Fall prevention: Simple tips to prevent falls

Fall prevention: Simple tips to prevent falls

Falls put you at risk of serious injury. Prevent falls with these simple fall-prevention measures, from reviewing your medications to hazard-proofing your home.

By Mayo Clinic Staff

Fall prevention may not seem like a lively topic, but it’s important. As you get older, physical changes and health conditions — and sometimes the medications used to treat those conditions — make falls more likely. In fact, falls are a leading cause of injury among older adults. Still, fear of falling doesn’t need to rule your life. Instead, consider six simple fall-prevention strategies.

1. Make an appointment with your doctor

Begin your fall-prevention plan by making an appointment with your doctor. Be prepared to answer questions such as:

• What medications are you taking? Make a list of your prescription and over-the-counter medications and supplements, or bring them with you to the appointment. Your doctor can review your medications for side effects and interactions that may increase your risk of falling. To help with fall prevention, your doctor may consider weaning you off medications that make you tired or affect your thinking, such as sedatives and some types of antidepressants.
• Have you fallen before? Write down the details, including when, where and how you fell. Be prepared to discuss instances when you almost fell but were caught by someone or managed to grab hold of something just in time. Details such as these may help your doctor identify specific fall-prevention strategies.
• Could your health conditions cause a fall? Certain eye and ear disorders may increase your risk of falls. Be prepared to discuss your health conditions and how comfortable you are when you walk — for example, do you feel any dizziness, joint pain, shortness of breath, or numbness in your feet and legs when you walk? Your doctor may evaluate your muscle strength, balance and walking style (gait) as well.

2. Keep moving

Physical activity can go a long way toward fall prevention. With your doctor’s OK, consider activities such as walking, water workouts or tai chi — a gentle exercise that involves slow and graceful dance-like movements. Such activities reduce the risk of falls by improving strength, balance, coordination and flexibility.

If you avoid physical activity because you’re afraid it will make a fall more likely, tell your doctor. He or she may recommend carefully monitored exercise programs or refer you to a physical therapist. The physical therapist can create a custom exercise program aimed at improving your balance, flexibility, muscle strength and gait.

3. Wear sensible shoes

Consider changing your footwear as part of your fall-prevention plan. High heels, floppy slippers and shoes with slick soles can make you slip, stumble and fall. So can walking in your stocking feet. Instead, wear properly fitting, sturdy shoes with nonskid soles. Sensible shoes may also reduce joint pain.

4. Remove home hazards

Take a look around your home. Your living room, kitchen, bedroom, bathroom, hallways and stairways may be filled with hazards. To make your home safer:

• Remove boxes, newspapers, electrical cords and phone cords from walkways.
• Move coffee tables, magazine racks and plant stands from high-traffic areas.
• Secure loose rugs with double-faced tape, tacks or a slip-resistant backing — or remove loose rugs from your home.
• Repair loose, wooden floorboards and carpeting right away.
• Store clothing, dishes, food and other necessities within easy reach.
• Immediately clean spilled liquids, grease or food.
• Use nonslip mats in your bathtub or shower. Use a bath seat, which allows you to sit while showering.

5. Light up your living space

Keep your home brightly lit to avoid tripping on objects that are hard to see. Also:

• Place night lights in your bedroom, bathroom and hallways.
• Place a lamp within reach of your bed for middle-of-the-night needs.
• Make clear paths to light switches that aren’t near room entrances. Consider trading traditional switches for glow-in-the-dark or illuminated switches.
• Turn on the lights before going up or down stairs.
• Store flashlights in easy-to-find places in case of power outages.

6. Use assistive devices

Your doctor might recommend using a cane or walker to keep you steady. Other assistive devices can help, too. For example:

• Hand rails for both sides of stairways
• Nonslip treads for bare-wood steps
• A raised toilet seat or one with armrests
• Grab bars for the shower or tub
• A sturdy plastic seat for the shower or tub — plus a hand-held shower nozzle for bathing while sitting down

If necessary, ask your doctor for a referral to an occupational therapist. He or she can help you brainstorm other fall-prevention strategies. Some solutions are easily installed and relatively inexpensive. Others may require professional help or a larger investment. If you’re concerned about the cost, remember that an investment in fall prevention is an investment in your independence.

Oct. 04, 2019

Show references

1. Kiel DP. Falls in older persons: Risk factors and evaluation. http://www.uptodate.com/home. Accessed Aug. 21, 2016.
2. Falls in the elderly. Merck Manual Professional Version. http://www.merckmanuals.com/professional/geriatrics/falls-in-the-elderly/falls-in-the-elderly. Accessed Aug. 21, 2016.
3. Important facts about falls. Centers for Disease Control and Prevention. http://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html. Accessed Aug. 21, 2016.
4. Ferri FF. Falls in the elderly. In: Ferri’s Clinical Advisor 2017. Philadelphia, Pa.: Elsevier; 2017. https://www.clinicalkey.com. Accessed Aug. 14, 2016.
5. AskMayoExpert. Fall prevention. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2016.
6. Falls and older adults: Fall proofing your home. NIH Senior Health. http://nihseniorhealth.gov/falls/homesafety/01.html. Accessed Aug. 21, 2016.
7. Takahashi PY (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 31, 2016.

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Prevent Falls and Fractures | National Institute on Aging

A simple thing can change your life—like tripping on a rug or slipping on a wet floor. If you fall, you could break a bone, like thousands of older men and women do each year. For older people, a break can be the start of more serious problems, such as a trip to the hospital, injury, or even disability.

If you or an older person you know has fallen, you’re not alone. More than one in three people age 65 years or older falls each year. The risk of falling—and fall-related problems—rises with age.

Many Older Adults Fear Falling

The fear of falling becomes more common as people age, even among those who haven’t fallen. It may lead older people to avoid activities such as walking, shopping, or taking part in social activities.

But don’t let a fear of falling keep you from being active. Overcoming this fear can help you stay active, maintain your physical health, and prevent future falls. Doing things like getting together with friends, gardening, walking, or going to the local senior center helps you stay healthy. The good news is, there are simple ways to prevent most falls.

Causes and Risk Factors for Falls

Many things can cause a fall. Your eyesight, hearing, and reflexes might not be as sharp as they were when you were younger. Diabetes, heart disease, or problems with your thyroid, nerves, feet, or blood vessels can affect your balance. Some medicines can cause you to feel dizzy or sleepy, making you more likely to fall. Other causes include safety hazards in the home or community environment.

Scientists have linked several personal risk factors to falling, including muscle weakness, problems with balance and gait, and blood pressure that drops too much when you get up from lying down or sitting (called postural hypotension). Foot problems that cause pain and unsafe footwear, like backless shoes or high heels, can also increase your risk of falling.

Confusion can sometimes lead to falls. For example, if you wake up in an unfamiliar environment, you might feel unsure of where you are. If you feel confused, wait for your mind to clear or until someone comes to help you before trying to get up and walk around.

Some medications can increase a person’s risk of falling because they cause side effects like dizziness or confusion. The more medications you take, the more likely you are to fall.

Take the Right Steps to Prevent Falls

If you take care of your overall health, you may be able to lower your chances of falling. Most of the time, falls and accidents don’t “just happen.” Here are a few tips to help you avoid falls and broken bones:

• Stay physically active. Plan an exercise program that is right for you. Regular exercise improves muscles and makes you stronger. It also helps keep your joints, tendons, and ligaments flexible. Mild weight-bearing activities, such as walking or climbing stairs, may slow bone loss from osteoporosis.
• Have your eyes and hearing tested. Even small changes in sight and hearing may cause you to fall. When you get new eyeglasses or contact lenses, take time to get used to them. Always wear your glasses or contacts when you need them. If you have a hearing aid, be sure it fits well and wear it.
• Find out about the side effects of any medicine you take. If a drug makes you sleepy or dizzy, tell your doctor or pharmacist.
• Get enough sleep. If you are sleepy, you are more likely to fall.
• Limit the amount of alcohol you drink. Even a small amount of alcohol can affect your balance and reflexes. Studies show that the rate of hip fractures in older adults increases with alcohol use.
• Stand up slowly. Getting up too quickly can cause your blood pressure to drop. That can make you feel wobbly. Get your blood pressure checked when lying and standing.
• Use an assistive device if you need help feeling steady when you walk. Appropriate use of canes and walkers can prevent falls. If your doctor tells you to use a cane or walker, make sure it is the right size for you and the wheels roll smoothly. This is important when you’re walking in areas you don’t know well or where the walkways are uneven. A physical or occupational therapist can help you decide which devices might be helpful and teach you how to use them safely.
• Be very careful when walking on wet or icy surfaces. They can be very slippery! Try to have sand or salt spread on icy areas by your front or back door.
• Wear non-skid, rubber-soled, low-heeled shoes, or lace-up shoes with non-skid soles that fully support your feet. It is important that the soles are not too thin or too thick. Don’t walk on stairs or floors in socks or in shoes and slippers with smooth soles.
• Always tell your doctor if you have fallen since your last checkup, even if you aren’t hurt when you fall. A fall can alert your doctor to a new medical problem or problems with your medications or eyesight that can be corrected. Your doctor may suggest physical therapy, a walking aid, or other steps to help prevent future falls.

Whether you are at home or somewhere else, a sudden fall can be startling and upsetting. If you do fall, stay as calm as possible.

Take several deep breaths to try to relax. Remain still on the floor or ground for a few moments. This will help you get over the shock of falling.

Decide if you are hurt before getting up. Getting up too quickly or in the wrong way could make an injury worse.

If you think you can get up safely without help, roll over onto your side. Rest again while your body and blood pressure adjust. Slowly get up on your hands and knees, and crawl to a sturdy chair.

Put your hands on the chair seat and slide one foot forward so that it is flat on the floor. Keep the other leg bent so the knee is on the floor. From this kneeling position, slowly rise and turn your body to sit in the chair.

