My grandma was the matriarch of the family. Strong, smart and stubborn.
You can see it from the way she walks. She would keep her back straight, clasp her hands together behind her back, and wobble a little from side to side while she observed, directed and commented at things around her. Expectedly, convincing her to exercise was as difficult as nailing jelly to a tree.
Once she almost fell while stepping out of her en-suite. She slipped in the corridor, between the foot of the bed and the wardrobe, but did not fall as she got stuck between the 2 pieces of furniture. We laughed about it and she exclaimed how glad she was that she was overweight.
While the incident was truly hilarious, i couldn’t help but consider all the what-if’s.
-What if she fell and got a fracture?
-What if she loses confidence and develops a fear of falling?
And for every scenario, I had a solution in my mind.
Then it struck me that that was all crisis management. Why am I finding solutions for the aftermath when I can prevent the fall entirely?
How should I go about doing it?
So, I did my readings and you see, falls are multi-factorial. The most common ones being frailty, polypharmacy, vitamin D deficiency, multi morbidity, impaired sensorium and home hazards. Interestingly, most of these factors are modifiable!
Since I’m a physiotherapist, let me share a little about frailty.
Frailty syndrome is a physical phenotype describing only physical components. It includes criteria such as skrinking, weakness, physical endurance, low physical energy, and slow walking speed.
Exercise programs have been shown to reduce the risk of falls, improve the fear of falling, increase or maintain physical performance, improve balance, especially in the pre-frail elderly, as well as reverse the frailty status.
If we are familiar with elderly, we will understand that each elderly can present very differently with the same conditions, especially frail elderly.
Tailored exercise programs not only target their weakest areas and most likely factor for falls, but also ensure they are able to perform at their optimum capacity while paying heed to other comorbidities. This reduces the risk of accidents during the exercise session and recovery period.
For non-frail and pre-frail elderly, I would suggest for them to keep a regular,
non-individually tailored exercise program at the very least, for maintenance
of physical performance. Both physiotherapist guided exercises and
general exercise programs offered in the community are shown to be
beneficial for reducing fall risks.
Ever since my grandma’s near fall incident, I’ve been coming up with different ways to encourage elderly to participate in exercise that they find meaningful. Exercises can be fun and relevant while increasing their confidence and physical performance. Why procrastinate when it is so simple?
Falls prevention can be as easy as abc with the right guidance. Consult your physiotherapist consult today for a fall-free tomorrow!
Pfortmueller CA, Lindner G, Exadaktylos AK. Reducing fall risk in the elderly: risk factors and fall prevention,
a systematic review. Minerva Med 2014;105:275-81.
Goodwin VA, Abbott RA, Whear R, et al. Multiple component interventions for preventing falls and fall-related injuries among older people: systematic review and meta-analysis.
BMC Geriatrics. 2014;14:15
Tricco AC, Thomas SM, Veroniki AA, et al. Comparisons of Interventions for Preventing Falls in Older Adults: A Systematic Review and Meta-analysis. JAMA. 2017;318(17):1687–1699.
Zhuang J, Huang L, Wu Y, Zhang Y. The effectiveness of a combined exercise intervention on physical fitness factors related to falls in community-dwelling older adults. Clin Interv Aging. 2014;9:131–140.
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