鄰舍輔導會 The Neighbourhood Advice-Action Council

離島地區康健站 Islands DHC Express

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Fall Prevention

In Hong Kong, each year 25% of community dwelling elders suffer from fall. 75% of them get injury include head injury and fracture. Elders who fell in the past six months had shown to have increased risk of fall in near future.

Fall is one of the most disabling conditions of the elderly, which will have significant impact on the elders’ functioning, independence and quality of life. Furthermore, falls had a significant adverse impact on the elders’ self-confidence—some would even avoid leaving their homes after only minor falls for fear of falling again. Their social life was thus affected, putting them at risk of developing low mood or depression. Falls could even be fatal if the elders failed to get up and seek medical help.

Risk factors for Falls

Falls do not happen without a reason—they usually occur due to the interaction of multiple risk factors:

  • Visual impairment
  • Poor balance e.g. Parkinson’s disease, stroke or dementia
  • Joint or gait problem e.g. osteoarthritis of knee, stroke
  • Dizziness e.g. cardiac arrhythmia, postural hypotension
  • Side effects of medications e.g. dizziness or poor balance due to the use of anti-hypertensive drugs or hypnotics
  • Stress due to urinary incontinence
  • Improper clothing e.g. too long or too loose
  • Environmental hazards in the home e.g. slippery floor, inadequate illumination, obstacles on the floor, and unsuitable furniture at home

Prevention in multiple aspects

Falls can be prevented but a multi-pronged approach is required to address the various risk factors. Elders are advised to exercise frequently to strengthen their muscles and to improve their flexibility, balance and coordination (such as Tai Chi). They also need to note the following tips to reduce the risk of falls.

Fall Prevention Tips

1. Beware of environmental hazards in the home

Keep walkways clear
  • Remove unnecessary objects on the floor. Keep all walking surfaces dry. Avoid waxing the floors
  • Paint door sills with sharp colors or attach bright-colored tapes along them
Suitable furniture
  • Choose stable chairs with suitable height
  • Avoid sitting on sofas, low chairs, folding chairs or chairs with wheels
  • Choose chairs with armrests to facilitate standing
Sufficient lighting
  • Install nightlights or bedside lamps
  • Position switches at convenient locations
Kitchen and toilet safety
  • Use non-slip mats instead of using cloths as floor mats
  • Use non-slip tiles in bathrooms. Apply non-slip tapes and install grab bars in the bathtub

2. Choose appropriate clothing and shoes

Clothing
  • Wear clothes that fit—avoid clothes that are too long or too loose
  • Choose clothes and pants that are easy to put on and take off
Footwear
  • Pick shoes of the right fit
  • Select shoes with non-slip soles
  • Replace shoes with worn out soles
  • Avoid wearing slippers when going out or only wear socks when walking indoor
  • Ensure shoelaces are properly tied, or wear adaptive footwear with velcro straps and zippers

3. Perform self-care and household chores safely

Body movement
  • Do not overestimate your ability. Keep motions slow while changing postures (e.g. getting up from bed, standing up)
  • Remain seated while performing actions that require balance, e.g. putting on trousers
Energy preservation—sit more, stand less
  • Sit down when performing housework e.g. ironing clothes, preparing foods etc.
  • Alternate between light and heavy housework
Keep necessities at easy reach
  • Keep necessities such as mobile phone, wallet, keys and clothing at places between waist to shoulder height
Avoid reaching up or squatting down
  • Use suitable tools when needed e.g. reaching aids, cleaning rods, long-handled shoehorns etc.
Avoid risky moves
  • Seek help if necessary
Use assistive devices
  • Utilise fall-prevention devices: long-handled reaching aids, long-handled shoehorn and socking aid
  • Make use of walking aids: walking frames, quadripods, walking sticks
  • Wear hip protection pants to reduce the risk of fracture after falls

4. Stay alert when going out

Stay alert when going out
  • Avoid multi-tasking or rushing
  • Take caution when going up or down stairs and escalators as well as hold the handrail
  • Always free a hand for emergencies

5. Use social resources wisely

Housework
  • Elders should discuss with family members on sharing housework if they encounter difficulties in managing housework. They can also consider apply for meal delivery service, home help service, and home care service if needed.
Family care
  • Family members can consider respite service or day care centre service in case they are not able to take care the elderly temporarily or elderly with rehabilitation need respectively
Living alone elders
  • Elderly living alone can consider using personal safety alarm or specially designed mobile phone for elderly

Management of Falls

Elders should assess their risk of falls regardless of having previous falls or not. After a fall, elders should do the following:

  • Stay calm.
  • Assess the degree of injury. Slowly move the body if injury is not severe.
  • Move along the floor until you reach a wall or stable furniture, then try to get up with the support of the furniture.
  • If you are unable to get up, you should make a phone call, ask for assistance via Personal Emergency Link Service or open the main door and call for help loudly
  • Cleanse the wound first if there is any abrasion.
  • Even if there is no obvious wound, you should consult a doctor promptly if you have difficulty moving or in severe pain as you may have sustained a fracture.

Source of information: Elderly Health Service, Department of Health