you should seek medical help if you require emergency medical assistance.
Call 999 in an emergency
If you are aged 65 or over and have had two or more falls in the last six months, you are eligible for a Falls Assessment to look at ways of reducing the risk of future falls. This assessment includes: Mobility, self-care, bone strength, medications, medical factors, falls history, hearing, foot health, memory/cognition and the home environment.
There is much you can do to help prevent yourself or someone you care for from suffering a fall:
- Maintain a healthy diet. Eat a balanced diet which includes calcium and Vitamin D to ensure good bone health and drink plenty of fluids to avoid dehydration
- Review your medication. Ask your GP or a pharmacist to look at your medication to ensure that you understand the most effective way to take it. For example, some drugs which are normally taken in the morning can cause a fall if taken at night. Some drugs may also cause drowsiness which may cause you to fall
- Have your vision tested. Ensure your eyesight is regularly checked and your glasses are the correct prescription
- Have your hearing tested. Ear problems can affect your balance and increase your risk of falling
- Limit your alcohol intake. Your ability to break down alcohol reduces with age. Alcohol can affect your co-ordination and exaggerate or limit the affects of some prescribed medication. Alcohol in combination with prescribed medication can lead to a fall
- Be active. Exercise helps maintain strength, balance and co-ordination and is one of the most important ways to cut the risk of falling
- Make your home safer. Nearly half of all falls happen at home. Therefore, wherever possible, attend to trip hazards, repairs, slip hazards and attend to any obstacles that hinder movement around your home
- Footwear. Wear shoes and slippers that are comfortable, a snug fit and have a non-slip sole. Avoid walking in socks or stockings/tights as you may slip in these
- Walking aids. Walking sticks and walking frames should be the correct height for you and used only as recommended
Surrey Downs CCG have put together a pack that provides lots of useful advice on how to prevent a fall, along with information about local services available to support you and keep you living independently in the community.