If you are hurt or cannot get up on your own, ask someone for help or call 911. If you are alone, try to get into a comfortable position and wait for help to arrive.

Carrying a mobile or portable phone with you as you move about your house could make it easier to call someone if you need assistance. An emergency response system, which lets you push a button on a special necklace or bracelet to call for help, is another option.

Keep Your Bones Strong to Prevent Falls

Falls are a common reason for trips to the emergency room and for hospital stays among older adults. Many of these hospital visits are for fall-related fractures. You can help prevent fractures by keeping your bones strong.

Having healthy bones won’t prevent a fall, but if you fall, it might prevent breaking a hip or other bone, which may lead to a hospital or nursing home stay, disability, or even death. Getting enough calcium and vitamin D can help keep your bones strong. So can physical activity. Try to get at least 150 minutes per week of physical activity.

Other ways to maintain bone health include quitting smoking and limiting alcohol use, which can decrease bone mass and increase the chance of fractures. Also, try to maintain a healthy weight. Being underweight increases the risk of bone loss and broken bones.

Osteoporosis is a disease that makes bones weak and more likely to break. For people with osteoporosis, even a minor fall may be dangerous. Talk to your doctor about osteoporosis.

Learn how to fall-proof your home.

Read about this topic in Spanish. Lea sobre este tema en español.

For More Information About Falls and Falls Prevention

This content is provided by the NIH National Institute on Aging (NIA). NIA scientists and other experts review this content to ensure it is accurate and up to date.

Content reviewed:
March 15, 2017

9 Ways to Prevent Falling at Home

One out of three seniors will fall this year, but fewer than half of them will talk with their doctors about it, according to the Centers for Disease Control and Prevention. Falls are also the No. 1 cause of injuries in seniors, resulting in hip fractures, cuts, and even serious head and brain injuries that can be fatal. And even when there’s no serious injury, a fall can still be so frightening that seniors may avoid certain activities because they’re afraid they’ll fall again.

Whether it’s slippery floors, rickety stairs, or electrical cords, some of the most common causes of falls are in the home where you might have a false sense of security. That’s why fall prevention starts with creating a safe living space.

Related: Exercises That Can Add Years to Your Life

This doesn’t have to involve a complete house remodel. You can make your home safe from falls with just a few basic changes. Senior care experts offer the following advice for preventing falls at home:

1. Clean up clutter. The easiest method for preventing falls is to keep your home neat and tidy. Remove all clutter, such as stacks of old newspapers and magazines, especially from hallways and staircases.
2. Repair or remove tripping hazards. Sometimes home fixtures can contribute to falls, which can then lead to back pain and other injuries. Examine every room and hallway, looking for items such as loose carpet, slippery throw rugs, or wood floorboards that stick up. Then repair, remove, or replace those items for more effective fall prevention.
3. Install grab bars and handrails. These safety devices are crucial for going up and down stairs, getting on and off the toilet, and stepping in and out of the bathtub without injuring yourself. Gary Kaplan, DO, founder and medical director of the Kaplan Center for Integrative Medicine in McLean, Virginia, suggests installing grab bars by toilets and bathtubs and handrails in stairways and hallways. Have a handyman or family member help with this if necessary.
4. Avoid wearing loose clothing. You want to feel comfortable at home, but baggy clothes can sometimes make you more likely to fall. Opt for better-fitting and properly hemmed clothing that doesn’t bunch up or drag on the ground.
5. Light it right. Inadequate lighting is another major hazard. To create a home that’s more suitable for the elderly, install brighter light bulbs where needed, particularly in stairways and narrow hallways. Robert Bunning, MD, associate medical director of inpatient services at MedStar National Rehabilitation Hospital in Washington, D. C., also recommends adding night-lights in bedrooms and bathrooms for better guidance at night.
6. Wear shoes. Socks may be comfortable, but they present a slipping risk. Preventing falls at home can be as simple as wearing shoes. You can also purchase non-slip socks that have grips on the soles of the feet if shoes are too uncomfortable.
7. Make it nonslip. Bathtubs and showers, as well as floors in kitchens, bathrooms, and porches, can become extremely dangerous when wet. To prevent falls on slick surfaces, Dr. Kaplan recommends nonslip mats.
8. Live on one level. Even with precautions like guardrails, stairs can present a significant falling hazard. “If possible, live on one level,” says Kaplan. “Otherwise be extra-careful when you negotiate stairs.” If it’s not possible to live on one level, try to limit the trips you take up and down the stairs.
9. Move more carefully. Dr. Bunning explains that many people fall at home by moving too quickly from a sitting to a standing position and vice versa. Preventing falls like this is as easy as taking your time. “All you have to do is pause after going from lying down to sitting and from sitting to standing,” he says. “Also take a pause before using the railing on stairs, whether going up or down.”

For the elderly, fall prevention means injury prevention. Ask your loved ones to help you ensure that your rooms and stairways are clutter-free and well-equipped with lighting, handrails, grab bars, and nonslip mats to help you avoid falling — all of which can go a long way toward keeping you safe in your home. In the event a fall does occur, having a proper Medicare plan can help alleviate surprise medical costs.

Diana Rodriguez also contributed to this report.

Prevention of Falls in Older Adults | Geriatrics | JAMA

The US Preventive Services Task Force (USPSTF) has recently published recommendations for providing interventions to prevent falls in older adults.

Falls are the leading cause of injury in adults aged 65 years or older. A serious fall can result in decreased functional independence and quality of life. Hip fractures in particular are a serious consequence of falling that can be devastating in older adults. The risk of falling increases with age for many reasons, including overall weakness and frailty, balance problems, cognitive problems, vision problems, medications, acute illness, and other environmental hazards. There is currently no ideal instrument or calculator for primary care doctors to decide who is at greatest risk of falls. The best predictor for an increased risk of falls is a history of falls.

What Are Some Interventions Used to Prevent Falls?

The USPSTF looked at several interventions including exercise therapy (working on gait, balance, and muscle strengthening in the legs), vitamin D supplementation, and multifactorial interventions, which involved creating a customized plan based on individual risk assessment. Examples of things that could be addressed include balance and gait, psychological health, cognition, vision, environmental conditions, diet and nutrition, and medications. Some of these interventions were found to be helpful while others were not.

What Is the Patient Population Under Consideration for Providing to Prevent Falls?

This USPSTF recommendation applies to adults who are aged 65 years or older, who live in the community (not in a nursing home or other institutional care setting), and who do not have known osteoporosis or vitamin D deficiency.

What Are the Potential Benefits and Harms of Providing Interventions to Prevent Falls?

The potential benefit of providing interventions to prevent falls for older adults is a decreased rate of falls in those at higher risk, thereby decreasing rates of injury (including fracture) that result from falls. Current studies have not shown a direct link between interventions to prevent falls and rates of death from falls. Current evidence suggests that exercise therapy provides the most benefit for decreasing falls and injury from falls. Some multifactorial interventions did have a small benefit. Vitamin D supplementation was found not to be effective at preventing falls. Potential harms of interventions to prevent falls include injury (including falling itself) due to exercise therapy; however, this risk is small. There is also a potential harm of side effects such as kidney stones from high-dose vitamin D supplementation in older adults, but these are also rare.

How Strong Is the Recommendation to Provide Interventions to Prevent Falls?

The USPSTF found adequate evidence that exercise reduces the risk of falls by a moderate amount, so there is a moderate net benefit to offering exercise interventions to older adults for fall prevention. For multifactorial interventions, the net benefit is small. The USPSTF found adequate evidence that vitamin D supplementation has no net benefit for preventing falls in older adults.

Bottom Line: Current Recommendation for Providing Interventions to Prevent Falls

The USPSTF recommends exercise to prevent falls in community-dwelling adults aged 65 years or older who are at increased risk of falls (“B” statement). The USPSTF recommends that clinicians selectively offer multifactorial interventions to prevent falls to community-dwelling adults aged 65 years or older who are at increased risk of falls (“C” statement). The USPSTF recommends against vitamin D supplementation to prevent falls in community-dwelling adults aged 65 years or older (“D” statement).

Box Section Ref ID

Source: US Preventive Services Task Force. Interventions to prevent falls in community-dwelling older adults [published online April 17, 2018]. JAMA. doi:10.1001/jama.2018.3097

Topic: Preventive Medicine

Preventing Falls in Older Persons

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15 Ways to Reduce Fall Risk and Help Prevent Fall for Seniors

It began as a casual visit. However, the situation could have been far worse. During a get-together with my mother, she tried to stand up from her chair but lost her balance and fell. Concerned, I rushed over to offer what help I could. Fortunately, Mom was perfectly fine. I helped her back to her feet and we both had a good laugh over what had just happened.

Seniors falling is not usually a laughing matter. As we age, falls can become increasingly common and risky for seniors. The World Health Organization (WHO) Global Report on Falls Prevention in Older Age states that “approximately 28-35% of people aged of 65 and over fall each year increasing to 32-42% for those over 70 years of age. The frequency of falls increases with age and frailty level. Approximately 30-50% of people living in long-term care institutions fall each year, and 40% of them experienced recurrent falls.”

What are the Facts About Fall Risk?

The Centers for Disease Control and Prevention paint a grim picture by telling us that “more than one out of four older people falls each year, but less than half tell their doctor. Falling once doubles your chances of falling again.”

