Balancing Act

ELDER CARE

balancing

act

Falls are a health risk for the elderly. Here’s why they are dangerous, and how they can be prevented. By NIRMALA SIVANATHAN

T

umbles and falls — you can laugh off your fair share of them when young, but the older you get, the less of a laughing matter these become.

By 2030, one in five Singaporeans will be aged 65 years and above. And one of the biggest health threats the elderly face is the risk of falls.

Dr Carol Tan-­‐Goh, a geriatric specialist and consultant at Raffles Internal Medicine Centre, says that falls are a cause for concern because these often result in fractures, and might have serious consequences for the elderly.

“For example, a fractured hip caused by a fall may lead to permanent immobility and disability,” says Dr Tan-­‐Goh. Figures cited by the Health Promotion Board (HPB) show that more than 20 per cent of hospital patients die in the first year after suffering a hip fracture, while 25 per cent of older people require a higher level of long-­‐term care after a fracture.

Falling also has psychological consequences. Seniors who have fallen before might be more inclined to stay at home and they might also refuse to exercise for fear of falling again, says Dr Tan-­‐Goh. “This is not ideal as it might result in other issues, such as muscle atrophy from a lack of exercise,” she adds. “This in turn could further increase the seniors’ weakness and increase their risks of falling again. These seniors can also become socially isolated when they

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WELLNESS FOR ALL

stay at home, and this might lead to depression.”

So what causes seniors to fall?

Dr Tan-­‐Goh identifies three main causes: medication, physical weakness and sensory or memory issues.

“Some medications are particularly prone to causing side effects such as dizziness and drowsiness,” Dr Tan-­‐Goh says. “These include sleeping tablets, some high blood pressure medication, and antidepressants.”

Conditions such as stroke and arthritis can also lead to falls as they can impair a person’s coordination and balance. Poor muscle tone and strength caused by a lack of physical activity, dizziness due to ear conditions, poor vision caused by cataracts, as well as dementia are also common causes of falls.

Secure wires and cords and tuck them away

Top gear Environmental factors can also cause problems. These include uneven or slippery surfaces; unsecured carpets and rugs; cords and wires; poor step design; inappropriate footwear and poor lighting.

If you are living out your golden years, or have an elderly relative at home, take some precautions to reduce the chances of a fall.

The elderly should invest in a pair of sensible shoes as well as spectacles with the right prescription so that they can see where they are going.

“High heels, flip flops, bedroom slippers and shoes with slick soles can

LET’S GET PHYSICAL Be it brisk walking, line dancing or tai chi — physical activity can go a long way towards reducing the risk of falls. This is because exercise will improve your muscle strength, coordination and balance.

If you are afraid of getting active because of injury, Dr Carol Tan-Goh, a specialist in geriatric medicine and consultant at the Raffles Internal Medicine Centre advises

that you talk to your doctor. “He or she will be able to recommend a carefully monitored exercise programme or refer you to a physical therapist, daycare centre and day rehabilitation centre.

“The physical therapists there will be able to create a custom exercise programme aimed at improving your balance, flexibility, muscle strength and gait,” she says.

Use a stool to reach a high shelf Install grab bars on walls beside the toilet

Use non-skid mats in bathrooms

All hands on deck According to the Agency for Integrated Care (AIC), a good hand rail design should be securely mounted and have the following features: s Distance from wall (wall clearance): 9cm s Height from stairs: 94cm from the edge of the step s Shape for grip: 38mm in diameter s Surface for adequate friction: matte varnish. Avoid chrome finishes.

all lead to slips, stumbles and falls,” warns Dr Tan-­‐Goh. “So can walking while wearing stockings.”

Instead, she recommends sturdy shoes with non-­‐skid soles and which fit well. Shoes with laces or Velcro fasteners are also preferable as these will not slip off the feet easily.

Vision checks are also recommended as glasses with the wrong prescription can affect judgment of depth and increase the risk of falling.

At the same time, Dr Tan-­‐Goh advises the elderly to bring a list of the medications and supplements they are currently taking when they see their doctor. “He or she will then be able to review the medications for side effects, such as dizziness or drowsiness,” she says.

Home improvement ILLUSTRATION: IstockPhoto

Removing hazards at home is probably one of the most important things to do to reduce falling at home. According to the HPB, about 70 per cent of falls by older people happen in the home, with the majority occurring in the bedroom and the living room.

If shoes are to be worn indoors,

Here are some tips from the Agency of Integrated Care (AIC) on how to improve safety at home:

Install night lights between the bathroom and the bedroom

these should be rubber-­‐soled to prevent slipping. Walking aids should be used if necessary, and any spills on the floor should be cleaned up at once.

Install handrails and grab bars in areas such as toilets and staircases if needed. Check with grassroots organisations if they have a home modification programme — many of them have schemes where you can apply for financial help to install such devices.

The Housing Development Board (HDB) also offers a home improvement programme called Enhancement for Active Seniors (EASE). This programme aims to improve the safety and comfort of seniors living in HDB flats by subsidising the cost of installing home safety aids such as anti-­‐slip treatment for bathroom and toilet floor tiles, grab bars and ramps.

LIVING ROOM Ȉ Ensure wires and cords are untangled and kept safely Ȉ Arrange the furniture in such a manner that the pieces are easy and safe to move around KITCHEN Ȉ Use a stool if you need to reach a high shelf Ȉ Move items to a lower shelf for easier reach Ȉ Ensure that wires and cords are safely tucked away BATHROOM Ȉ Install grab bars on walls beside the toilet Ȉ Use non-­‐skid mats Ȉ Consider using a shower chair and hand-­‐held shower head BEDROOM Ȉ Install night lights between the bathroom and the bedroom Ȉ Get out of bed slowly to avoid dizziness STAIRWAYS Ȉ Keep the path free of clutter and ensure that the stairway is well-­‐lit. Ȉ Install handrails on either one or both sides of the stairs if possible.

Jul-Sep 23