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Falls and fractures at home - can we make homes safer?

As people get older, they are more likely to fall over due to muscle weakness, visual impairment, poor balance, side effect of medications, unsafe housing or some other medical conditions. Falls cause distress, pain, loss of confidence, and make older people anxious of going outside, what is detrimental for their health and mental wellbeing.

Some statistics:

  • In 2017-2018, there were 220,160 emergency hospital admissios related to falls in patients over 65. 
  • Fractures from falls alone cost £4.4 billion per year in the UK. However,  a fall may result in ability of a person to stand up (and they may end up laying on the floor for the whole day), or it can cause fractures (older people generally have more fragile bones), wounds and their infection, brain hemorrhage (bleeding in brain, or stroke) or even death. 
  • Falls were the leading cause of injury in 2013, and the 9th highest cause of disability in England. 
  • Falls are the leading reason for people calling for an ambulance (8-10%).
  • 25%+ people have extensive injuries resulting from fall.

Doctors usually suggest various solutions: better shoes/slippers, vision check, health checks, etc. Additionally, they recommend that home hazard assessment and intervention is conducted by a suitably trained healthcare professional. These professionals identify potential hazards such as slippery surfaces, loose rugs, poor lighting, clutter, trip hazards, etc. Walking support and handrails improve the mobility of people around their house, but do not completely eliminate the likelihood of a fall. 

My grandmother has problems with falls due to her painful joints and back, and muscle weakness. She has had all possible support necessary, except for a carer support - she wants to stay independent. However, falls made her have some fractured bones, minor stroke and fear of walking. One time she was unable to stand for half a day, and she was unable to reach phone or grab glass of water. Every time she fell, she hit herself against hard furniture or door. I wonder whether homes can be even safer. 

For example, can we make furniture and doors safer? Can we make flooring which would absorb the impact? Can we have a device which alerts a carer/medical professional/relative about the incidence even if the person loses counsciousness from the fall? What do you think?

 

Information was obtained from from the Public Health Outcomes Framework, Ambulance Service Network, WRVS, NSW Falls Prevention Network, and National Institute for Health and Care Excellence

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Siana Jones 11 months ago

Status label added: Useful insight

Reply 0

Octavio Zamudio 11 months ago

Hi Miroslava,

This discussion topic is quite critical, what you describe is encompassed in one of the six determinants of the Active Ageing framework proposed by the WHO (Access to health and services, Behavioural, Physical Environment, Personal, Social, Enomic).
The physical environment is definitely something that requires emphasis, and here are some complementing figures (to your data) to put this further in perspective for other readers too:

- By 2050 the UN estimates 1 in 6 people worldwide will be 65+.
- About one third of the population aged 65+ fall each year.
- Physical environment are the main cause of falls in older people, 30-50% of the total.
- Globally, falls account for ~40% of injury-related deaths.
- Nearly half of the falls happen at indoors (this increases with age, as people are less willing to going out).


I haven't seen anything developed for doors yet, however, we could definitely think of some design modifications to decrease the risk of injury in case of falling and hitting a door or door frame. The selection of furniture is a good point to start, for example avoiding sharp edges in coffee tables and other low-level furniture that could be impacted a fall.

The NHS, provides some very basic guidance about falls prevention, one of the topics is Home Hazard Assessment. It includes also the use of assistive technologies to track hazardous situations ( https://www.nhs.uk/conditions/falls/prevention/ )

I have attached one example of how environmental factors interventions, in this case impact-absorbing flooring (compliant flooring), can decrease fall-related injury risks, while maintaining a positive economic impact.





Data: WHO

Reply 1

Miroslava Katsur 11 months ago

@Octavio That's heartbreaking statistics! We should do more to protect older people... Also, some old people can stand up from the floor if they can have something to hold to pull themselves up. I wonder how to address this problem...

P.S. The file that @Octavio wanted to share is a paper by Lachance et al. (2017) "Compliant flooring to prevent fall-related injuries in older adults". I cannot attach it as well...

Reply 0

Octavio Zamudio 11 months ago

The article about compliant flooring systems can be found here:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5293217/

Lachance, C. C., Jurkowski, M. P., Dymarz, A. C., Robinovitch, S. N., Feldman, F., Laing, A. C., & Mackey, D. C. (2017). Compliant flooring to prevent fall-related injuries in older adults: A scoping review of biomechanical efficacy, clinical effectiveness, cost-effectiveness, and workplace safety. PloS one, 12(2), e0171652.

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Georgie Cade 9 months ago

Status label removed: Useful insight

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