And unfortunately, there is more. The WHO report shares even more alarming statistics relating to elderly falls:

• “Falls lead to 20-30% of mild to severe injuries and are the underlying cause of 10-15% of all emergency department visits. More than 50% of injury-related hospitalizations are among people over 65 years and older. The major underlying causes for fall-related hospital admission are hip fracture, traumatic brain injuries and upper limb injuries.”
• “The duration of hospital stays due to falls varies; however, it is much longer than other injuries and can range from 4 to 15 days.”
• “Falls may also result in a post-fall syndrome that includes dependence, loss of autonomy, confusion, immobilization and depression, which will lead to a further restriction in daily activities.”
• “Falls account for 40% of all injury deaths. Rates vary depending on the country and the studied population. The fall fatality rate for people aged 65 and older in the United States of America is 36.8 per 100,000 population (46.2 for men and 31.1 for women).”
• “Fatal falls rates increase exponentially with age for both sexes, highest at the age of 85 years and over. Rates of fatal falls among men exceed that of women for all age groups in spite of the fewer occurrences of falls among them. This is attributed to the fact that men suffer from more co-morbid conditions than women of the same age.”

4 Long-Term Consequences of Falls Among Older Adults

There are many possible outcomes from a senior’s fall, including:

1. Injury. Depending on where and how a senior falls, there is a high risk of injury. A senior’s brittle bones can easily become his or her broken bones.
2. Reduced Independence. Even the smallest fall can result in uncertainty in the mind of a senior. A senior can put up a brave front and appear to be healthy and robust. He or she may even say that the fall is nothing to worry about. However, there may be a lingering doubt about what he or she is capable of doing. After a fall – or a series of falls – a senior may think twice about heading outside for fear of another fall.
3. Multiple Falls. A single fall can begin a chain reaction of more falls. These continual falls are often the result of a senior’s lack of confidence. Reduced eyesight can result in a senior reaching for a caregiver’s supportive arm or a handrail but missing their target. While a senior or a family caregiver may dismiss a fall as not being serious, this could be completely wrong. A senior may sustain more serious injuries or even die. Let that single fall serve as a red flag of warning.
4. Further Family Impact. Falling doesn’t always just affect the senior. It can also affect the senior’s family. Family caregivers may have to rush away from their workplaces following a phone call alerting them of such an accident. Repeated phone calls may result in a complete departure from the office. Excessive chatting on the phone can be deemed unnecessary and a distraction from the job at hand leading to job dismissal. A caregiver may also decide to quit a job to be available for their loved one after a fall and tend to any needs that may arise. Or they may wish to be there to help prevent a fall in the first place.

Wondering how to support a loved one’s goal of being able to age at home? We’re here to help. Whether it’s for one month or ten years, our caregivers can help your loved one live the life they want at home. Call a Care Advisor today at 866-454-8346 or click here to schedule a free assessment and learn more about how we can support your needs.

15 Ways to Reduce Fall Risk and Help Prevent Falls

While you may not be able to always stop a senior from falling, you can take some steps to help reduce the risk. There are many reasons for falls in the elderly, so make sure to look at the whole picture. Use these precautions to take care of your loved one and their home to prevent falls:

1. Begin with the bathroom. Wet surfaces (on the floor or counters) can be very dangerous. Seniors lack the balance and reaction time needed to avoid a fall. While it may seem easy to step out of a shower, an unsteady senior may slip and come crashing to the floor. To help, provide non-slip mats in the bathtub and shower. Install grab bars in strategic points around the bathroom. Towel bars are not sufficient because they will collapse under someone’s full body weight. Grab bars can be attached inside the shower stall or just above the bathtub to help a senior with lowering or standing up.
2. Provide a shower seat. Seniors can be far more secure when they are seated when showering.
3. Replace the shower head with a hand-held nozzle. Seniors can become more confident with showering with a nozzle. The nozzle can be easily turned away in the case of sudden water temperature changes. In addition, it can result in a much more thorough cleaning. Long-hoses are now available, which are far easier to use for someone seated in the shower.
4. Stairs. Whether inside or outside the senior’s home, stairs can be major concerns. I recall my parent’s first retirement home in Victoria, British Columbia. This was a beautiful two-bedroom condo with a view of the ocean but outside access proved to be too much. I often saw my mother grabbing the handrail and pulling herself up the stairs to get inside. If a senior does have stairs, there are plenty of precautions you can take.
5. Clear the stairs. Whether it is a few dropped clothes or a grandchild’s toy, anything left on the stairs can become a tripping and falling hazard.
6. Differentiate between the stairs. Aging eyes may not always be able to separate one step from the next. To help, you could try replacing the carpet on each step to make the steps easier to spot. In the case of bare steps, try painting each step a different color. Other options include adding safety tape or removing carpeting and adding stair treads. All flights of stairs should also have handrails on both sides of the stairs.
7. Consider a stairlift. These mechanisms can safely take a senior up or down a flight of stairs. The senior will sit in a comfortable chair without having to climb up or down the stairs. A colleague of mine used this with her father. This enabled her and her family to turn the basement into a fully-furnished suite for him and his caregiver.
8. Shovel snow and chip ice off stairs in the winter. This work can be too much for a senior to handle. So why not delegate the job to a younger family caregiver or hire a neighbor? This task prevents slipping and falling outside the home.
9. Tighten stair handrails. A loose handrail is of little good to anyone grabbing for it. Secure these handrails both inside and outside the senior’s home.
10. Tuck away extension cords. Are there any power cords stretched across a senior’s floor? Tape them down or slide them underneath or behind furniture.
11. Remove excess furniture. A more mobile senior may be able to sidestep a footstool or a coffee table but not all seniors can do this. Remove unneeded furniture to give the senior more room to maneuver and help to create a safer living environment. Also, a deep plush armchair may look comfortable but the senior may become trapped if he or she lacks the body strength necessary to push up and out of the chair.
12. Get a cane or a walker. A doctor can best advise if the senior will need a mobility aid. This could be a wheelchair, a walker, a cane, or a motorized scooter. As with any mobility aid, make sure that is properly fitted for the best and easiest use. Reducing or eliminating the walker stigma that often exists may be a little more difficult to do. However, seniors may find that using a walker increases their own freedom, independence, and quality of life. Be aware that an occupational therapist needs to train the person to use these properly. For increased convenience, choose a wheelchair, walker, or scooter that can collapse and fit easily in a car’s trunk or back seat. Be mindful of the size of mobility aids. A wheelchair or walker may be too wide to fit through a senior’s doorways. A four-wheeled scooter will be better for outdoor use and will provide more stability. A three-wheeled scooter can be far more maneuverable inside the home.
13. Evaluate a senior’s footwear. Shoes need to fit well and have non-slip soles. Shoes with Velcro straps can be easier to tighten or loosen. They also remove any risk of tripping over long laces. Do not choose senior’s shoes based on how easily they can be put on and taken off. I’ve heard from at least one person whose father wore loose shoes and she had to buy all new shoes for him.
14. Install better, brighter lighting. Seniors cannot always see that well in a dark or shadowed room. Better, brighter lighting can help to light the way. On this same subject, assess the location of light switches. These may be out of reach for someone in a wheelchair.
15. Keep a senior active. Whether through regular walking or light exercising and stretching, an active senior can remain more stable than a sedentary senior. Exercising can help prevent falls by keeping stabilizing muscles strong.

What to Ask the Doctor After an Elderly Person’s Fall?

Family caregivers need to understand that falls in the elderly, whether just once or repeatedly, can be a serious matter. Among the first steps for caregivers is to schedule a doctor’s appointment. Accompany your senior loved one into the examination room. Make sure to share the details of the fall and to ask the doctor questions.

What types of questions should a caregiver ask? Leslie Kernisan, MD MPH outlines her recommended medical checks in her article, “8 Things to Have the Doctor Check After an Aging Person Falls.” Make sure to ask for:

An assessment for an underlying new illness. “Just about any new health problem that makes an older person weak can bring on a fall. Some common ones include:

• Urinary Tract Infection
• Dehydration
• Strokes”

A blood pressure and pulse reading when sitting, and when standing. “This is especially important if you’ve been worried about falls — or near falls — that are associated with light-headedness, or fainting.

If your older relative takes blood pressure medication, you should make sure the doctor confirms that he or she isn’t experiencing a drop in blood pressure when standing. (Note that tamsulosin — brand name Flomax — is a popular prostate medication that also causes drops in blood pressure.)”

Blood tests. “Falls can be worsened by problems with an older person’s blood count or by things like blood sodium getting too high or too low. Generally, a complete blood cell count (CBC) and a check of electrolytes and kidney function (metabolic panel, or “chem-7”) are a good place to start.”

Medications review. “Many older adults are taking medications that increase fall risk. These medications can often be reduced, or even eliminated.”

Gait and balance. “Simple things to do, if gait and balance don’t seem completely fine, are:

• Address any pain or discomfort if that seems to be a cause of problems. Many older people are reacting to pain in their feet, joints, or back.
• Consider a physical therapy referral for gait and balance assessment. A physical therapist can often recommend suitable strengthening exercises, and also can help fit the older person for an assistive device (e.g. a walker) if appropriate.”

Vitamin D level. “Studies suggest that treating low vitamin D levels might help reduce falls in older adults. Low vitamin D levels can also contribute to fragile bones.”

Evaluation for underlying heart or neurological conditions. “An older person may be falling because he or she has developed a chronic problem with the heart or blood pressure system or Parkinson’s disease.”

Vision, podiatry, and home safety referrals. “Could your loved one be in need of a vision check, podiatry care, or a home safety evaluation? If you’ve brought an older person in after a fall, it’s a good idea to talk to the doctor about whether these services might help.”

Eyesight’s Impact on Fall Risk for Older Adults

It’s been said that our eyes are the windows to the world. But if those windows are dirty or blocked, we cannot properly see people and things around us. Seniors may experience this happening as they lose their eyesight resulting in in significant problems:

• Focusing difficulty
• Poor depth perception
• Trouble balancing
• Falling

Fortunately, options exist to correct poor eyesight. These include the following:

• Properly prescribed glasses can sharpen vision (attach a strap between the earpieces to help keep glasses on the face and to reduce the chance of loss)
• Surgery may clear up glaucoma, macular degeneration, and cataracts
• Eye drops or medication may soothe eye dryness, watering/tearing, or itchiness, or remove “floaters” (spots which appear in a senior’s line of sight and impede vision)

Diagnosing the nature and scope of the problem is best done by an optometrist during a complete eye exam. Caregivers may find accompanying the senior into the eye exam may reduce the senior’s anxiety and better allow them to listen to the doctor’s report or ask questions.

