Prevention of falls in old age: tips

Prevention of falls in old age: tips

I. Understanding the risks and factors affecting the fall

The falls are a serious threat to the health and well -being of the elderly. They can lead to injuries, disability, a decrease in the quality of life and even death. Understanding the risks and factors contributing to falls is the first and most important step in their prevention.

A. Age changes and their impact on stability:

With age, natural changes in the body occur, which can increase the risk of falls. These changes include:

1. Reducing muscle strength and mass (sarcopenia): Especially important is the strength of the leg and back muscles to maintain balance. With age, the muscles weaken, which makes it difficult to hold the body in an upright position and increases the risk of losing equilibrium.
   • Mechanism: Reducing the amount and size of muscle fibers, a decrease in muscle nervous stimulation.
   • Consequences: A slow reaction to the loss of balance, a decrease in the ability to corrective movements.
   • Recommendations: Regular strength training aimed at strengthening the muscles of the legs and body (squats, lunges, climbing socks, exercises with weights under the supervision of a specialist).
2. Violation of coordination and balance: With age, the work of the vestibular apparatus (inner ear), which is responsible for the feeling of equilibrium, is worsening, and proprioceptance (sensation of body position in space) is reduced.
   • Mechanism: Degenerative changes in the vestibular apparatus, a decrease in the sensitivity of proprioceptors in the muscles and joints.
   • Consequences: Difficulties with maintaining equilibrium when walking, especially on an uneven surface or in the dark, a tendency to dizziness.
   • Recommendations: Balance exercises (standing on one leg, walking in a straight line, Tai-chi exercises), training of visual-motor coordination.
3. Reducing of visual acuity and hearing: Vision and hearing play an important role in maintaining equilibrium and orientation in space. With age, visual impairment (cataracts, glaucoma, maculodistrophy) and hearing (age -related hearing loss) can increase the risk of falls.
   • Mechanism: The clouding of the lens (cataract), damage to the optic nerve (glaucoma), degeneration of the retina cells (maculodistrophy), damage to the auditory cells of the inner ear.
   • Consequences: Difficulties with assessing the distance, detecting obstacles, determining sound sources, which can lead to loss of orientation and falls.
   • Recommendations: Regular inspections by an ophthalmologist and otolaryngologist, vision correction with glasses or contact lenses, the use of hearing aids, if necessary, improve lighting in the house.
4. Slow down of the reaction speed: With age, the rate of transmission of nerve impulses slows down, which leads to a slowdown in the reaction to sudden changes in the environment and an increase in the time required to perform protective movements.
   • Mechanism: Reducing the rate of nerve impulses along nerve fibers, a decrease in the number of neurons in the brain.
   • Consequences: A slow reaction to the loss of balance, a decrease in the ability to avoid falling during stumbling or sling.
   • Recommendations: Exercises to the reaction (catching the ball, imitation of evasion from obstacles), an active lifestyle, maintaining cognitive functions.
5. Gait changes: With the age of the gait, it can become less stable, with a smaller step length and a larger support width.
   • Mechanism: Decrease in muscle strength, impaired coordination, arthritis, neurological diseases.
   • Consequences: Unstability when walking, a tendency to stumbling and falling.
   • Recommendations: Exercises to improve gait (walking with high knees, walking in a straight line), using a cane or walkers if necessary.

B. diseases that increase the risk of falls:

Many diseases can increase the risk of falls in older people. It is important to know about them and take measures for their control and treatment.