Strategies to Support Seniors After a Fall

Preventative measures to help reduce fall risk in seniors is always the first step, but if a fall does happen, supporting seniors who have fallen takes two approaches. A caregiver must provide physical support to help a senior safely stand upright again. A caregiver may also provide emotional support to help a senior regain any lost confidence or composure. Helping a senior up from the floor is the first step. Remember these recommendations:

1. Calm down. Seeing a senior fall can result in panic or worry. Seniors may mirror these reactions and respond in a similar manner.
2. Check for injuries. Resulting injuries from a fall can vary from slight bumps and/or bruises to more serious fractured ribs. Cuts and/or blood flow can be conspicuous.
3. Resist rushing. Family caregivers looking for injuries and seniors trying to stand again should proceed gently. Hurrying the process may result in further damage.
4. Offer help – but don’t get too close. Extending a hand may seem like the simple reaction. But lifting a senior takes strength, balance, and experience. Even well-meaning caregivers may risk strain and undue harm. Encourage the senior to use a chair to pull him/herself to a standing position.

A Longer-Lasting Problem of Falling

A fall may lead a senior to adapting a “once-bitten, twice-shy” mindset and becoming extremely nervous about even standing up out of bed in the morning. It may take time for the senior to regain his or her personal trust. Physical reactions can be accompanied by emotional problems:

1. Increased fear. Even with offered help, a senior may become tentative about standing or walking. After falling, a senior may take slower and smaller steps.
2. Anger. Typically stubborn loved ones may greatly dislike knowing of or having a family caregiver’s help. Losing one’s independence can be a difficult thing to accept. Imagine being unable to do something that you could do previously with great ease.
3. Depression. They have lost their purpose and may simply give up. Family caregivers may also see their loved one withdraw, become sadder, or show severe mood swings.
4. Denial. Seniors who have fallen may casually dismiss the problem, refuse to talk about it, or conveniently forget about it entirely.

Addressing the emotional impacts of a fall can prove to be trickier for family caregivers. Try these recommendations:

1. Recognize the senior’s emotions. A senior who has fallen may become increasingly frightened, confused, and even resistant to talk about the experience. Family caregivers can help them by showing understanding, support, and patience.
2. Appreciate the risk. Unfortunately, a senior who has fallen is, typically, more likely to fall again. When walking with Dad in his later years, I worried about him stumbling. A support belt – which fit snugly around Dad’s waist – was advised. I was shown how I could grab onto this behind Dad’s back and help to keep him upright. I was not, however, completely confident though that I could safely catch Dad if he tripped, or be able to lower him to the ground, so I kept our walks shorter or borrowed a wheelchair for Dad’s use. If precautions need to be clarified with a loved one, explain why they are necessary for the senior’s safety.
3. Offer encouragement: A reassuring smile, comforting pat on the back, or positive feedback can greatly help a senior who has fallen. Understanding falling has occurred is simple to understand but accepting falling has happened is a much harder thing to ask for. Respond positively, reassure, and help the senior in any way possible. Remember to work within the senior’s capabilities.

Resources:

CDC and Prevention: Older Adult Falls

Senior & Elderly Care: Caring for your loved one

90,000 Prevention of falls and fractures in the elderly

As part of the implementation of the national project “Demography” and the federal project “Older Generation” in the Bryansk region, employees of the geriatric service of GAUZ “Bryansk Regional Hospital for War Veterans” remind of the recommendations of the Russian Gerontological Research and Clinical Center about such important aspects in the life of elderly and senile people. age, as the correct arrangement of the home and physical education and sports.

Every year thousands of elderly people fall at home. Many of them receive serious injuries, including fractures (most often – of the femoral neck, remote parts of the arms and legs, pelvic bones, vertebrae). Falls often occur due to external reasons that are not considered important in the domestic environment, but they can be easily eliminated.

Tips:

• check the condition of the floor in each room: the floor surface should be even, smooth, but not slippery;
• Install good lighting at home;
• it should be convenient for you to move around the house: free the aisles, if necessary, ask someone to rearrange the furniture;
• Remove rugs that slide easily on the floor, or use double-sided tape or a non-slip backing to secure the carpet to the floor and prevent slipping;
• check the height of the bed: it should be comfortable for you to get up and sit on it, the top edge of the mattress should not be lower than knee level;
• all necessary items (glasses, books, newspapers, medicines, drinking water, watches) must lie next to the headboard;
• install the lamp in such a way that it is easy to turn it on while in bed; roll up wires / cables (for example, from lamps, telephone or extension cords) or fasten to the wall so that there is no possibility of tripping over them;
• invite a specialist and install the handles inside the bathroom and near the toilet;
• Use an anti-slip mat or self-adhesive anti-slip tapes on the bathroom or shower floor.

Avoid:

• independently remove items from the upper shelves and mezzanines;
• step on ladders and chairs;
• to use flip flops as home shoes, they increase the risk of falling and often slip off your feet.

Tips for reducing the risk of falls:

• Exercise regularly: exercise makes your body stronger and improves coordination;
• Talk to your doctor and ask to see all the medicines you are taking, including over-the-counter medicines: some of them may cause drowsiness or low concentration;
• have your vision checked by an ophthalmologist at least once a year: poor vision increases the risk of falling;
• try to always get up and up from lying and sitting positions very slowly;
• If it is hard for you to lace up shoes, it is advisable to sew wide elastic bands instead of laces or make a Velcro fastener.

Additional recommendations:

• Consider using mobile devices to alert you if you fall and are unable to get up;
• write down and keep in an accessible place the names and phone numbers of your attending physician, close relatives and friends, at the right time they can prompt important medical information;
• your loved ones should know where your personal documents are kept.

Better protection than falling: the elderly will be saved from injuries and bruises | Articles

Russia has developed and is launching a fall prevention program for older people in seven pilot regions.Its final expert discussion will take place at the III All-Russian Congress on Gerontology and Geriatrics, which opens on May 16 in Moscow. By 2024, the program will be implemented in all regions of the country, the Ministry of Health told Izvestia. According to European statistics, falls are the fifth cause of death in elderly patients after cardiovascular, oncological, cerebrovascular and pulmonary diseases. Geriatricians are confident that falls must and can be prevented, and an emergency response in such cases will help save 30 thousand people.lives per year.

No coincidence

Currently, the program for the prevention of falls and fractures in senior citizens (over 65 years old) is in the final stage of revision. The methodological document has already been prepared and approved by the leading traumatologists-orthopedists, endocrinologists and rheumatologists of the country. It was included in the action plan of the federal project “Older Generation” of the national project “Demography”.

This year the program is being launched in seven pilot regions – Volgograd, Voronezh, Samara, Kaluga and Belgorod regions, as well as in the Perm Territory and Bashkiria.Olga Tkacheva, the chief geriatrician of the Ministry of Health of the Russian Federation, told Izvestia about this.

Fall is considered one of the main geriatric syndromes. In developed countries with high life expectancy, where geriatric services have been successfully developing for a long time, there are plans to prevent falls in the elderly. In Russia, however, such a program is being introduced for the first time.

In our country, it is still believed that falls are “normal” among older people. This opinion is also found in the medical community.And this is a big problem, because the consequences of falls are very severe.

“Almost half of the injuries sustained as a result of a fall lead to a loss of the quality of life, independence,” explained Olga Tkacheva. – Among centenarians, falling is one of the leading causes of death and disability. But one must understand that this is not an accident or inevitability. They are preventable.

In a document developed by the Russian Association of Gerontologists and Geriatricians in cooperation with the Gerontological Research and Clinical Center of the Russian National Research Medical University named after V.I.N.I. Pirogov, it is said that, according to WHO estimates, a third of people over 65 fall annually, and more than half of them – repeatedly. Approximately 10-15% of falls result in serious injury, such as head injuries or hip fractures. Falls are now the fifth leading cause of death in older people.

Disability following a fall hits the family budget hard, and the costs associated with it are one of the leading health care expenditures worldwide.

Take care of the balance from your youth

According to one of the developers of the document, the deputy director for scientific work of the Russian Gerontological Research and Clinical Center of the Russian National Research Medical University named after V.I.N.I. Pirogov of the Ministry of Health of Russia Yulia Kotovskaya, the fall of an elderly person should be treated as an acute coronary syndrome in cardiology – perceived as a serious threat to health and look for reasons.

“There are several groups of factors: old age, extinction and changes in body functions, an unsafe environment that surrounds an elderly person, behavioral factors plus social conditions that can also increase this risk,” Yulia Kotovskaya explained to Izvestia. – Prevention should be carried out in all these areas.

The expert believes that falling prevention should be done from a young age, because good physical condition is the key to reducing risk in old age.

“It is necessary to maintain physical activity in old age, and do not only exercise for endurance, but also for balance,” she said.

Bed for rent

It is planned to send an extensive information program to reduce behavioral risk factors. But more serious measures are needed to eliminate external and socio-economic factors.

The document primarily provides for the updating of educational programs for medical workers.

– Already, the program for the training of geriatricians and the program of thematic improvement of primary care physicians – therapists, general practitioners, geriatric nurses – includes the section on prevention of the risk of falls, – said Olga Tkacheva. “We consider it very important that social workers and family members caring for the elderly receive education in this area.Because falls often happen at home.

Correction of educational programs is carried out at the federal level. And at the regional level, services should be created to help prevent falls and quickly respond to cases that have already occurred.

The document provides for the creation of services for organizing a safe environment in apartments and houses of the elderly, as well as resource centers for renting adaptation means, including functional beds and wheelchairs.

– Services do not have to be public.It is possible to connect commercial organizations that will be engaged in social business, – noted Olga Tkacheva.

30 thousand lives

In addition, the regions will create “panic button” and response services to the falls of the elderly. They are planned to be organized on the basis of an ambulance with the involvement of trauma centers, geriatric and rehabilitation centers. The purpose of such services is the earliest possible diagnosis and effective care for fractures.

Traumatologist-orthopedist of the Moscow City Clinical Hospital No. 13, Deputy Chairman of the Russian Section of the Osteosynthesis Association Leonid Farba explained to Izvestia that the sooner an elderly patient with a hip fracture is operated on, the more chances he will get to his feet.But not so long ago, the ambulance often did not even pick up elderly patients with such injuries. Now in some regions the situation has improved. And in the whole country it is mosaic.

– Now all traumatology courses are aimed at teaching surgeons to work with elderly people, the expert said. – These are fast operations, minimally invasive methods, small incisions, little blood loss during the operation, good fixators. The main thing is to put in the head of the Russian traumatologist the idea that the older the patient with a hip fracture, the more indications he has for surgery.Statistics show that without surgery, more than 70% of patients over 60 years old die in the next few months from physical inactivity and complications.

The fall prevention program states that all patients with a fracture of the proximal femur should be admitted to specialized departments, at least 95–98% of whom should be operated on within 24–48 hours. However, according to Leonid Farba, not all hospitals in Russia can perform such surgical interventions.Therefore, it is necessary to develop a “road map” for the transfer of these patients from remote areas to large hospitals, the expert is sure

Experts’ calculations show that the implementation of these international principles for the treatment of patients with fractures of the proximal femur will save 30 thousand human lives annually.

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The problem of falls among the elderly: the main risk factors and the most effective preventive measures – Prevention of diseases – Catalog of articles

Source: the magazine “Chief Physician”.

The elderly make up a significant part of the population and their number is increasing. As you age, the risk of falls and, consequently, injury increases. A fall may be the first manifestation of an undiagnosed illness. Preventing falls is important because they can significantly increase mortality and morbidity, bring suffering to the elderly and their families, and impose significant costs on society in hospital admissions and nursing homes.

Every year, falls are reported in 30% of people over 65 years old, and among people over 75 years old, this percentage is even higher. 20-30% of those who fall are injured, which reduces their degree of mobility and independence and increases the risk of premature death. The incidence of falls among older people living in institutions is much higher than among people living in a familiar home environment.

Fall prevention programs can help reduce the number and frequency of falls.The most promising are targeted strategies aimed at changing behavior and modifying risk factors among those living in the home. Effective results have been obtained with integrated intervention programs that include risk assessment and screening.

The use of physical and pharmacological restraints leads to even more serious injury from falls. The use of complex measures of influence in patients with impaired cognitive functions who are in inpatient conditions after a fall did not give positive results, however, the effectiveness of targeted prevention measures in people with impaired cognitive functions living in specialized care institutions was noted.It appears that fall prevention programs can be cost effective, although further research is needed.

Falls could increase over the next 25-30 years unless concerted action is taken. Health and social care agencies need to work together to prevent falls, which should be a priority as part of an overall strategy for promoting the health of older people.

Effective interventions include the following:

– performing exercises at home as prescribed by specialists, designed to develop dynamic balance and strengthen muscles, as well as walking;

– group exercises based on Tai Chi exercises or to develop dynamic balance and strengthen muscles, as well as to develop safe walking skills;

– visiting elderly people who have had cases of falls at home and making changes to the arrangement of the home;

– study of the composition of drugs taken, especially if their number reaches four or more and, if possible, the exclusion of psychotropic substances.

A fall is generally defined as “an incident in which a person is suddenly on the ground or other low surface, except as a result of a blow, loss of consciousness, sudden paralysis or epileptic seizure” .

Falls and related injuries among older people represent an important problem for health care providers and social workers in Europe and around the world due to the significant increase in life expectancy of people observed during the 20th century . Falls are the most serious and frequent domestic accidents among the elderly. Falls constitute one of the main reasons for hospitalization or admission to a nursing home, even in the absence of serious injury . The incidence of fall-related injuries is increasing more rapidly than could be explained by an increase in the elderly population .

In conducting epidemiological studies on falls and related injuries, scientists have encountered a number of conceptual and methodological difficulties.Most of the fractures of the hip as a result of falls fall into the scope of medical attention, but people with less serious injuries often do not seek medical help. Considering that in most cases falls go unnoticed by physicians , statistical indicators of the frequency of falls among the population are largely based on data recorded retrospectively from the words of the victims themselves and / or their loved ones. Despite these difficulties, a number of generalizing conclusions regarding the frequency of falls can already be found in the scientific literature.

The frequency of falls and their consequences

This section summarizes epidemiological data on populations affected by falls from numerous studies across countries. Fall-related injury rates vary across countries and parts of Europe , however, the summary below provides an indication of the overall magnitude of the problem and potential risk factors that should assist in the design of any fall prevention program.

Elderly people living at home

30% of people over 65 and 50% over 80 suffer a fall at least once a year .

Seniors who have experienced a single fall are two to three times more likely to fall again during the same year .

Approximately 10% of ambulance calls in the United Kingdom are from people over 65 due to a fall. About 60% of these cases are hospitalized .

From 20% to 30% of falls result in injuries that reduce mobility and independence and increase the risk of premature death . Somewhat less often falls requiring medical attention lead to fractures . Among people prone to falls, one year after the start of observation, 20% were either in the hospital or in a nursing home with 24-hour care, or died .

Older people are hospitalized for fall-related injuries five times more often than for other injuries . Falls are the leading cause of injury-related deaths among people aged 65 and over; in half of these cases, the fall occurs at home .

For women over 55 and men over 65, age-specific mortality and hospitalization rates for trauma increase exponentially with age. More than a third of all women experience a bone fracture due to osteoporosis at least once in their lifetime, in most cases after falling . For men, the risk of a bone fracture at some time in their life is about half that for women. Fractures account for over 50% of hospital admissions for serious injury from accidents and 39% of fatal injuries.

Elderly people in nursing homes

Approximately 50% of seniors in nursing homes suffer a fall at least once a year , up to 40% fall more often than once a year .

Falls are recorded as one of the justifications in 40% of cases when admitted to nursing homes .

The incidence of falls in nursing homes is 1.5 per person in a year .

The incidence of falls may double after relocation of older people and return to baseline after three months .

Among people aged 85 and over, 20% of falls-related deaths occur in nursing homes .

Falling fractures

Although the proportion of falls resulting in fractures is small, the absolute number of older people with fractures is significant, placing a heavy burden on health systems.

Approximately 10% of falls result in serious injuries , of which 5% are fractures . Fractures in the wrist, spine, hip, humerus and pelvis are most common in old age.

Fractures of the femoral neck account for approximately 25% of all fractures resulting from falls in people living at home .

Among those living in nursing homes, the incidence of hip fractures is higher – up to 81 per 1000 people / year . At least 95% of hip fractures occur as a result of a fall .

Approximately half of cases of hip fracture as a result of falling do not recover the ability to walk, 20% of cases are fatal within six months .

Falls not causing physical injury

75% -80% of non-injury falls do not seek medical attention .

A common consequence of repeated falls is the so-called post-fall syndrome: a combination of depression, constant fear of falling, and other psychological disorders . Even in the absence of trauma, loss of self-confidence, social isolation, disorientation and feelings of loneliness may develop.

A fall that is not accompanied by physical injury, however, can lead to death if the victim is unable to get up on his own and is unable to call for help. If an elderly person lies on the floor for more than 12 hours, bedsores develop, dehydration, hypothermia, pneumonia and death may develop . In almost half of the observed cases, elderly people with repeated falls required assistance at least once to get up, but only in 10% of falls the victim was forced to lie on the floor for more than one hour.

Risk factors

Further research is needed to develop strategies for preventing falls in the elderly population. It is of utmost importance in this regard to identify the groups most at risk in order to maximize the effectiveness of any proposed preventive measures. Published literature has identified specific risk factors for falls and related injuries. However, direct comparison of research results is difficult due to a number of methodological obstacles, such as the use of different populations, lack of clarity and consistency in definitions, variability in follow-up periods, and the inevitable difficulties associated with collecting information retrospectively from people’s words.In addition, the causal relationship between risk factors and the incidence of falls is complex.

The risk factors for falls can be divided into three categories: internal factors, external factors and the degree of exposure to risk. The following section presents the potential risk factors that fall into each of the categories. However, it should be borne in mind that falls are often due to the dynamic interaction of risks of all categories and that the isolated consideration of the individual risk factors presented below does not take into account the influence of confounding factors (in which the effect of one risk factor in multivariate analysis is explained by the effect of another).

Internal risk factors

A history of falls are associated with an increased risk .

Age: The incidence of falls increases with age .

Gender: Falls are similar in men and women in younger ages, but women in the very elderly are more likely to fall than men and are much more likely to fracture from falling.

Living alone: ​​May be functional, but injuries and falls can be more severe, especially if the victim is unable to get off the floor.Living alone is also a risk factor for the frequency of falls, although this effect is in part related to certain characteristics of older-occupied dwellings .

Ethnicity: Research data from the United Kingdom and the United States show that Indo-European ethnic groups are more prone to falls compared to Africans, Hispanics or South Asian groups , However, there is no evidence of ethnic variability within continental Europe. confirmed.

Drug use: Benzodiazepine use in old age is associated with a 44% increased risk of hip fracture and falls out of bed while sleeping . The risk of falls increases significantly with psychotropic drugs, class 1a antiarrhythmics, digoxin, diuretics and sedatives . As the evidence base for the use of drugs in the treatment of chronic diseases expands, the number of drugs prescribed is increasing.A significant increase in the risk of falls when more than four different drugs are given concurrently, regardless of type, has been demonstrated by all relevant studies with the exception of one . Concurrent use of four or more drugs is also associated with a nine-fold increase in the risk of cognitive impairment and the development of fear of falling .