1. Neurological diseases: Parkinson’s disease, stroke, dementia, polyneuropathy can cause impaired equilibrium, coordination, muscle strength and cognitive functions, which significantly increases the risk of falls.
   • Parkinson’s disease: Tremor, rigidity, bradykinesia (slowdown in movements), postural instability.
   • Stroke: Paralysis or weakness of one side of the body, impaired coordination, loss of sensitivity.
   • Dementia: Violation of memory, attention, thinking, reducing the ability to plan and implement movements.
   • Polyneiropathy: Weakness and numbness in the legs, impaired sensitivity, loss of balance.
   • Recommendations: Treatment of the underlying disease, physiotherapy, labor therapy, use of auxiliary products (cane, walkers), ensuring a safe environment.
2. Cardiovascular diseases: Arrhythmias, orthostatic hypotension (a sharp drop in blood pressure when rising), heart failure can cause dizziness, weakness and loss of consciousness, leading to falls.
   • Arrhythmias: Violation of heart rhythm, leading to insufficient blood supply to the brain.
   • Ortostatic hypotension: Reducing blood pressure when rising, causing dizziness and weakness.
   • Heart failure: Reducing the ability of the heart to pump blood, leading to fatigue, shortness of breath and dizziness.
   • Recommendations: Treatment of the underlying disease, monitoring of blood pressure, slow getting out of the position of lying down or sitting, wearing compression knitwear, avoiding overheating and dehydration.
3. Speaking diseases: Arthritis, osteoporosis, fractures can cause pain, limitation of mobility, muscle weakness and joint deformation, which complicates the maintenance of equilibrium and increases the risk of falling.
   • Arthritis: Inflammation of the joints, causing pain, stiffness and limitation of mobility.
   • Osteoporosis: Reducing bone density, increasing the risk of fractures.
   • Fractures: Violation of bone integrity, causing pain, edema and limitation of mobility.
   • Recommendations: Treatment of the underlying disease, physiotherapy, the use of auxiliary products (cane, crutches), environmental modification (installation of handrails), taking calcium and vitamin D.
4. Visual disorders: Cataracts, glaucoma, maculodistrophy, diabetic retinopathy can worsen vision, make it difficult to assess the distance and detect obstacles, which increases the risk of falls.
   • Cataract: The clouding of the lens that reduces visual acuity.
   • Glaucoma: Damage to the optic nerve, leading to narrowing of the field of view.
   • Maculodistrophy: Degeneration of the central part of the retina, leading to a decrease in central vision.
   • Diabetic retinopathy: Damage to the circulatory vessels of the retina, leading to visual impairment.
   • Recommendations: Regular examinations of an ophthalmologist, vision correction, improvement of lighting in the house, avoiding bright light and glare.
5. Other diseases: Diabetes, dehydration, urinary incontinence, depression can also increase the risk of falls.
   • Diabetes: Violation of glucose metabolism, leading to damage to nerves and blood vessels.
   • Dehydration: The lack of fluid in the body, leading to dizziness and weakness.
   • Urine incontinence: Uncontrolled urine release, leading to a hurry and increase the risk of falls.
   • Depression: A mental disorder characterized by a decrease in mood, energy and motivation, leading to a decrease in physical activity and increasing the risk of falls.
   • Recommendations: Treatment of the underlying disease, maintaining an adequate level of hydration, regular visits to the toilet, treatment of depression.

C. Medicines and their side effects:

Many drugs can increase the risk of falls, especially with the simultaneous use of several drugs (polyprahmasia). It is important to know about potential side effects of drugs and discuss them with a doctor.

1. Sedative and sleeping pills: They can cause drowsiness, dizziness, impaired coordination and a decrease in reaction rate.
   • Examples: Benzodiazepines (diazepam, drums), barbiturates, zolpidem, gallpaper.
   • Mechanism: Suppression of the activity of the central nervous system.
   • Recommendations: To avoid taking these drugs, especially before bedtime or before performing potentially dangerous actions, to discuss alternative methods of improving sleep with the doctor.
2. Antidepressants: Some antidepressants can cause orthostatic hypotension, dizziness, drowsiness and impaired coordination.
   • Examples: Tricyclic antidepressants (amitriptyin, Imipramine), selective inhibitors of the reverse capture of serotonin (SIOOS) (paroxetine, cermeralin).
   • Mechanism: The impact on neurotransmitters in the brain.
   • Recommendations: Start taking antidepressants with a low dose, slowly increase the dose under the supervision of a doctor, avoid a sharp cessation of taking the drug.
3. Antihypertensive drugs: They can cause orthostatic hypotension, especially with sharp rising.
   • Examples: Diuretics (hydrochlorortiazide, furosemide), beta-blockers (atenolol, metoprolol), ACE inhibitors (enalapril, lysinopril), Angiotensin II receptors (Lozartan, Valsartan).
   • Mechanism: Decrease in blood pressure.
   • Recommendations: Monitoring of blood pressure, slow getting out of the position of lying down or sitting, avoiding overheating and dehydration.
4. Anti -Parkinsonian drugs: They can cause dizziness, dyskinesia (involuntary movements) and orthostatic hypotension.
   • Examples: Levodopa, Pramipksol, Ropinirol.
   • Mechanism: Impact on the dopamine system of the brain.
   • Recommendations: Start taking drugs with a low dose, slowly increase the dose under the supervision of a doctor, avoid a sharp cessation of taking the drug.
5. Nonsteroidal anti -inflammatory drugs (NSAIDs): They can cause dizziness, nausea and fluid retention, which can increase the risk of falls.
   • Examples: Ibuprofen, Naproxen, Diclofenac.
   • Mechanism: Suppression of the synthesis of prostaglandins.
   • Recommendations: Use NSAIDs with caution, especially in older people with kidney diseases and cardiovascular system, and discuss alternative pain relief methods with the doctor.
6. Other drugs: Antihistamines, diuretics, drugs for the treatment of diabetes can also increase the risk of falling.
   • Antihistamines: They can cause drowsiness and dizziness.
   • Diuretics: They can cause dehydration and orthostatic hypotension.
   • Diabetes treatment drugs: They can cause hypoglycemia (a decrease in blood sugar), which can lead to dizziness and loss of consciousness.
   • Recommendations: Discuss with the doctor all the drugs taken, including overcomplex drugs and food additives, regularly review the list of drugs and adjust the doses if necessary.