Health disorders: cardiovascular disorders, chronic obstructive pulmonary disease, depression and arthritis are all associated with a 32% increased risk . The prevalence of falls increases as the burden of chronic disease increases . Thyroid dysfunction with excessive release of thyroid hormones, diabetes mellitus and arthritis leading to impaired peripheral sensitivity also increase the risk. The prevalence of cardiovascular falls in the general population is unknown, but dizziness is common in those affected by falls. There are also frequent cases of depression and urinary incontinence in this group .

Disorders of motor functions and gait: the process of age-related decrease in physical strength and endurance, starting after 30 years (every ten years – by 10%), as well as muscle performance (every ten years – by 30%) gradually leads to such a level of decrease in physical functions when performing the simplest responsibilities of daily life becomes difficult and then impossible. In people with a predominantly sedentary lifestyle in previous years, this condition may occur even before the onset of extreme old age . In conditions of a significant decrease in physical strength, endurance and muscle performance, and, accordingly, deterioration of motor functions, when a person stumbles or slips, he is no longer able to keep from falling. Muscle weakness is a significant risk factor for falls, as are disturbances in gait, balance, or the use of walking aids . Any functional disorders of the lower extremities (decreased muscle strength, orthopedic pathology or sensory disturbances) lead to an increased risk. . Difficulty getting up from a sitting position is also associated with an increased risk .

Sedentary: People prone to falls tend to be less active and this can inadvertently further develop muscle wasting as a result of insufficient training around already unstable joints. A 14-day decline in daily physical activity due to illness is associated with an increased risk of falling . People with reduced activity levels fall more often than those who are moderately or vigorously active in a safe environment. However, the level of physical activity is so closely related to the functional state of the muscular apparatus that it is very difficult to determine the separate effects of decreased activity and muscle dysfunctions.

Psychological state – fear of falling: up to 70% of those who had experienced a fall shortly before the survey, and up to 40% of those who did not have this, reported having a fear of falling . Decreased physical and functional activity is associated with anxiety and fear of falling. Up to 50% of people with fear of falling limit or completely stop social and physical activity . A strong relationship was found between fear and a slowdown in walking speed and muscle weakness , A low level of assessment of one’s health status and a decrease in the quality of life . Fear of falling and the occurrence of falls were predictive of each other when observed during the year . Women with stroke are at risk of falls and fear of falls . Taking four or more drugs concurrently also increases the risk of falls independently . However, older people are often unable to adequately assess their level of risk.

Eating disorders: A low body mass index, indicative of malnutrition, is associated with an increased risk of . Vitamin D deficiency is particularly common among the elderly in nursing homes and can cause gait disturbances, muscle weakness, osteomalacia and osteoporosis .

Cognitive impairment: cognitive impairment is clearly associated with an increased risk, even when it is relatively minor (not reaching the level of profound dementia). The Amsterdam Study on Aging demonstrated that impairment of short-term memory in people over 75 years of age is an independent risk factor for falls . Among those living in nursing homes, people with diagnosed dementia fall twice as often as those who are not cognitively impaired, but there was no difference in injury severity between groups .

Visual impairments: visual acuity, contrast sensitivity, size of visual fields, as well as cataracts, glaucoma and degeneration of the retinal spot – all these factors affect the risk of falls , as well as wearing glasses with bifocal or multifocal lenses . Multifocal lenses interfere with depth perception of space and contrast visual sensitivity, which makes it difficult to detect external obstacles in a timely manner. It is possible that it is more advisable for older people not to use multifocal glasses when walking up the stairs and in unfamiliar surroundings outside the home .

Pathology of the foot: curvatures and bursitis in the big toe, deformities of other toes, ulcers, deformities of the nails, as well as pain in the feet when walking create additional difficulties in maintaining balance and increase the risk of falls . The nature of the shoe also matters. .

External risk factors

The extent to which environmental factors influence the risk of falls in older adults is uncertain.Some studies have shown that 30% to 50% of falls in older people living at home are due to environmental factors, while others have shown that 20% of falls are caused by intense external factors (which would have caused any healthy adult to fall) 90 149 … Elderly people often slip and stumble and find it difficult to balance to avoid falling. The following external factors are distinguished:

1) environmental defects (poor lighting, slippery and uneven floors, etc.)n.) ;

2) the nature of shoes and clothing ;

3) unsuitable walking aids and aids .

Degree of exposure to risk

In some studies, a U-shaped relationship has been identified, that is, the most and least active people are subject to the maximum risk of falls . This indicates a complex relationship between falls, activity level and risk.The nature and intensity of the impact of environmental factors, determined by the lifestyle of an elderly person, interact with internal risk factors. One study found that walking itself increases the risk of falls , others – suggest that increased physical activity, on the contrary, reduces the risk of falls, but increases the risk of serious injury . Overall, however, it appears that maintaining a moderate to high enough level of physical activity with the use of walking aids appears to have a beneficial effect on the elderly living in nursing homes .

In some situations, physical activity increases the risk of falls due to either greater exposure to adverse environmental factors (slippery or uneven floors, areas with a pile of various objects that need to be repaired sidewalks), or fatigue, or non-compliance with precautions when performing exercises .

Conclusions on risk factors

Since all of the above studies, evaluating a large number of factors, are predominantly exploitative in nature, identifying the determining risk factors in relation to falls seems to be very difficult.However, there is reason to believe that for people aged 80 and over, internal factors , are of greater importance, since loss of consciousness is more often observed in this group (indicating that the fall is associated with one or another general disease). Falls among people under the age of 75 are likely to be more related to external risk factors. A number of studies have shown that the likelihood of falls among older people living both at home and in nursing homes increases exponentially as the number of exposure risk factors increases . The Robbins model , considers only three risk factors (hip instability, imbalance and concurrent administration of more than four drugs). In people not exposed to any of these factors, the risk was 12%; in the presence of all three factors, the risk reached 100%.

It would be wrong to conclude that the risk factors that exist for a particular group of people in a given setting are exactly the same as for another group of people in identical or different conditions.For example, a study by Lord , showed that people living in nursing homes are exposed to different risk factors for falling, depending on whether they can stand without assistive devices or assistance. It is concluded that those who can stand alone but are exposed to multiple risk factors are the highest priority group for falls prevention interventions .

Prevention of falls and injuries

As a result of many years of research, a large amount of epidemiological data has been accumulated to help determine the specific causes and risk factors associated with falls.Based on the identified risk factors, various diagnostic methods have been developed. However, it was only ten years ago that the first attempts were made to test in practice the effectiveness of measures to prevent falls.

A series of multivariate studies in the prevention of falls among older people living at home have shown that five to 25 people need to be covered to prevent one fall , , which compares favorably with many medical screening programs.There is evidence that slightly different interventions are effective for nursing home residents . Despite the widespread adoption of fall prevention programs among inpatients, there have been no adequate randomized controlled trials (RCTs).

The review by Feder , contains the following findings:

1) priority should be given to comprehensive measures, including stimulation of physical activity, training and adaptation of the home;

2) it is necessary to use targeted measures to maintain physical activity among people over 80 years old;

3) assessment of housing conditions without referral for assistance and without specific preventive measures is not effective;

4) it is necessary to assess the economic efficiency of complex measures;

Key Findings of the Cochrane Database Systematic Review on Fall Prevention:

1) The most effective prevention of falls can be achieved by addressing multiple risk factors in individual patients;

2) medical care services are recommended to carry out preventive examinations of elderly people at risk, followed by targeted interventions to control detected violations;

3) maintaining physical activity at home, exercises according to the Tai Chi system, eliminating unfavorable factors in the arrangement of the home for people who have experienced falls, withdrawal of psychotropic drugs and coverage with comprehensive preventive programs – all these are most likely effective measures to prevent falls, their results are associated with values ​​of the total relative risk from 0.34 to 0.80;

4) the effectiveness of measures such as group exercise, supplementation, pharmacotherapy, home improvement for fall survivors, and fall prevention measures for nursing homes is unknown.

The most compelling evidence for the effectiveness of falls prevention comes from prevention programs that target selected high-risk groups and use multiple interventions combined with a personalized approach . Among the specific measures, the revision of the list of prescribed drugs, as well as the detection and treatment of orthostatic hypotension, turned out to be effective. The effect of the ongoing therapeutic interventions for the tendency to fainting and carotid sinus syndrome has also been demonstrated, although these disorders are not among the typical causes of falls . Evidence in favor of measures taken in isolation to correct the housing environment is still unconvincing . There is now solid scientific evidence that stimulation of physical activity is effective as part of a comprehensive fall prevention program. The data on the isolated use of this measure are less clear , so some studies have shown no or very little effect of exercise on the risk of falls despite having a positive effect on a number of known risk factors such as physical strength.The greatest effectiveness among the most diverse age groups, including people with varying degrees of functional limitations (from mild to very pronounced), are those programs where balance training takes the central place among physical exercises.

Exercise-only programs have primarily targeted older people living at home. Group exercises on the Tai Chi system in a modified version turned out to be effective in prophylactic terms among people over 65 with reduced physical strength and imbalance . Similar activities with physically impaired people aged 70 and over over a 48-week follow-up period did not have the desired effect in terms of preventing falls . A 15-week group exercise program for people over 70 was found to be more effective in reducing the risk of falls than eye and home safety examinations . The same authors were able to obtain even more demonstrative results in their next study – with a one-year program duration of . In another study, it was shown that in persons over 65 years of age with a decrease in muscle strength in the lower limbs, imbalance and delayed response participation in a one-year program of group and individual home exercise, the frequency of falls decreased by 40% compared with the control group . Likewise, a nine-month program of group and home exercise to train balance and increase muscle strength in people over 65 with frequent falls resulted in a reduction in falls . Older adults may be expected to be less accurate in their prescribed home exercises than in groups, but a study of a home exercise program, partly instructed by an instructor, has been shown to be highly effective in preventing falls. At the same time, the maximum economic efficiency was achieved in the group of people over 80 years old .