D. Environmental factors:

The environment plays an important role in the risk of falls. It is necessary to identify and eliminate dangerous factors in the house and on the street.

1. Lighting: Poor lighting makes it difficult to detect obstacles and assess the distance, especially at night.
   • Recommendations: Improve lighting in all rooms, especially in corridors, stairs and bathroom, use nightlights, install light switches at the entrance to the room.
2. Obstacles: Scattered things, carpets, wires, furniture can create obstacles on the way and increase the risk of stumbling.
   • Recommendations: Remove all the extra things from the floor, fix the carpets or remove them, hide the wires, make sure that the furniture does not interfere with the free passage.
3. Uneven surfaces: Uneven floors, thresholds, steps can lead to loss of balance.
   • Recommendations: Eliminate irregularities on the floor, install ramps or handrails on the steps, use non -slip coatings on slippery surfaces.
4. Slippery surfaces: Wet floors, polished floors, ice and snow can be very slippery and increase the risk of falls.
   • Recommendations: Use non -slip mats in the bathroom and in the kitchen, wear shoes with a non -slip sole, clean the sidewalks of ice and snow.
5. Inappropriate shoes: High -heeled shoes, with a smooth sole or without an ass, can be unstable and increase the risk of falls.
   • Recommendations: Wear comfortable shoes with non -slip soles and good support of the foot.

II. Downs prevention measures

Prevention of falls requires an integrated approach, including medical examinations, physical exercises, environmental modification and the use of auxiliary tools.

A. Medical examinations and consultations:

1. Regular examinations at the doctor: Regular visits to the doctor allow you to identify and treat diseases that can increase the risk of falls, as well as evaluate the drugs taken and their side effects.
2. Consultations with specialists: Consultations with a geriatrician, neurologist, cardiologist, orthopedist, ophthalmologist, otolaryngologist and physiotherapist can help determine the causes of falls and develop an individual preventive plan.
3. Risk assessment of falls: The doctor can conduct special tests and questionnaires to assess the risk of falls and identify factors requiring attention.
   • Examples of tests: The test “Stand and go”, Romberg’s test, Berg’s balance.

B. Physical exercises:

Regular physical exercises play an important role in the prevention of falls, as they help strengthen muscles, improve coordination and balance, and increase self -confidence.

1. Exercises for strength: Power training helps strengthen the muscles of the legs and body, which is necessary to maintain balance.
   • Examples of exercises: Squats, attacks, climbing socks, exercises with dumbbells or elastic tape.
   • Recommendations: Start with a small weight and gradually increase it, perform exercises under the supervision of a specialist.
2. Balance Exercise: Balance exercises help improve coordination and reduce the risk of losing balance.
   • Examples of exercises: Standing on one leg, walking in a straight line, Tai-chi exercises, exercises on a balancing platform.
   • Recommendations: Start with simple exercises and gradually move on to more complicated ones, use support if necessary.
3. Exercises for stretching: Stretching helps to improve the flexibility and mobility of the joints, which can reduce the risk of injuries during falls.
   • Examples of exercises: Stretching the muscles of the legs, back and shoulders.
   • Recommendations: Perform stretching slowly and smoothly, avoid sudden movements.
4. Aerobic exercises: Aerobic exercises (walking, swimming, cycling) help improve the general health and physical endurance.
   • Recommendations: To engage in aerobic exercises regularly, start with small loads and gradually increase them.

C. Modification of the environment:

Modification of the environment helps to make the house and the street safer for the elderly.