There are some concerns about the appropriateness of increased physical activity and exercise for elderly people with balance disorders.One study that recommended walking in the street as a preventive measure for a group of older people at risk of falls actually showed an increased risk of injury compared to a control group . Strength and flexibility training should probably be done first before embarking on exercises that require good balance; its duration should be sufficient both to achieve the desired physiological changes and to increase a sense of self-confidence .

There is a growing body of data on programs in care facilities for the elderly. Among these, exercise, balance training and environmental improvement are central. Adequate training of personnel leads to a positive effect only in combination with other measures . A recent RCT showed a reduction in the incidence of falls in an elderly group receiving vitamin D and calcium supplements compared with a control group . Convincing data are not yet available for prevention programs for patients in hospital settings.

The strategic approach to preventing falls and fractures involves the following three steps:

1) identification of high-risk groups among the elderly;

2) detailed examination of people in these groups to identify individual risk factors for falls and fractures;

3) taking measures to reduce the identified risk factors .

Conclusions

The costs of falls and their aftermath are likely to remain one of the leading health care expenditures in all European countries for the foreseeable future. Close collaboration of health and social services, nongovernmental organizations and other official and community structures is needed to address this critical problem for older people and to provide effective care.

There are still some information gaps and unresolved questions regarding the possibility of transferring the experience of the pilot programs to other countries and social settings. Nevertheless, the main conclusion that follows from the work reviewed in this review is that targeted comprehensive programs are more effective than isolated measures aimed at only one of the risk factors. Strategies to reduce the overall risk for the entire population may be less costly, but targeting people at highest risk appears to be more effective; both approaches should be pursued in parallel.The list of measures with proven effectiveness includes exercises for training balance and increasing muscle strength, correcting the living environment for people who have experienced falls, revising the list of drugs taken with a large number of them and the presence of psychotropic drugs among them. Restraint measures are ineffective and can cause more serious injury. More research is needed to develop the most effective interventions for the elderly with cognitive impairment.

This publication is based on the WHO European Office report “Falls in the elderly: what are the main risk factors and the most effective preventive measures?”.The report reflects evidence-based considerations compiled from published systematic reviews of the scientific literature , general reviews , , as well as the most important original publications in English. Its main purpose is to highlight key issues of importance to health care providers.

Source: magazine “Chief Physician” 2017/07

Other articles on the topic

(PDF) falls in old age

343

SUCCESSES IN GERONTOLOGY • 2016 • T.29 • No. 2

for the prevention of falls among the population of the older

age group, as one of the priorities

ate directions of state administration,

along with assistance in increasing physical activity

, in carrying out an influenza vaccine

nations, in the prevention of infectious diseases

in medical institutions, in supporting the provision of informal care and self-help [25].

A number of studies have been devoted to the study of

causes, nature of falls, gender characteristics –

and other situations associated with falls,

for the formation of programs aimed at

prevention in the elderly.In this regard,

proposed to divide the falls into internal and

external, depending on the place of the fall (at home or

outside the house) [1].

There are many risk factors for mortality: age, gender, history of falls,

presence of certain diseases, pain syndrome

ma, depression, medication,

cognitive impairment and others [ eight].

Visual impairment, degenerative diseases

The joints are also associated with falls.

The likelihood of falls may increase with the

disturbances in sleep, gait, use of uncomfortable

shoes and clothing, unsuitable auxiliary

means and devices for walking [3, 4].

Cluster analysis of the study by T. Vu et al.

(2011) on the effect of polymorbidity on the risk of falling

showed that a history of more than three diseases

significantly increases the risk of falls in

elderly people [23].The simultaneous use of

more than 3-4 drugs (polypharmacy), regardless of the pharmacological group

, also increases the risk of falls [7].

The fall prevention system is based on the

modification of risk factors such as low

serum vitamin D levels, low

or high BMI, low physical activity –

, smoking, alcohol abuse.

The purpose of the study is to analyze falls in

residential people in different age groups for

the subsequent formation of a complex of medical and

preventive measures.

Materials and methods

The study included 537 patients

over 65 years old, there were more women than husband –

rank, the average age was 73.7 ± 13.5 years, from

Urban geriatric medical and social

center and Clinical rheumatological hospital –

# 25 (St. Petersburg). The patients were

divided into three age groups: 65–74 years

(57.46% of patients), 75–84 years (29.82% pa-

patients), 85 years and older (12.72% of patients ).

Patients were interviewed using a

multidimensional questionnaire and internationally validated

questionnaires.

The state of physical activity was determined by

using the international questionnaire IPAQ

(International Physical Activity Questionnaire).

Hypodynamia was assessed when a total of

was recruited less than 7 points [16].

Results and discussion

During the study, it was found that 30.56%

people over 65 consider the incident that happened to

as a fall only when this incident

led to serious consequences

(bruises, fractures).56.58% of patients had

at least one fall in the 12 months prior to the

follow-up. When assessing the frequency of falls in

different age groups, it was found that 82.76% of

(95% CI 64.2–94.2) cases of falls were in the

age group of 85 years and older. With approximately

, the falls occurred in the daytime,

, evening hours, as well as in the morning and night

(37.43; 39.66 and 27% of cases, respectively,

).

Analysis of falls depending on the season

showed that patients 65–74 and

75–84 years old fell significantly more often in the autumn and winter periods

(17.64 and 25.93% of cases, respectively), which ob-

due to external factors (slippery road,

at night, and the like). Patients

over 85 years old in 50% of cases (95% CI 28.2–

71.8) fell in the summer. The results obtained indicate that this category of people

had falls more often than at a younger age,

because in winter they try to go out on the street

less often, and in summer they lose their vigilance (Fig.1).

The place where this event occurred

is important in assessing falls, which determines the tactics

of further preventive measures. 50.96% of

of the respondents had falls on the street. When analyzing

places of falls in different age groups, it was

it was found that falls on the street prevailed in

people 65–74 years old (66.25% of cases). Approximately

with the same frequency, people aged 75–84 years fell

both in residential premises and on the street (34.88 and

48.84% of cases, respectively).

A program to prevent falls in the elderly starts in Russia – Rossiyskaya Gazeta

A program to prevent falls in the elderly starts in Russia

Every year in the world, as a result of falls, 646 thousand people die, mostly elderly people. Meanwhile, simple household measures plus the necessary medical care reduce the risk of falls many times over. That is why in our country, within the framework of the federal project “Older Generation”, gerontologists have developed a program for the prevention of falls and fractures in people over 65 years of age.

“Pilots” will start this year in Belgorod, Volgograd, Voronezh, Samara, Kaluga regions, Perm Territory and the Republic of Bashkortostan. And by 2024, the program should work throughout the country. Its implementation, according to experts, will help improve the quality of life of senior citizens and save up to 30 thousand lives a year. The director of the Russian Gerontological Research and Clinical Center of the Russian National Research Medical University named after V.I. N.I. Pirogova (RGNKTS), chief freelance geriatrician of the Ministry of Health of Russia, Professor Olga Tkacheva and Deputy Director of RGNKTS for scientific work, curator of the program, Professor Yulia Kotovskaya.

“Unfortunately, falls are a very common phenomenon. Every second person over 65 has ever fallen, every second of this number has fallen again. And we are talking about falls without external apparent reasons,” Olga Tkacheva explained. percent of cases, a fall has serious consequences, leading to disability, inability to care for oneself, that is, complete dependence, and often death. That is why it is so important to engage in prevention of falls. ”

Who is at risk

Age threshold, according to geriatricians, is 65 years.With age, a person accumulates many diseases that provoke imbalance, and muscle strength decreases. For a young and flexible person, an accidental fall most often ends well, but at an older age, falling is extremely dangerous, often fatal.

We treat falls as inevitable: they say, well, what can you do if both muscle strength and coordination of movements are not the same … But experts insist: falls are a medical and largely social problem, since the environment – from the arrangement of everyday life in the apartment to the urban environment – often not adapted to the needs and capabilities of the elderly.And this is wrong.

What can be done

“First and foremost, we must change the attitude to falls as an unpredictable event. We must understand that this does not happen by chance, and it can be prevented,” says Olga Tkacheva.

That is why the RGNCC has developed a program, a special methodology aimed at reducing the risk of falls.

In medical institutions accepting elderly patients, it is necessary to introduce an assessment of the individual risk of falling and take it into account in treatment.”It is not difficult to do, there are appropriate tests, you just need to introduce them into compulsory practice,” says Professor Tkacheva.

And then it will become clear what the approach to the patient should be: does he need to be accompanied on a walk, perhaps he will need a cane or a walker. Even medication for these patients needs to be carefully selected, as there are drugs that increase the risk of falls.

Second point: medical and social institutions have to be re-equipped – we need reliable furniture, handrails on the walls, “anti-slip” floors.

Third – on the basis of the “Ambulance”, together with gerontological centers and trauma departments, it is necessary to create services for responding to falls of the elderly. The fact is that in case of a hip fracture, surgery should be done as quickly as possible. Otherwise, the patient remains bedridden. The purpose of creating a response service is that if an accident has already happened, the elderly person should receive help immediately.

Children, take care of your parents

Much depends on how an elderly person’s life is arranged.“Falls are possible not only in a hospital,” says Yulia Kotovskaya. “He can fall both at home and on the street. Therefore, creating a safe environment is extremely important. children “.

Adequate lighting is needed, and if an elderly person gets up regularly at night – both a night light and the ability to easily turn on the light before the toilet.

Non-slip floor – especially useful for bathrooms and toilets. By the way, it is better to replace a bathtub with high sides with a comfortable shower cabin.

There are special comfortable toilets from which it is easy to get up, in addition, in the toilet, along the route to the room and in the kitchen, it is good to make handrails on which an elderly person can lean.

Smooth surface. If there are thresholds, it is better to remove them, as well as carpets (or fix their edges so as not to stumble). Check for wires that interfere with walking around the apartment.

Comfortable home shoes. Flip-flops are easy to put on and take off, but from a safety standpoint, they are not the best shoes.We need slippers or house shoes that would “hold” the foot, with a sturdy heel counter.

In many cases, a cane helps. An even more convenient device that protects against falls when walking is a walker on wheels. In Europe, America, people calmly walk the streets with them. So far, unfortunately, we rarely find them where.

Senility can be pushed aside

Experts call this condition differently – senile asthenia and sarcopenia. It is necessary to begin to fight against its onset, as well as to engage in the prevention of osteoporosis (it is because of it that a fall in an elderly person often ends in a fracture), long before a person feels a deterioration in physical condition.And here there is only one secret – physical activity and proper nutrition.

“In geriatric departments it is obligatory to carry out physiotherapy exercises and balance trainings,” notes Olga Tkacheva.

Professor Julia Kotovskaya recommends adding simple exercises to your daily exercise to train balance, strengthen the muscles and ligaments of the legs and feet. In the WHO recommendations, oriental practices are called: gymnastics such as qigong, tai chi is very suitable for the elderly, since it does not require much physical effort, but it perfectly strengthens muscles and trains the ability to maintain balance.

How to eat properly

For the elderly, it is important to have enough calcium in food and vitamin D, the deficiency of which in our northern country is observed in the majority of the population, notes Yulia Kotovskaya. Therefore, calcium-rich dairy products are a must.

Protein is a must. The norm for an elderly person is 1-1.5 grams of protein per 1 kg of body weight. The elderly often do not want meat, and they begin to lean on carbohydrates – rolls, white bread, pasta. It is not right. If you don’t want meat – let it be chicken, fish.Protein can also be obtained from legumes – beans, lentils. Well, of course, good sources of protein are eggs, cottage cheese, cheese and other dairy products.

Salt-free diets may not be safe. “You need to accustom yourself to a small amount of salt from a young age,” explained Professor Kotovskaya.

It is important to drink enough fluids.A day, taking into account liquid food (soups, milk, etc.), should be about 1.8 liters. Of these, 700-800 milliliters of water or unsweetened drinks.

Infographics “RG” / Alexander Chistov / Irina Innocent

Be healthy, do not fall! – MK

Pensioner Anna Timofeevna from Rostov-on-Don fell in her bathroom. The son took her to a traumatologist, and he announced the diagnosis: a hip fracture. This is one of the most common causes of disability in older people.According to medical studies, mortality during the first year after this fracture is 12 to 40%.

Nowadays, the problem has acquired a significant scale, therefore, to solve it within the framework of the national project “Demography”, a set of measures for the prevention of falls and fractures in the elderly was developed, which is gradually being introduced throughout the country.

Every year, thousands of elderly people fall in their own apartments and houses.Fall-related injuries can significantly worsen a person’s life prognosis and cause serious illness and addiction. Therefore, it is important to make the life of the elderly safe in order to minimize the risk of falls. Experts at the Rostov-on-Don Geriatric Center have developed a useful guide on how to prevent falls and fractures.

According to statistics, after 55 years, even ordinary healthy people fall 3 times a year. The most common causes of injuries and falls in old age are osteoporosis (according to the Russian Osteoporosis Association, every third woman and every fourth man over 50 in our country suffers from osteoporosis), blurred vision, dizziness, decreased coordination of movements, neurological and musculoskeletal diseases in which the frequency of falls increases, etc.The greatest danger of osteoporosis is for postmenopausal women – the probability of a fracture in a woman over 50 reaches 53% (this is much higher than the risk of developing cardiovascular disease or breast cancer). Sarcopenia (loss of muscle mass) is the main cause of senile frailty and weakness. Subsequently, it leads to the fact that a person loses the ability to take care of himself, move around, and begins to fall.

Prevention of falls is a multifactorial task that includes therapy for osteoporosis, correction of vision, and strengthening of coordination of movements (due to individually selected exercise regimens), and identification of diseases that increase the risk of falls.Fall prevention strategies for the elderly include muscle training, protein nutrition, and emotional support. If a person has an unstable gait, dizziness, you need to seek help, doctors warn.

The reasons for the fall are very often external conditions, which are rarely given importance in everyday life. However, eliminating them is not at all difficult. First of all, you need to pay attention to the floor in each room of the living quarters. The surface should be level, smooth, but not slippery.There are modern materials that make it possible to achieve the fulfillment of all these conditions. To make your apartment safe, you will have to get rid of rugs that you can slip on. But on the floor in the bathroom, an anti-slip rug should be a must! It is also recommended to equip the bathroom with additional handrails inside near the bathtub and toilet bowl – they will help the elderly person to do as much as possible without outside help.

It is also important to provide good lighting.High power bulbs are best suited in this sense.

It should be convenient for your elderly relatives to move around the house. Therefore, passages cannot be forced. If there is such a need, it is better to rearrange the furniture. Remove any foreign objects that interfere with your movement from the floor: shoes, pet food bowls, bags, boxes, etc. The most commonly used items should be stored on shelves, which should be approximately at the height of the person’s waist.Wires and cables (for example, from the same lighting fixtures, landline phones), as well as extension cords should not be scattered throughout the apartment.

The height of the bed is very important. An elderly person should be comfortable sitting on and getting out of bed after rest or sleep. To do this, the upper edge of the mattress must be at a level not lower than the level of the knees.

The essentials of a person of age are glasses, medicines, books and newspapers, drinking water, watches.Make sure they are always in access mode. Ideal – to lie next to the head of the bed.

Elderly people need good comfortable shoes (with stable grooved soles or “school” heels), walking sticks, and some walkers. A lot of useful household inventions have been invented that make it possible to do without laces at all. There are shoes with wide elastic bands, there are shoes with Velcro. And then there are special flexible laces that do not need to be tied at all.

In addition, geriatricians emphasize that doctors should be especially careful when prescribing medications for the elderly – some of them have dizziness and falls on the list of side effects.

If the fall has already occurred, the elderly person needs to be examined by a doctor – perhaps the loss of balance happened due to dizziness caused by high blood pressure, heart rhythm disturbances, problems with the cerebellum. You can follow the example of older Europeans with joint problems. They move along the streets with walkers and rollators (three- or four-wheeled trolleys with a locking brake). And the risk of a new fall is reduced many times over.

Photo: “MK” editorial office

It is important to change the attitude towards the very concept of old age

Watch the related video

90,000 Regional healthcare professionals became participants in the V All-Russian Congress on Gerontology and Geriatrics

On May 20-21, 2021, the V All-Russian Congress on Gerontology and Geriatrics with international participation was held.From the Altai Territory, the event was attended by Natalya Tselyuk, head of the regional geriatric center, geriatrician of the Altai Regional Hospital for War Veterans; Vyacheslav Myasnikov, head of the office of medical prevention and Albina Savarguzova, therapist of the district KGBUZ “Pervomaisk central regional hospital named after A.F. Vorobyov “.

The main topic of the congress this year was the prevention of falls and fractures in the elderly.

According to statistics, about 18% of elderly people fall annually.At least 7-8% of falls end in severe injuries – a hip fracture or traumatic brain injury. The consequences of falls and fractures significantly worsen the quality of life of an elderly person, lead to disability and loss of independence. Prevention of falls and fractures in elderly and senile people is one of the priority directions of the state policy of Russia in the field of health care and demography.

The start of the congress was given by Olga Tkacheva, President of the RAGG, Director of the Pirogov Russian National Research Medical University, Director of the Russian Gerontological Clinical Center life in Russia.To achieve them, we must solve two global tasks: increasing active life expectancy and creating a system of long-term care. By 2024, Russia should have 6,615 geriatric beds, 68 geriatric centers (in each region) and almost 2,000 geriatricians. By 2030, Russia should enter the 80+ club. To achieve these goals, the national projects “Healthcare” and “Demography” were launched. An integral part of the Demography national project is the Older Generation project, within the framework of which a geriatric service should be created throughout the Russian Federation by 2024.Traditionally, the congress is a platform for the exchange of views and international experience. ”

During the V All-Russian Congress on Gerontology and Geriatrics such issues were raised as:

organization of geriatric care in Russia and abroad;

problems of diagnosis, prevention and management of senile asthenia and other geriatric syndromes;

treatment of chronic non-communicable diseases in old and senile age;

national programs for the prevention of falls and fractures;

Nutrition and Nutrition in Old Age;

rational pharmacotherapy in geriatrics;

long-term care.

At medical symposia, participants discussed interdisciplinary aspects in modern geriatrics, vaccination issues and complex treatment of patients with age-associated diseases.

Much attention was paid to interagency cooperation and long-term care system. The executive director of the Association of Professional Participants of the Long-Term Care System, Alexander Shkrebelo, said that in September last year, the Ministry of Labor and Social Protection of the Russian Federation adopted an order that approved the standard model of the long-term care system.Now the system of interdepartmental interaction is being built on the basis of a regulatory document, and over the past three years this is a huge breakthrough in this direction.

The section for nurses addressed the organization of home health care and the creation of an urban environment accessible to all ages. Claudia Konson, a well-known Israeli expert in the field of palliative care, a nurse with a higher nursing education, presented a portrait of the patient of the future in her speech.

The final stage of the V All-Russian Congress on Gerontology and Geriatrics was the holding of a specialized commission, which discussed the organization of a long-term care system, prevention in geriatrics, additional screenings for people over 65, vaccination of the elderly against pneumococcal infection, and forms of statistical reporting on geriatrics.