1. In the house:
   • Improve lighting in all rooms, especially in corridors, stairs and bathroom.
   • Remove all the extra things from the floor, fix the carpets or remove them, hide the wires.
   • Install handrails in the bathroom and toilet.
   • Use non -slip mats in the bathroom and in the kitchen.
   • Install nightlines.
   • Install light switches at the entrance to the room.
   • Check the serviceability of stairs, railings and steps.
   • Organize the space so that all the necessary things are easily accessible.
2. On the street:
   • Wear shoes with non -slip soles.
   • Use cane or walkers if necessary.
   • Clean the sidewalks of ice and snow.
   • Apply for help when crossing the road.
   • Avoid walking on uneven surfaces.
   • Be attentive when walking in the dark.

D. Auxiliary means:

Auxiliary means can help older people maintain balance and reduce the risk of falls.

1. Cane: The cane helps to improve balance and reduce the load on the joints.
   • Recommendations: Correctly choose the height of the cane, use the cane on the healthy side of the body.
2. Hoddene: The walkers provide greater stability than a cane, and can be useful for people with equilibrium disorders or weakness in the legs.
   • Recommendations: Correctly choose the height of the walkers, use the walkers with or without wheels, depending on the needs.
3. Orthopedic shoes: Orthopedic shoes provide good support for the foot and can help improve balance.
4. Protective linen: Protective linen can help soften the blow in the fall and reduce the risk of injuries.

E. Education and training:

Increased awareness of the risks of falls and preventive measures is an important component of the preventive program.

1. Information about risk factors: Elderly people should know about risk factors that can increase the likelihood of falls such as age -related changes, diseases, drugs and environmental factors.
2. Training in prevention measures: Older people should be trained in measures to prevent falls, such as physical exercises, environmental modification and the use of auxiliary means.
3. Family and friends support: Family and friends can play an important role in the prevention of falls, providing support, helping in the modification of the environment and recalling the need to observe precautions.

F. Nutrition and hydration:

Proper nutrition and adequate hydration are important for maintaining the health of bones and muscles, as well as to prevent dizziness and weakness.

1. Sufficient consumption of calcium and vitamin D: Calcium and vitamin D are necessary to maintain bone health and prevent osteoporosis.
   • Recommendations: Eat products rich in calcium (dairy products, green vegetables, nuts), take vitamin D in accordance with the doctor’s recommendations.
2. A full -fledged protein diet: Protein is necessary to maintain muscle mass and strength.
   • Recommendations: Consume foods rich in protein (meat, fish, eggs, legumes).
3. Adequate hydration: Enough fluid consumption helps to prevent dehydration, which can lead to dizziness and weakness.
   • Recommendations: Drink enough water during the day, especially in hot weather.

G. Psychological support:

Falls can cause fear and anxiety, which can lead to a decrease in physical activity and an increase in the risk of repeated falls.

1. Overcoming the fear of falls: It is important to help older people overcome the fear of falls and increase self -confidence.
   • Recommendations: Participation in support groups, consultations with a psychologist, physical exercises under the supervision of a specialist.
2. Maintaining social activity: Maintaining social activity helps to improve mood, reduce stress and increase motivation for taking care of your health.
   • Recommendations: Participation in social events, communication with friends and family, volunteer activities.

III. Actions after falling

Even if all measures of the precaution of the fall may happen. It is important to know what to do after falling to minimize the consequences.

A. immediate actions:

1. Keep calm: Try not to panic and evaluate your condition.
2. Assess the presence of injuries: Check if you have fractures, dislocations, bleeding or other serious injuries.
3. Call to the aid: If you cannot rise yourself, call for help or click the emergency call button.
4. If you can get up: If you can rise yourself, do it slowly and carefully using furniture or other supports.

B. Application for medical help:

1. Consult a doctor: Even if you do not have visible injuries, consult a doctor to appreciate your condition and exclude hidden damage.
2. Replace the fall: Tell the doctor about the fall and all the factors that could contribute to him.
3. Follow the doctor’s recommendations: Follow the doctor’s recommendations for treatment and rehabilitation.

C. Prevention of repeated falls:

1. Determine the causes of the fall: Try to determine the causes of the fall and take measures to eliminate them.
2. Improve prevention measures: Review your fall prevention measures and make the necessary changes.
3. Do not be afraid to seek help: Feel free to seek your family, friends or specialists, if you need support.

Prevention of falls is a constant process that requires attention and effort. Following these tips, older people can significantly reduce the risk of falls and maintain their health and well -being.